Are You a Butt Man or a Leg (Quad) Man?

[galibier_numero_un]

[edit] Well, lots of useful (Gimp Central) information was posted here after all, and I quoted everything through post #12 and added it to a Gimp Central thread, so others might benefit. It's great stuff, and others should be able to find it in a logical place.

Here's that thread: https://www.tetongravity.com/forums/...rome?p=5482358

Original post follows ...
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This could go in Gimp Central (Padded Room?), but I wanted to relate my injury and diagnosed muscle imbalances as they apply to my preferred ski stance and resulting ski preferences (centered vs. shin driving).

The last couple of seasons, I've been struggling with patellofemoral pain syndrome (PFPS), or in layman's terms - irritation under the kneecap. I've tried numerous therapies with only minor improvement. I was referred to a local PT who diagnosed my muscle imbalances as primarily stemming from weak glutes, although there are numerous other imbalances and exercises which are too detailed for the purpose of this thread.

One takeaway (apart from doing all of the prescribed exercises) is that my resistance to adopting a more centered stance stemmed from both habit (old dog/new trick) as well as these muscle imbalances. My thinking went along the lines: "this has worked for me in the past, why bother to reeducate my muscles to adopt a new stance?" Well, I now know that some of my problems are due to it no longer working for me.

I got a hint of this being the solution (ski more centered) when I adopted boots with a flatter stance two years ago (Lange XT 130 Freetours). I noticed less quad tiredness, but didn't connect the dots with respect to skiing more centered and knee pain.

My PT is working to get me more glute focused (we're not talking Padded Room material here, although a nice butt is a thing of beauty).

All of this is to say that I'm really interested in how I respond to my Qs this Winter after mixed results in the 10-15 days I spent on them last Winter

... Thom

[rod9301]

This could go in Gimp Central (Padded Room?), but I think it's more valuable here, with respect to ski stance (centered vs. shin driving) as it relates to ski type preferences.

The last couple of seasons, I've been struggling with patellofemoral pain syndrome (PFPS), or in layman's terms - irritation under the kneecap. I've tried numerous therapies with only minor improvement. I was referred to a local PT who diagnosed my muscle imbalances as primarily stemming from weak glutes, although there are numerous other imbalances and exercises which are too detailed for the purpose of this thread.

One takeaway (apart from doing all of the prescribed exercises) is that my resistance to adopting a more centered stance stemmed from both habit (old dog/new trick) as well as these muscle imbalances. My thinking went along the lines: "this has worked for me in the past, why bother to reeducate my muscles to adopt a new stance?" Well, I now know that some of my problems are due to it no longer working for me.

I got a hint of this being the solution (ski more centered) when I adopted boots with a flatter stance two years ago (Lange XT 130 Freetours). I noticed less quad tiredness, but didn't connect the dots with respect to skiing more centered and knee pain.

My PT is working to get me more glute focused (we're not talking Padded Room material here, although a nice butt is a thing of beauty).

All of this is to say that I'm really interested in how I respond to my Qs this Winter after mixed results in the 10-15 days I spent on them last Winter

... Thom

I think having strong glutes is really good for a number of sports, including skiing, mountain biking and climbing.

The best exercise i found for glutes is the hip thrust where you have your shoulders on a bench, feet straight in front of you on the floor, weight bar one the pelvis and lift your butt off the floor and back down. A few hundred pounds of weight once you get the hang of it.

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[hafjell]

I have the same diagnosis which was greatly improved by twice-a-week (at most) strength exercises in the gym (the ones from House and Johnston's book) and a lot of low intensity aerobic trail running and hiking.

[riff]

I’ve got these problems too, and I’m working my way back from a back injury last year. I spent a decade patrolling, and stacked up lots of knee issues along the way. I’m using a combo of trail running and yoga to get some balance back in those muscle groups. So far I feel better than I have in a long time, and lost 20 pounds this summer too.
I’ve been edged closer to an upright stance as well, and digging it. I’m not all the way there yet, but Planning to give it more attention this season.


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[galibier_numero_un]

I have the same diagnosis which was greatly improved by twice-a-week (at most) strength exercises in the gym (the ones from House and Johnston's book) and a lot of low intensity aerobic trail running and hiking.

This is the first bit of encouragement I've had in three years, and it might even have the benefit of my fully bonding with my Qs. I've been googling for that book but am coming up empty. Do you have the title?

I’ve got these problems too, and I’m working my way back from a back injury last year. I spent a decade patrolling, and stacked up lots of knee issues along the way. I’m using a combo of trail running and yoga to get some balance back in those muscle groups. So far I feel better than I have in a long time, and lost 20 pounds this summer too.
I’ve been edged closer to an upright stance as well, and digging it. I’m not all the way there yet, but Planning to give it more attention this season

Maybe that light at the end of the tunnel isn't an oncoming train after all ;-)

... Thom

[nickel]

i sincerely hope you can solve your issues. hard to abide threats to one's skiing.

[I've seen black diamonds!]

I've got glute imbalance issues that, along with some arthritis I earned over a few decades of wreatling, have cause a lot of back pain. After years of tinkering and working with PT's I'm in a pretty good place. I'm happy to share what has worked. Have a basement gym set up.

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[Slow 'n Steady]

This is the first bit of encouragement I've had in three years, and it might even have the benefit of my fully bonding with my Qs. I've been googling for that book but am coming up empty. Do you have the title?

Maybe that light at the end of the tunnel isn't an oncoming train after all ;-)

... Thom

“Training for the New Alpinism: A Manual for the Climber as Athlete”

[galibier_numero_un]

“Training for the New Alpinism: A Manual for the Climber as Athlete”

Thanks!

[Any]

go glutes definitely.
crushed a couple of vertebrae a few years ago, but i still chase the endless winter. by the end of the season with superman quads of steel i still couldn't make it through the day without some back and knee pain. even short uphill bootpacks were something that took determination. with so much exercise and muscle tone i was pretty disappointed with my recovery.
eventually went to a fancy expensive sports physio who had me diagnosed and pointed in the right direction within seconds. glutes. solution started with a bunch of squat related exercises.
im not saying im cured, but i am a whole lot happier with my performance nowadays.

[theetruscan]

It's worth thinking about glute engagement as well as glute strength. Strengthening muscles and fixing imbalances is great, of course. It's also worth some warmups to make sure you are consistently using the muscle.

Things like glute band walks and glute-ham bridges won't do too much to strengthen the muscles. They will get them firing/engaging and help correct only using quads. Worth making sure that's part of your warmup if you have issues.

I broke my pelvis a while back, have some issues with my hip on that side. The muscles are all plenty strong (I weightlift and some other things), and I still get pain and imbalance issues if I stop adding in the proper warmups to remind my body how to move.

[galibier_numero_un]

It's worth thinking about glute engagement as well as glute strength. Strengthening muscles and fixing imbalances is great, of course. It's also worth some warmups to make sure you are consistently using the muscle.

Things like glute band walks and glute-ham bridges won't do too much to strengthen the muscles. They will get them firing/engaging and help correct only using quads. Worth making sure that's part of your warmup if you have issues.

I broke my pelvis a while back, have some issues with my hip on that side. The muscles are all plenty strong (I weightlift and some other things), and I still get pain and imbalance issues if I stop adding in the proper warmups to remind my body how to move.

Thanks for mentioning that (engagement). My PT definitely has me focused on this.

Since this is (after all) turning into a Gimp Central conversation, I quoted all of the above useful information posted here and added it to this Gimp Central thread, so others might benefit. This is the first bit of optimism I've had about this in some 3 years, and others should benefit. Thanks for the validation/encouragement!

Here's the thread: https://www.tetongravity.com/forums/...rome?p=5482358

... Thom

[stuckathuntermtn]

When I first skied my Lupos I got HORRIBLE back pain. Thought it was just me and my chronic condition. More ramp and forward lean and it's good.
I can't do this new/old school centered thing

[auvgeek]

IMHO, research is showing more and more evidence that the hips are a huge driver of knee pain, PFPS, patellar tendonitis, etc. Your hips can be tight, weak, or both. If you're tight, you need to prioritize functional flexiblity. If you're hypermobile, you're need to prioritize strength. It can take some experimentation (and resulting discomfort) to understand what your biggest weakness is. Personally, my hips are both weak and tight, so I work on strength and flexibility equally.

Keep in mind that active range-of-motion (ROM) -- what you can control muscularly -- is all that really matters. The difference between passive and active ROM is a great diagnostic tool to help you determine whether there are structural (tissue) limitations or strength at end range limitations. In other words, you can be strong over a limited range of motion, but that doesn't necessarily mean you have strength at end range of motion. This is why the House-Johnston text mentioned above says "Lack of strength is often mistaken for lack of flexibility."

IME, there are 3 components to regaining healthy, happy hips (after they've been neglected or if you have bad anatomy). Again, it's all focused on the idea of strengthen and lengthen.

1. strengthen (isolation exercises to get your neglected muscles firing)
2. stretching (with or without banded distraction)
3. (self) myofascial release.

For strengthening, cramping is good. It means the muscle is firing but it's so weak the best it can do is cramp up immediately. Get it to relax and try again.

For stretching, the "contract and relax" approach is your friend. Go slow and do stretch for 1-2 minutes.

For self myofascial release, it's almost like meditation where you slowly relax into it. Move around on a lacrosse ball, back buddy, or jacknobber until you find the area of most tension. Hold there and attempt to relax the muscle. Less can be more -- you have to apply enough pressure to the area to get a response but not enough that the muscle tenses up and can't relax. Learn to control your breathing and focus on relaxing the muscle. On a lax ball, I can get my quads to spasm and release if I'm in the right head-space. The first time I did that, my knee pain went away immediately. Keep in mind, this isn't a long term fix, but the idea is it will help get your body back into balance so you can retrain it better.

If you're tired of paying PTs, here's a great resource -- it's aimed at healing your hips, but I bet it will help your knees a TON if you fit the pathology (weak and/or tight hips): https://www.thefaifix.com/ Really good stuff -- most of it is available elsewhere if you look hard enough, but this wraps it all up into a single package with videos of exercises, stretches, and mobilizations.

Don't focus exclusively on any one muscle -- work everywhere regularly, with a focus on your biggest weaknesses and tightness. You need to strengthen and lengthen the muscles that control: internal rotation, external rotation, abduction, adduction, flexion, extension, and all combinations of them. Test and re-test regularly to ensure you don't need to alter your focus as you've addressed your biggest weakness.

For example, say you're working glute med (controls rotation) super hard. Strengthening with banded x-walks, monster walks, leg lifts, hitler's dogs (or some variation of that), hip 90/90s, etc....and you're following up that strength work with stretching (pigeon stretch, maybe with banded distraction if you have hip impingement) and also self-myofascial release for your glute med, using a lax ball, back buddy, or jacknobber. Great!

But after several weeks or a month of that, glute med is probably not your limiting factor anymore. Maybe you've strengthened that enough that you now need to strengthen and lengthen your hamstrings or hip flexors or adductors to really see additional results. Adductors especially get neglected, IMHO. I have a big, tight mass of muscle there that pulls my hip anteriorly and medially. So for me, the below video is absolute torture (in a good way):



Finally: it's important to remember that you *will* go through a period of different discomfort as you get things stronger, like for example, maybe your knee pain will move around or maybe your hamstrings will start to get sore more easily, etc. These things are all normal as your body learns how to become balanced differently and rely less on your quads. But you need to learn the difference between discomfort and pain. But IME, a pinching sensation in the hip is NEVER good, and you should get out of that position IMMEDIATELY and figure out a work around until you have the range of motion to successfully be in that position.

And yeah, getting these muscles firing and engaged is the point. Isolation exercises are absolutely not a replacement for "functional" strength work like squatting, deadlifting, etc.

Disclaimer: I'm not a doctor or physical therapist and the above doesn't constitute medical advice.

[auvgeek]

^^Jeez. Didn't realize how long that was. Hope some people find it helpful despite the length.

[galibier_numero_un]

^^Jeez. Didn't realize how long that was. Hope some people find it helpful despite the length.

This is great stuff. The only thing I can add it's that self diagnosis can be be really tricky, and that a couple of visits to a COMPETENT PT can be beneficial.

Ask me how I know ;-)

... Thom

[auvgeek]

This is great stuff. The only thing I can add it's that self diagnosis can be be really tricky, and that a couple of visits to a COMPETENT PT can be beneficial.

Of course. But also seeing a PT twice a week for months on end is expensive and can sometimes be avoided. And taking control of your body and understanding how the human body works is empowering, despite how corny that sounds.

That link I mentioned above for the FAI Fix really helps you design a program with test/re-test. It's been better for my hips than most PTs I've seen, personally. It's a steal for $80 with a full money-back guarantee if it doesn't work for you.

[TAFKALVS]

I want auvgeek to write me a ski conditioning program.

[galibier_numero_un]

Of course. But also seeing a PT twice a week for months on end can sometimes be avoided, and that link I mentioned above really helps you design a program. It's been better for my hips than most PTs I've seen, personally.

Yup. The thing I continually rediscover, is what a complex system this is. One principle that usually holds true (note heavy disclaimer) is that you feel pain in the opposing STRONG muscle.

As an example, with a weak calf, you're likely to overwork (and feel pain in) your anterior tib.

I doubt I would have ever self-diagnosed my hip (glute med) along with my other areas of weakness/inflexibilities. The fact that I was going to the wrong guy just exacerbated matters, and resulted in a lot of self-blaming along with two wasted years.

Having additional resources never hurts (thanks for the links) ... except when it involves lacrosse balls ;-)

... Thom

[auvgeek]

Yup. The thing I continually rediscover, is what a complex system this is. One principle that usually holds true (note heavy disclaimer) is that you feel pain in the opposing STRONG muscle.

As an example, with a weak calf, you're likely to overwork (and feel pain in) your anterior tib.

Sure, creating length by strengthening the opposing muscle is a pretty common approach. I'd say the opposite is more true of people: if you have a strong, tight calf, you need to work the anterior tibialis to make it stronger. Generally, on most athletes, the anterior upper leg is strong (quad) and then posterior lower leg is strong (calf).

But many people's lower-leg issues are related to the hips, whether your weak hips are the cause or a result of some other injury. Like magnesium deficiency, I would bet a vast majority of the western world has some sort of hip dysfunction, whether they realize it or not. Mostly because we sit so much and we don't move enough.

I doubt I would have ever self-diagnosed my hip (glute med) along with my other areas of weakness/inflexibilities.

That's honestly surprising to me. Hip rotator strength is super "in" right now.

Self myofascial release is amazing. I think you'll see big gains if you embrace it and treat it like meditation. If you need something softer than a lax ball, try yoga tune up balls. If you just can't do it to yourself, try to find a good masseuse or acupuncturist. But it's WAY cheaper to embrace the yoga tune up balls -> lacrosse ball -> back buddy and jacknobber (as a progression) than go to weekly or biweekly acupuncture/massage. Dry needling by a PT is also good, but remember that they've probably taken a weekend course in it while a good acupuncturist has a doctorate in it and does it professionally all day every day. That's who I want sticking needles in me, personally.

[Island Bay]

Definitely one of the symptoms of weak glutes. Not saying that that is your problem, but it could very well be. As someone who's suffered knee pain and weak glutes for ages, I can sympathise, and here are some of my findings:

Going straight into glute exercises won't do a thing if they are deactivated. And before you can work your glutes, you'll have to stretch your tight hip flexors (look up Lower Crossed Syndrome).

-Use a foam roller to gently massage your hip flexors, followed by stretches for the hip flexors.
-Do simple exercises to fire up the glutes. One legged hip bridges, for instance, while mentally focussing on your glutes. Your nerves are sending impulses to other muscles, and the tricky thing is to change that.
-Then do proper weight exercises for the glutes. Squats, deadlifts, backward lunges, etc.

Good luck :-)

[jasonb]

i battled this for about a year of ups and downs. initially went the same route you did (PT -> weak glutes diagnosis) and saw some improvement but had poor luck targeting specifics (glutes / hamstrings / quads / even tried lots of ankle mobility work). i often ended up feeling worse off than i had before.
after the ski season i took a couple months off everything (i found even biking could bring about irritation). after that started adding slow bodyweight squats in. something like 3x15 once a day, then twice a day. after a month or two i had stopped noticing the knee pain day to day and added in some single leg stuff (bodyweight bss), biking / other low impact stuff.
i've now been running / putting weight on a bar with no ill effects. i really believe i needed serious rest (not even PT directed exercises) followed by a slow build up in overall lower body strength/conditioning.
as always YMMV with internet fitness advice

[stuckathuntermtn]

tl;dr
Hands in front.