Solving Knee Problems, Part 3

By Kelly Starrett

In ExPhysiology, Medical/Injuries, Videos

September 08, 2009

Video Article

Kelly Starrett suggests more solutions to knee problems in Part 3 of a seminar held at CrossFit Santa Cruz on March 14, 2009. Starrett is the owner of San Francisco CrossFit and a Doctor of Physical Therapy.

According to Starrett, knee problems can sometimes be alleviated by creating slack in the system both “upstream and downstream.” By stretching hip flexors and calves and integrating foam rolling into your rehab, you can give a compressed joint some breathing room.

Movements such as push presses and box jumps can be problematic for people with knee problems, but the former can be modified by turning the feet out slightly, and the latter can be scaled with step-ups and step-downs.

Starrett also talks about patella-tracking problems, which may be less about the patella jumping the track and more about the track dropping out from under the patella. The best fix is having “a really strong ass,” which helps create an integrated system where the components work properly in unison to keep everything stable.

Ultimately, the job of the trainer is to figure out a motion and a position that solves any dysfunction with best mechanics.

11min 58sec

Additional reading: A Postural Error: A Costly Biomechanical Fault: Muted Hip Function (MHF) by Greg Glassman, published Jan. 1, 2003.

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12 Comments on “Solving Knee Problems, Part 3”

1

wrote …

Thank-you.

A lot of what I'm getting from these videos is not a set of exercises or stretches that I can use, but a set of principles that guide me to generating those things. That's enormously more useful.

2

wrote …

Fantastic video. Thanks.

3

wrote …

I probably say this for every KStar video, but this is great. Another gem.

4

wrote …

Fantastic, couldn't agree more with you Craig!

5

Rob Barrese wrote …

Again, outstanding video. Aside from best mechanics, lets find the position, ect. Kelly would you agree that there might be some instances when the athlete may just have a significantly weak VMO? There are some athletes, who you just look at, and see an emply void where the VMO should be. Should you assign rehab on the side or should you just get them into activity (i.e. squat, DL, ect.)

I'd say get them into activity and let the VMO sort itself out but I'm just curious what you say as I'd like to put the VMO issue to bed on all accounts.

Thank you again for ANOTHER outstanding video!

6

replied to comment from Rob Barrese

Rob,

As a chiropractic physician with a masters in sports science and rehab, and a provider with the same line of thought as Kelly, I would say that he answered your question in the video.

It was the part when he talked about the guy who failed out of rehab because he couldn't get his VMO going. You make him do something functionally sound (ie. squat with hips being the driving mechanism) and bam, VMO starts to quiver and fasciculate! In other words, your hunch on activity is correct. Find out what they do crappy, correct it and see how that improved function fixes the VMO. In my practice, we consider looking at the VMO specifically as chasing pain...doesn't get very good results. Look to the cause, motor pattern failure, correct it, "best fit", and things change.

7

wrote …

Bravo Kelly--another great installment. You make us better trainers...

8

wrote …

Question for the masses, I'm an athletic trainer at a high school with a senior female athlete (volleyball only, in season currently and positioned as a hitter/blocker)she dislocated her patella as a sophomore and went the non-surgical route with physical therapy. She has recently been complaining of sporadic knee pain specifically on the lateral side of the patellar tendon below the knee (bi-laterally) and above laterally, and her knees sound like a fresh bowl of rice krispies when taken through a complete range of motion. She has obvious strength deficiencies and she has returned to wearing a brace on the injured knee. She is playing with the discomfort but i'm more concerned with the long term health. What, if any, could be short term and long term solutions to the issue? I feel that it may be some form of inflammation aka bursitis or tendonitis and have advised her on the importance of the ice massage. Any help would be appreciated!! sorry I know it is a complex question! (I did advise her to return to her doctor)

9

wrote …

I paid the CFJ subscription just for this video & it has saved my knees!!!! Thank you!!!

10

wrote …

Mr. Starrett, Your a Genius. I am a massage therapist, and want to venture into phyiscal thereapy. I would like to shadow you if i may. rj.waldron@yahoo.com.

11

wrote …

This knee injury series has given me some hope after a UK physiotherapist (from a sports injury clinic) just told me to cut out deep squatting altogether. He said the wear and tear has begun and the smoothness behind the patella is no longer there, instead that creaking polystyrene kind of feeling as the cartilage rubs. I went to him wanting to get any mechanics and root issues corrected (after months of no squatting at crossfit and the knee not settling down) and merely got told I'm too fixated on my injuries and sent on my merry way. He didn't think there was any link around the chain of events of 1st) tight left hip flexor 2nd)multitude of tight spots in my left quad 3) identifying my dormant left glute 4)having to stop squatting due to pain in my knee area. In his words "there are no systemic problems...you're injuries aren't linked". It makes me despair how many of the professionals I've seen have failed to invest in some testing of my form to actually analyse what's going on.

12

wrote …

Thank you so much for these videos. I have knee pain for years. Xray shows nothing wrong. Doctors to avoid certain movements. This was very informative for me. Thanks.

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