Brian Schiff’s Blog

It is fairly well accepted in medical/rehab circles that much of the lateral knee pain felt by runners is related to the IT band.  Researchers report that frictional forces are greatest between 20 and 30 degrees of knee flexion (this occurs in the first part of stance phase with running).   But what about the differences in hip and knee kinematics between healthy and injured subjects?

I currently train two competitive female marathoners.  Both are in their thirties.  One has run Boston and the other is training with me to qualify this year (she missed by 36 seconds last year).  Many female runners deal with iliotibial band issues during their training.  My client trying to qualify for Boston has issues on her right side.  My other runner does not.  The client affected by this also has some ankle instability which certainly affects closed chain mechanics.

Historically, researchers have felt increased rear-foot eversion has contributed to such injuries.  Why?  well, increased rear-foot eversion leads to increased tibial internal rotation, and by the ITB’s attachment point distally on the tibia this would in turn increase strain.  In addition, it has been postulated that gluteus medius weakness leads to greater hip adduction moments and undue strain.

One recent prospective study done by Noehren et al. concluded that runners who developed ITBS exhibited increased hip adduction and knee internal rotation angles compared to healthy controls.  Today, I wanted to briefly update you on a study just published in the Journal of Orthopaedic and Sports Physical Therapy looking at the running mechanics of those with previous bouts of ITBS and those without.  The study observed 35 healthy female runners and 35 age matched runners (ages 18-45 who run no less than 30K/week) with a history of ITB issues.  They measured:

1. Hip, knee and ankle kinematics
2. Internal moments during stance phase

So, what did the results say?  In a nutshell, the ITBS group did in fact exhibit increased hip adduction angles and peak internal rotation angles at the knee.  There was , however, no significant difference among groups with respect to the rear-foot eversion.  This particular study did not measure hip abductor strength.

As far as limitations to the study, one primary one was the fact that the ITBS group was healthy during the study (meaning they had some time in the past suffered ITBS).  With that said, the results did mirror the prospective study by Noehren.

The practical takeaways for runners and trainers are:

• Prior ITB issues may increase risk for recurrence due to increased strain
• Prior ITB issues indicate atypical hip and knee kinematics may be present
• The rear-foot position may have a lesser role in causation of ITBS
• Addressing hip stability, strength and eccentric control is paramount to injury prevention
• Observing frontal/transverse plane knee mechanics is prudent

In training, I recommmend video analysis or using a mirror independently to observe what I term a single leg hop and stick maneuver.  I teach it to all my cutting and impact athletes.  Simply begin on the left leg and hop forward onto the right and lower down into a lunge type single leg landing position.

Observe the foot/ankle, knee and hip as the body declerates.  This image and sequence of events leaves strong clues about the strength and force dissipation that is or isn’t happening.  Perform at least 3 trials and repeat on the other side.  This evalaution technique then also becomes a training tool to correct imbalances and improve deceleration mechanics - the very essence of the injury problem to begin with.

I routinely have my athletes with assymetrical or atypical kinematics engage in this drill no less than 2-3 times per week.  I have them perform 2-3 sets of 5-10 quality reps on each side (alternate sides).  Focus on preventing the femur from adducting too much or the patella moving inward.  In addition to this drill, obviously include steady glute max and medius work in your programs to help reduce ITBS.  With all that said, happy running!

So, do you own a TRX? I honestly think it may be one of the best fitness training pieces around for the money. It is versatile, travels well and builds strength, stamina, balance and stability.

I use the TRX to train clients of all ages and abilities from my elite swimmer to the middle age woman with knee arthritis.  Some of the biggest objections to getting in shape I hear are:

• No time
• Hate the crowded gym scene
• No money for personal training

So, my solution is to buy a TRX.  In this short video, I outline a continuous sequence of 7 exercises.  They are not intense, but they can be made more challenging by altering the body vector (moving your body in relation to the attachment point) and adding more time and sets within the circuit all with very little rest.  The sequence of exercises in the video are:

1. Single Leg Squats
2. Rows
3. Push-ups
4. Biceps Curls
5. Triceps Press
6. Saw Plank
7. Hamstring Bridges

I demo 5 reps of each exercise in the video to show you how to do it, but in reality you crank through each exercise for at least 30 seconds.  Using the TRX over the door anchor you can do this workout at home or on the road (and far more advanced exercises as well) in less than 20 minutes and see results.

So, say goodbye to all the objections and get yourself a TRX and door anchor if you don’t have one yet.  I am 100% confident you will love the workouts and add a new dimension to your fitness routine. 

From now until March 11, all my readers can save 15% on the TRX door anchor by visiting my OpenSky shop and using the promo code ANCHOR15.  Click here to visit my shop.  In addition to this discount, you are eligible to receive 10% off any of the spring promo items at OpenSky.   

To see the entire collection of items in the Spring promotion click here.

The longer I train (myself) and my clients, the more and more I gravitate to bodyweight and bodyweight plus training.  Why?  Namely because I find people struggle to control their bodies in space against gravity.  No matter what sport or work task people need to complete, they must be able to move, stabilize, and resist and apply force effectively with respect to their body.

I also find myself looking to integrate systemic, progressive and kinetic chain based core strengthening exercises for maximal efficacy.  The lack of proper core stability and strength will often leave the back and other limbs of the body vulnerable to unwanted force dissipation.  That means increased chance for injury. 

Adding a stability ball (when you are ready) to abdominal exercises will add spice to your routine and surely FIRE UP your core too!  In today’s post, I want to share some pics of core based training related to my most recent column in PFP Magazine.  Before I share one of my favorite ball exercises with you, consider the following pre-requesite steps before attempting this particular exercise:

• Master floor based planks
• Master static stability ball planks
• Master static holds in hand supported plank position (balance/stability)

Pictured below is the stability ball ab circles.  This is great exercise for shoulder stability training and core activation.  Trust me when I say you will feel it after 10 good slow reps.

Ab Circle to the Left

 Click the image below to check out my column on how to execute the stability ball ab circles.

I have used Thera-Band Stability balls for years and love them.  If you are looking to add a stability ball to your training tool box, click on the stabilityball images below to grab your very own today.  The 55 cm ball works great for the ab circles for most people.  Enjoy!

So, if you know me well at all, you know my first “law of exercise” is to ALWAYS know why you do what you do.  I read a newsletter by Mike Boyle yesterday.  He talked about being a cook or chef when it comes to exercise.  He advises those with less than 5 years of expereicne not to mess with the recipe much so to speak.  Since I have been doing this for 12 years, I consider myself to be much more of a chef.

I am constantly creating and tweaking my programming to deliver the best results.  So, when I decide to use a training aid or piece of equipment, I have to believe in it 100%.  My athletes and adult clinets alike love bands, vests, balls and training toys if you will.

But, I have to remind them (and myself at times) that the training aid exists only to further advance the original exercise or its desired outcome.  Using these things just for variety is not really a sound plan.  Today, I have a short video for you that reveals four progressive ways to use the Thera-band stability trainer.

I have used this in the rehab setting and in my fitness programs with great success.  Please note - all of the exercises I show you should be mastered on flat ground first.  After that, the stability trainer adds a great new dimension to the exercises and provides a very natural disturbance to balance and stability throuhg the kinetic chain that exists in sport and life.

Now, these are a just a small sampling of some of my favorite Thera-band trainer drills.  The cool thing about this item is that it comes in three different levels of difficulty moving from green (easiest) to black (hardest).  I tend to prefer the blue as it is middle of the road, making it easy enough for those without the skill of an Olympian and yet challenging enough for even the more advanced athletes.  However, starting with the green may be necessary for those with ankle/knee instability or limited experience with stability training.

You can grab your very own blue Thera-Band trainer in my OpenSky Shop.  Click the image below to head on over and get free shipping for a limited time as well.

Well, I just finished day two of the 2nd IYCA Youth Summit.  I attended last year as well.  Each year I took away some new info, reinforcement about what I am currently doing along with motivation to become a better coach.  Yet, the best part of attending these live events is building relationships. 

I have met so many incredible coaches and people.  Whether having breakfast with the likes of Kwame Brown and Carlo Alvarez or chatting with Dave Jack and Chris Mohr, I am reminded that greatness is not about ego or self seeking.  Rather, greatness comes from giving, humility and most importantly “doing the right things” for our clients.

What does this look like in my fitness and sports performance business?  Well, it involves the following:

• Putting 100% of my passion into products, training and consulting
• Assessing the needs, abilities and goals of my clients
• Constantly re-assessing to “tweak” programming and exercise prescription
• Being willing to admit when you are wrong or change the way you do or see things when it is in the best interests of the client
• Continually learning and striving to get better each day
• Delivering results through sound evidenced based training (knowing “why” I do what I do)
• Being honest and dedicated to improving the lives of my clients

So, you may be asking why I am telling you all this.  I have a simple answer.  I want you to trust me and look to me as a credible expert when it comes to corrective exercise, rehab and sports performance.  I also want to assure you it really is the proper application of knowledge that defines success with exercise.  It is an exact science.

The types of exercise, reps, sets and such really do matter.  See what one client recently said about my shoulder rehab program:

I began using your exercises immediately.  In just 6 days I have seen significant change.  I have been able to use my hamd/arm again to wash my hair, close my car door, reach for items and just stop holding it up and against my body.  Today I had a weekly massage (she was formerly a PT) and she was amazed at my progress.  I feel there is hope again.  I know the book cost a fee, but I still want to say thank you for creating an exercise plan that does not include torture.

Wow, torture is never good, right?  Exercise should never be painful - just effective.  If you have not seen significant positive change within 30 days, this should raise a red flag.  So, beware of ultra hype and too good to be true claims, yet understand that you should see some measurable results in a reasonable time frame.  I will always stand behind my programs and products. 

With that said, I will be revealing a series of specific exercises I use with my clients over the next month.  In these posts, I will show you the exercise, explain the applications and reveal the training tools I use to make them work.  The posts will give you real exercises you can use to fix muscular imbalances, improve strength and maximize physical health and performance.  Most importantly, you can rest assured I remain 100% committed to doing things the “right way.”