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Shattering the Training Myths Associated with Knee Health
By Brian Cassidy, Founder of ADAPT Training, Beaverton, Oregon

Brian CassidyThe “knee” is not a complex machine. It has one function: flex and extend while supporting the weight of the human body. It is labeled a hinge joint because bending is all that it is designed to do. Each component of the knee facilitates this hinge function. Any time the knee is recruited to perform an action other than a hinge — such as a twist or glide — parts of the knee will be compromised and potentially damaged. That is the short answer to the big mystery behind all symptoms or limitations that are labeled as knee injuries.

You may be asking yourself who I am and how I possess these hidden secrets that have eluded some of the mostdecorated professionals in the field. I am an actual product of the misunderstanding of the knee. I was a projected NFL first round draft pick who had my career ripped away by improper rehabilitation of my blown out knee. I played offensive line for Stanford University Football, and was a three-year starter who never missed a single game or practice due to injury. At the end of my third season, an opposing player was thrown into my extended knee — tearing my ACL (anterior cruciate ligament) and MCL (medial cruciate ligament). My rehabilitation ended with the rupture of two discs in my spine that required emergency surgery to prevent permanent paralysis. The heavy weight lifting on an improperly rehabilitated knee created a spine vulnerability that did not exist before my knee injury.


This ADAPT pre/post running routine is designed to introduce the muscular function necessary to create an efficient relationship between your hip, knee, and ankle to maximize the running motion and ideal weight distribution. If any of the following exercises are difficult to perform the potential for damage while running is dramatically increased.

  running pre post

Since 1993, I have spent all of my resources on discovering the truth behind my rehabilitation mistakes and creating a training system that prevents this from happening to other athletes. The simplicity to my discoveries will be shocking to most of you and hopefully eye opening to others.

To begin this adventure in common sense let us first look at the function of the knee in relation to the action of the entire leg. One major oversight is the belief that the muscles associated with the knee are solely responsible for knee strength and stability. The reality of knee health is that the hip, knee, and ankle each have specific movement responsibilities for the overall performance of the leg. Unfortunately, most rehabilitation programs emphasize building the specific muscles that articulate (move) the knee (strong quads) rather than focusing on attaining the ideal relationship between these three joints. Think of all the combinations that these joints can produce in an athletic action (squatting, twisting, lunging, jumping, and running).

The key to knee health is that when a movement is performed by the leg, the knee is only required to hinge (bend) in accordance to its design. All rotation and lateral movement should initiate in the hip. The hip is a ball and socket joint designed for multi-directional movement. The ankle is also a dynamic joint with multi-directional movement intended to support the action of the hip and adjust to the ground surface. Any time the knee is asked to make up for a lack of range of motion or strength in the hip or ankle, the components of the knee will suffer.

1) Framework (Bones) The knee is a composite of specifically shaped bones that are designed with matching grooves to maximize the hinge movement. The force of impact should be distributed evenly over the entire surface of the knee. When the muscular mechanics alter the alignment of these bones, deterioration can occur (osteoarthritis). If proper alignment is restored, the bones can regenerate just as any bone break can heal. Therefore, rather than assuming there is a debilitating condition in the bone, practitioners need to focus on the muscular system creating the improper alignment.

2) Shock Absorbers (Cartilage) This material is the whipping boy of the knee. All faulty movement is initially absorbed by the main shock absorber (meniscus). Any twist, lateral shift, or uneven force will create damage over time, or in a single action. Without correcting the mechanics, individuals will require continual “clean-ups” of this material. It is not the failure of the meniscus that creates these tears; it is the abuse of the intended usage of the material.

3) Connectors (Ligaments) Here is where the controversy lies. Why have ligaments become so fragile that they tear with increased frequency and seem to have a sexual bias? Why are common movements like jumping and cutting, putting ligaments in such danger? I’ve heard some of the most far-fetched explanations for this epidemic in comparison to any other condition I have come across at my clinic. Here is the simple truth: Ligaments can tear with excessive external force (contact), or when expected to hold the bones of the knee together while the knee performs a dysfunctional movement (twist/glide).

The number of non-contact related knee injuries in professional and recreational sports is staggering. To put it simply, these injuries should never occur and indicate a dysfunction in the body. Dysfunctional movement patterns are caused by strength imbalances, range of motion restrictions, and uneven weight distribution. These physical conditions are products of improper and/or lack of sufficient training and a surplus of sport specific drills. One example of detrimental training is limiting the range of motion for the benefit of a joint. Many studies have created the misconception that we should train within limited degrees of movement. This information is based on studying the impact of load angles on people with pre-existing dysfunctional patterns in relation to weight lifting. Training should be focused on increasing functional range of motion to create the durability of a four-year-old. Getting stronger within limited range of motion will only increase injury vulnerability, especially when an activity requires range one hasn’t trained in. A second example of disadvantageous training is the high volume of sport specific drills. The same repetitive movements create muscular imbalances. This is the greatest cause of non-contact related knee injuries in women’s athletics.

Examine the physical development of children; they learn how to walk and run by using dynamic movement to build muscular function. Athletic training should reflect the same dynamic movements that develop the body — and match sport specific physical demands. Want to read a study? Look up early childhood development and the importance of crawling to create ideal muscular patterns. One wouldn’t use a leg press to develop the muscles needed for a baby to walk because that movement doesn’t build the necessary multi-directional strength and stability.

The moral of the story is the knee is an incredibly durable piece of machinery when used as it’s designed. It’s time to
stop blaming faulty parts and bad luck and start looking at training and rehabilitation techniques. An injured knee is just
a casualty of improper function of the musculoskeletal system. If you’ve ever experienced a knee injury: Did your trainer, doctor, or therapist watch you walk, lunge, and twist before condemning the “defective” parts of your knee? Does your training program include every combination of positions that your hip, knee, and ankle can produce? Take a step back and understand that the knee has become a scapegoat for bigger problems that exists elsewhere in the body.

The ADAPT Training facility is located in Beaverton, Oregon and specializes in the development of training systems in
accordance with the original design and intent of the human body. Our programs utilize muscular education ranging
from acute physical therapy to elite athletic development and everything in between. Before deciding on a course of
action for your condition or sport, take advantage of our free training diagnostic. You have nothing to lose but pain.

Click here to download a PDF of this article.

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