Kids Fitness Physiology
by Dr. Kwame M. Brown
This article will by no means be an exhaustive discussion of the evidence, but I look forward to elaborating as we get responses.
Installment #476 in things I keep hearing people say:
“You should lock out the joints at the end of a (bench press, squat, etc)”. The joints need stress to get stronger.”
By this logic I should do the following:
1. Beat my head against a wall to protect myself from brain injuries (After all I am putting my cranium under much needed stress, right?
2. Yell at kids all the time and berate them to improve their self esteem
I think we can agree that just because something needs to get stronger, this doesn’t mean that all stress on that thing is good!
I could just simply say that this is wrong, but it’s better for all concerned (especially kids) if we address the real problem. The real problem is a combination of a lack of understanding of how joints work combined with a pretty loose application of terminology.
First, let me explain (quickly) what locking out a joint does with regard to hinge joints. What happens is what’s called a “screw home” mechanism. The smaller bones lock into place with the larger bone. This is true at the knee and elbow, which aren’t identical but are very similarly constructed (two small bones connecting to a larger bone).
Second, let’s talk about what most people think they are talking about when they say “lock out”. What they really mean (and I think maybe some don’t realize it) is “lock out the lift”. This involves full joint extension, a completely different thing than locking out the joint. This is healthy and should be done on a regular basis. The difference is that the muscles are involved in extension. They are not involved as much in a lockout, meaning therefore that the joints are at risk.
Lock out your knee joint by letting the joint go as straight as it can. You will find that the muscles are quite lax. You may also feel that you have to expend some effort to unlock the knee. What do you think is happening inside that joint? You are likely wearing away the lubricating structures.
This means most of the stress is being borne by the joints, in a way that is rubbing the very structures responsible for lubricating them. Yes, is true that there is more contact in a knee flexed position, but the difference is that the stress is on the muscles!
Now extend the legs all the way as if you are pushing the floor away. Extend your upper body. The muscles are engaged, the joints are getting good strengthening stress, instead of the potential wearing away stress.
Most people who lock out their joints during a lift are trying to get a rest. Well, if you have an external weight, the stress / force has to go somewhere! Where, you ask? The stress is likely travelling to your spine.
A member recently asked me did I have any evidence that locking joints out will cause injuries in young athletes: I don’t. Do you want to know why?
Because proving this would require me to purposely put kids fitness at risk to prove my point.
But we can certainly extrapolate things from what we know about biomechanics (a discipline that applies the laws of physics to the tissues in the body).
Now, if you want to lock out your joints, I say go for it. But please don’t instruct kids to do this for a couple of reasons:
1) They don’t understand the nuanced difference between lockout and extension. They will likely lock the joints when you tell them to lock out the lift. Case in point: Every time I have seen someone instruct kids to “lock out”, I have seen a hyper extended lumbar spine. Every time – because it is the natural reaction.
2) Now the second part of the logic is: Well, why is lockout bad? The reason: Most agree that those with hyper-mobile joints should avoid locking the joints, because it promotes further laxity. Guess what young kids often have? Yes, that’s right, you guessed it: hyper-mobile joints! Guess what else they have issues with: Control over their muscles. Did you guess that one too? Now, why would we want to take that individual and instruct them to lock out their immature joints? Furthermore, why would we need to?
And to the detractors of my statements here, I will say that you are the prosecution here, not I. In the face of a risk to a body part, the onus is on the one taking the risk to prove it’s safe. Where is your evidence that this is a necessary thing? Where are the people that are getting injured and not realizing their potential just because of not locking out joints?
Kwame is just one of several international superstar Youth Fitness Specialists who will be taking the stage at the 2nd Annual IYCA International Summit next month in Louisville.
Click Here to Read all about this monumental event right now
—-> www.IYCA.org/2010Summit
Well said Dr. Brown!! I could not have said it any better.
Thank you for addressing this and the importance & need for kids to work out with knowledgeable trainers. I try to stress the importance of who is teaching your child all the time to my parents and it seems so many dont care – they assume everyone knows what they are doing. Great advice that I will gladly pass along to my trainers, even though we go over the importance of posture and use of equipment all the time. My equipment is hydraulic and quite safe for kids as long as they are using it properly under educated direction. Thanks for your advice.
Really good article. Thank you Dr. Brown
did not receive prior article on cross-fit, how can i get it ,since my gym offers cross fit
This is very good info, thank you. In addition to not hyperextending joints for young athletes perhaps as trainers and coaches we could identify the kids at risk for hyper mobility and design appropriate corrective exercise routines that will protect and/or correct this anatomical feature, thus reducing joint/ligament injuries.
@Pat: Press your back button and scroll down, you should see the Cross Fit Article.
Great points, Kwame! Can you share your cuing recommendations for the lengthening phase of a lift?
I have lost clients to Crossfit and, wouldn’t you know it, they came back. Before I go on I should clarify, I’ve done crossfit workouts and actually enjoyed them. The methods are great for ADULT learners with a strong fitness profile. However, of the kids I have lost to Crossfit and have come back, I have seen, more importantly the client has noticed little in they way of sustainable gains or changes in motor behaviour. Again, I am not taking a cheap shot at Crossfit here, I am just glad to see that someone is setting the record straight with regard to Crossfit Kids. No Coach should claim to care about kids and then ask them to do something which they know so little about. Thanks Kwame.
Well stated, Dr. Brown! I can not believe we still have professionals
training young athletes using the term “locking” the joint…….. more education
and organizations like IYCA.
Mike Kozul
YMCA Personal Training
Great article Kwame. This sounds like another example of trainers working with young athletes as if they were adults. The sooner this practice stops, the better off young athletes will be.
@Everyone:
I don’t think that they were really working with the kids like they were adults in totality to be fair. I think (in the case of this specific program) they were just unaware of some basic physiological / biomechanical principles with regard to kids. But as I wrote in my review, the environment was very play based and kid friendly. Literally everything else about this particular program was right on with IYCA principles.
I do not want this to be an environment of bashing or indictment of a discipline or method because it has some issues / problems. Let’s be analysts. Let’s figure out exactly what’s wrong and fix it. This especially becomes true when the instructor / program in question has the right spirit and they just need a little guidance.
This is a very interesting discussion, and I also think it’s worthwhile erring on the side of caution, especially when dealing with young subjects. Thus, if one is unaware of the difference between moving through a full range and locking out in hyperextension, then one should avoid terminal ranges.
That said, however, and in the spirit of being analytical, we need to consider that the compressive loading to which you are referring is created by two forces; the external load (of which you’ve alluded) and the internal muscle forces (which you’ve omitted in your discussion). Also, in considering the knee, there are two joints of importance, the tibio-femoral joint, and the patello-femoral joint. Compressive forces are particularly noxious to the latter, as they create patello-femoral pain syndrome and ultimately, osteo-arthritis.
Continuiing this line of thinking, patellar compression is caused by a combination of knee joint angle and the internal muscular forces generated in response to joint torque created by the external loads, and not the loads themselves. Thus, as the knee flexes, torque generally increases with a concomitant increase in muscular force and patellar compressive loading. In a terminally fixed (standing) exercise, peak patellar compression occurs at 60 degrees of flexion. This can, potentially, cause as much damage to the articular surfaces as direct compressive loads.
Conversely, while standing with the knee in full extension, the line of force passes directly through the joint, creating no torque, and thus, no patellar compression. So there is an advantage to that position.
There is also significant compressive loading occurring at the tibio-femoral joint throughout a range of motion, not just in the terminal position, again because of the forces generated by the muscles. When a line of force is applied at an angle to the lever – in this case the line of force is directed through the patellar ligament, inserting on the tibia – the resultant force can be resolved into two components, one perpendicular to the lever and one parallel to the lever. As the patellar ligament pulls on the tibia, the component perpendicular to the tibia moves the joint. The component parallel to the tibia also helps to move the joint, but more significantly, pulls the bone towards the joint, creating joint compression. As the knee flexes, and torque increases, the muscles create more force, resulting in a larger parallel component, and therefore, increased joint compression. This is the same type of force that you suggest has the potential for wearing away articular surfaces.
This is not to suggest that locking out is a good thing. But, before we assume a “this is good and that is bad” attitude towards certain exercises, let’s at least try to explain some of the basic sciences – in this case biomechanics – that underlie these applications, so that readers have a better understanding of the topic as a whole, and not just one perspective on the issue.
Dr. Brown,
Thanks for coming back to this topic.
I’m a little ashamed to admit that, much like the kids you mention, I don’t really understand the nuanced difference between locking out and extension. I’ve always thought that they were the same thing, but maybe I’ve been missing something!
Can you be any more specific about the differences between locking out a lift (or going to full extension) and locking out a joint? Is it a specific limitation of ROM (e.g., 179 degrees instead of 180), or more of a subjective, you-gotta-feel-it sort of thing?
Erik,
The way I see it…
Full extension would be 180 degrees
and
“locking out” would be anything past that. The joint would go past 180 degrees, the muscles would relax, and the weight would be supported by the ligaments and very possibly compressing the cartilage in a way that it should not be.
Can you imagine the kid who used 100% of their strength to get the weight up then hyperextended his elbow then not having enough strength to unlock it? Ouch!
So there. 🙂
Dr. Brown,
I’m guessing that this discussion applies more so to the knees and elbows than the hips, since hip hyperextension occurs during things like sprinting, and the motion is typically not in the context of locking out a lift as with the knees in squatting movements and the elbows in push-up/pressing motions.
The only issue at the hip would seem to occur if hyperextension were forced beyond a certain point, but I can’t see many people exposing kids to a situation where that would be a common occurrence.
Paul, may I ask where you received your education?
@Paul:
First, thanks so much fo taking the time to write such a detailed post. We benefit here from your knowledge. Great points. One problem with this logic is that we are looking at joints potentially in a vacuum, away from the influence of the nervous system, and without an eye on the value of muscles forces in stabilizing a joint. This is not just a question of biomechanics, but of neurobiomechanics. We have to remember during this discussion why we have muscles and a nervous system with which to excite and read information from those muscles. It’s not just to move the skeleton, but also to stabilize the skeleton. Your joints are actually pretty flimsy without muscles (which is part of why the danger of joint injury is higher during fatigue). Furthermore, without good muscle action, they are under far less control.
So, the issue here is not looking at just the forces in the joint, and the muscles producing parallel forces, but what the many muscles involved are (or are not) doing to stabilize and counteract those forces. The fact is, though in certain positions joints are more stable on their own than in other positions on their own – a joint is always more stable with activated, opposing muscles.
It is my strong opinion (and I have seen this time and again) that in young children and in most teenagers, the cue to “lock out” the joint results in muscles going slack. The force is then almost completely transmitted through the joint instead of being dissipated through muscle action.
Furthermore, it is not just compression I am thinking about, but grinding and the like. We need not think that in the locked position the bony structures are somehow lifted completely “off” the lubricating structures like the menisci and the cartilage. They are still in contact. there is slightly less compressive force, but there is still, nonetheless, compressive force. If the muscles are not active, then that force is not stabilized as well as it should be, and there will likely be grinding.
I will be highly interested in responses to this.
I will also add this:
My major concern isn’t even necessarily the knee joint being put at risk (though it is a concern in kids). My concern is the transmitted stress to the hips and back when the muscles go “quiet”.
I will also critique a conclusion I saw online that more compression happens during knee flexion. With the screw home mechanism of lockout, and especially once an external load is added, someone explain to me how that’s true. Then explain to me how it would be true in kids who have hypermobile joints anyway.
Remember, kids don’t have the same level of muscular control and feel that we do. They are different. Most of the research specifically on joint forces, lockout and knee flexion, including the issues of compressive and shearing force (see Escamilla, Med Sci in Sports and Exercise, 33(1) 127-141 for a decent review of some of the adult research.
The bottom line here: Remember, as I have said before, the risk vs. benefit assessment. Could we come up with better cues for promoting muscle – joint stability in extension? I think so, and here’s one:
“Use your leg muscles to stand up really tall. Keep your belly strong”. Now we have full extension, active muscles (stable knee) + frontline abdominal involvement (preventing excessive hyperextension). That’s just one example of a better use of our time and connection to these kids.
I appreciate Paul’s comments as well, and I agree that it’s important get a deeper understanding of WHY or WHY NOT whenever we’re teaching or deciding not to teach a concept. In the spirit of being even MORE analytical, I’m going to try to break things down to the most basic points. For those that don’t need this much detail, my apologies for making this thread way nerdier….
If I understand Dr. Brown’s & Paul’s posts correctly (and please correct me if I don’t!), it sounds like the root concerns here are the following:
1) Hyperextending a joint is bad b/c it stretches connective tissues that aren’t meant to be stretched, which can cause problems over time.
(“hyperextending” = taking a joint past the full extent of its normal range of motion for a particular person — let’s say usually 180 degrees for the knee & elbow)
1a) #1 above is especially bad/risky in a person with compromised connective tissue (esp. youngsters).
2) Small movements of a joint (e.g., the knee) when already at full extension can lead to “grinding” which will damage the articular/cushioning surfaces over time.
2a) It is important for the muscles surrounding a joint to stay “active” while it’s in full extension, because doing so minimizes #2 above.
2b) People who don’t keep their surrounding muscles active while their joint is in full extension have a higher risk of joint problems than those who do keep said muscles active.
2c) Kids tend to have a hard time maintaining 2a, above.
3) Going to full (but not hyper-) extension of a joint while performing a lift is a good thing.
3a) (at least in the knees) The “screw-home” or “lockout” mechanism of the joint adds stability to the joint when executed properly.
4) Well-trained/strong/developed people can safely be taught the concept of lockout.
5) It is important to err on the side of caution when dealing with kids: we have to be extra sure of our facts when training kids as opposed to training adults.
First of all, do the points above correctly & adequately summarize the issues here?
(If not, please help me get ’em right….)
If they do, then it seems like if we implement it correctly, then we could safely use this concept with kids.
If we can find or develop a way to reliably ensure that a person could maintain active muscles and NOT go into hyperextension while finishing a lift (think squats & presses for this discussion), then that would allow us to safely teach “lock-out”.
Is that correct, or have I missed a key part of the analysis?
If the above is correct, then in my mind, the question then becomes:
How can we more effectively teach kids to lock out?
We already know:
We have to make sure they don’t hyperextend.
We have to make sure they keep the opposing muscles surrounding their joint active and engaged.
We have to make sure they have the strength to unlock after they lock.
Do we just need to change the cue? (e.g., don’t use the term “lock”)
Do we need to break the action into smaller pieces? (I can’t even think of an example yet)
Is it just too hard to teach properly? Should we not even try?
Could we establish a standard for when/how to start introducing the concept?
To return to the scene that prompted the post, let’s look at locking out an overhead press/support. (sorry to switch joints, but this is the best example I know that might illustrate healthy lockout)
USA Weightlifting coaches teach that one should keep the scapulae/traps active or “shrugged up” in the overhead support position, and that one should think about pushing up on the bar to help maintain a stable OH support position.
Would this example provide sufficient protection of the elbow joint to safely teach it to kids?
Are there any other examples or ideas out there that might be considered safe methods of teaching kids to finish a press/squat?
Sorry for the novel here — I hope some of you will help me refine my thinking above. I look forward to further comments.
Regards,
Eric S.
St. Pete, FL
As per my comment last week,weight training for the younger athlete’s needs to be done in a controlled and safe environment,with experienced trainers who understand what physical issue’s that need to be addressed.But these issue’s and all the other thing’s we discuss make it so worthwhile being involved with IYCA thank you Dr Kwame.
Erik, thanks for taking the time to write the summary, great job!!!
To answer your questions:
Do we just need to change the cue? (e.g., don’t use the term “lock”):
Yes, I gave an example of that up above. The concept is to extend, not lock. This provides (by virtue of the laws of physics that we are aware of) the most stability to the SYSTEM, not just the joint in isolation.
Do we need to break the action into smaller pieces? (I can’t even think of an example yet)
Try developing feel at different depths of the squat, literally “ticking” through the movement (if you don’t know what “ticking” is, look up ticking by Safi Thomas, head of the Hip Hop Conservatory.
Is it just too hard to teach properly? Should we not even try?
Again, yes, you should try, but focus on teaching extension of the entire system through feel and experience, rather than the (frankly quite lazy) cue to “lock”. TEACH my freinds, TEACH!
Could we establish a standard for when/how to start introducing the concept?
Around 7 years old or so through about age 12, kids start being capable of understanding more and more ocmplicated instructions like this. Remember that this is a long period, so slightly earlier, we can start, slightly later, we still may have some issues. Remember they are JUST STARTING at 7, so be VERY simple and give TIME. Also, age combined with training age must be considered as well.
Hint to continue your learning (these individuals’ opinions aren’t law, just more clues): Piaget, and Erikson.
Dr. Brown
you stated that someone online said that more compression happens during knee flexion. Did you mean knee extension? Cause that would go with the theme you’re talking about with screw home. Just wanted to clarify. Thanks!
No, more compression happens (according to the available research) during flexion vs. extension. However, my overall point is that extension and lockout are not equal. The only stipulation in the studies done has been 0 degrees. That does NOT necessarily mean the joint was locked and that the “screw home” happens. That speaks to my original point: It is understanding the research + understanding lifting technique + the way the system (neural, mechanical, muscular) works + differences in special populations.
Most people that advocate locking the joint have only (from what I’ve seen) demonstrated knowledge of one or two of the above mentioned factors.
I hope that clears things up.
Thanks for responding. Actually now that I know you said the research said more compression happens in knee flexion, it is more confusing cause I need more information. How was the study done, what were the subjects doing, where was the external load placed, how were the subjects doing the exercise? To blanket say that more compression happens isn’t enough. One more thought, when the knee is fully extended, or at 0 degrees to 5 degrees past zero , the screw home mechanism has taken place. It’s not a “locked” position and depending on where the load is placed, how far from the joint the load is, the direction of load, magnitude of load, and position of the joint(s) the person may easily come out of the “locked” position. If it’s in a squat, standing position, whatever, there’s a nice muscle behind the knee called poplitius that is in perfect alignment to pull the knee out of the fully extended position or screw home mechanism. It is under max tension with the tibia externally rotated and knee fully extended. It’s not the position that’s dangerous, and I think we are all talking about the closed pack position, it’s the position of the joint, direction of force, and understanding hidden resistances like inertia. Then being able to CONTROL your body and the loads.
First of all, I’m sorry to have been absent from this most fascinating discussion; I’ve been on the road with little access to the internet (believe it or not).
The purpose of my original post was to suggest, that in looking at the wearing of articular surfaces, one must consider the internal forces that are generated by the muscles, and not simply the external forces. I also commented that, at the knee, the tibio-femoral joint and related soft tissues are one consideration. Nothing had been discussed regarding the patello-femoral joint, which is equally important when considering the knee. By the way, my point regarding knee flexion and compression was in regards to patellar compression, which is the product of knee joint angle and muscle force.
A comment was made that I’m thinking of this in a vacuum. I assure you that I’m not. In fact, there are myriad issues that must be considered when addressing training practices. The introduction of a discussion on neuromotor control mechanisms, spinal issues, etc., serve to further illustrate my point. Thus, to appply a “do this and not that” approach to any application would be a diservice to all those who hope to learn more about these issues.
So much of this discussion has focused on the “screwing home” mechanism of the knee. Interestingly, the very purpose of that mechanism is to stabilize the knee joint so that the system may bear loads without the need for muscle activity. In so doing, this makes the system much more efficient in, and I emphasize this point, certain conditions of stance.
But here’s a question; under what conditions will there be no muscle activity around the knee joint? Let’s accept for the moment, that in the close packed position, muscles are quiet (I’m not necessarily conceding that point, but it’s not where I want to put a stake in the ground). At what point during the extension process do the muscles turn off? Does it occur instantly upon terminal extension? Is there a latency between reaching that position and the muscles going quiescent? Is there any further joint motion at that point? What are the forces acting on the system at that point?
If, by the time the body has reached a static condition, which is my sense of where it would need to be in order to have no ongoing muscle activity, then how are the articular surfaces affected? Degradation of the articular surfaces requires motion. To my knowledge, there is little empirical scientific evidence relating osteo-arthritis to standing still.
I think there is an interesting discussion to be had here regarding joint stability, apart from the articular and fibro-cartilage issues. I’d also love to get into a discussion of the sensori-motor mechanisms that control and regulate these processes, but maybe that would be reserved for a different forum.
Shawn,
Regarding whether higher compressive loading occurs during knee flexion, I think you basically answered your own question. The real answer to when and where the greatest compression occurs is, “it depends.”
The variables which determine compressive loading are the external force vector (magnitidue and direction), the joint torque created by that vector, the joint angle, the muscle force required to balance the torque loading, and the angle of insertion of the tendons.
The part that’s hard to calculate is the angle of tendinous insertion. We can get close, but not necessarily exact, so there will be some variability in the results when attempting these calculations.
But I think you get the point. There’s rarely an absolute in any of these conditions. It’s probably best to ask oneself “what shade of gray am I looking at?”
Paul,
Thank you for responding. There are other variables that can affect the external load placed on the body, which will then dictate how much internal force is needed to accomplish the goal of the exercise. How fast is the person moving, how dramatically do they want to start and stop? Actually I don’t think it’s what shade of gray, it’s what is each client ready for. Where on the continuum are they? I hope all this fosters a push to get more accurate info. There are posts on this forum that try to explain advanced concepts and inaccurately describe joints, mechanisms of joints, and so on. IYCA,please don’t take that as a slam, it’s just that it brings so much confusion because so many steps have been excluded. We must start with the basics and master them before we start making claims and rules about exercise and what’s wrong and right.
Shawn:
Before you read this, I am not angry (or offended), just adamant. This discussion has gotten so mired in minutia, we have lost our focus on the original point.
As far as the basics go: Maybe you don’t know my background, but my postdoctoral training was in biomechanical analysis, PH.D. dissertation in neural development. Does that mean I know everything about the knee joint and how it works? No, but neither do you or anyone else on here. But (speaking for myself) I am a trained researcher with a good deal of experience considering data and interpreting results. We have a variety of levels of expertise from posters, that is evident. This is meant to be a discussion, not a dissertation on knee / elbow mechanics. You still haven’t addressed my question about the available research showing 0 degree angle, and whether or not the joint is in a locked position in these experiments showing a widening of the contact. Until that is answered, I am inclined to disregard the value of such research in addressing the LOCKING out of joints. I would like to have a list from you of everything that was inaccurate that I said. In the meantime, here is what I DO know:
1) Kids have a tendency to hyperextend, placing not only the knee at risk, but the spine and hips. Anyone who works with young kids (especially the untrained) has seen this tendency. It is quite evident. No I have not measured angles or forces force plates, or used indwelling electrodes to measure electromyographic activity in supporting musculature. An IRB would almost certainly NOT approve that with kids unless we were working with a special population with the goal of curing disease.
2) There is no proven injury result from this, because as I have stated before, we would have to put kids at risk to prove this. Unethical and unnecessary.
3) I cannot stress the risk vs. benefit assessment enough here: Why do kids NEED to lock their joints? This mechanical choice does NOTHING for them athletically. This is not about rules but about, once again assessing what is needed and the risks we are taking.
4) With my (pretty extensive) background in neural development, athletic development, spinal injury, and biomechanics, I cannot think of one good reason to lock the joints. Can you? If not, then what would be the purpose of advocating against the main idea of my recommendation here? Or is the more important discussion point how many Newtons of force go through the knee at each millisecond time frame?
My main concern is that this was done when teaching a technique that would eventually put them under an external load. Again, why with THIS population would we teach them this? Why?
I will also give you a little more food for thought:
“Stability” as we view it from the perspective of the joint itself, does not necessarily (and likely does not) translate to stability in MOVEMENT. This is a different question entirely, and a question of the ability to move.
This is what I was referring to when I mentioned the “vacuum”. WE seem to be considering the joint and not the child. Not what the child needs to learn. Only that the “joint science” is satisfied. This is not good enough. Consider the child’s NEEDS first, and consider the joint within THAT matrix.
Also, Shawn, to your point about motion being required, yes you are certainly correct. My whole concern here is how the children are being trained to MOVE. You must realize that for most of these children, they are not experienced athletes, and for some, this is the main source of athletic training they receive. So, my concern is what happens later when presented with a load during movement.
I appreciate this discussion, and EVERYONE’s input SO much that I am considering just creating a panel of people to discuss stuff like this. Who would participate in something like that?
I was hoping that we could keep to the issues, rather than present our curricula vitae. But, since that seems to be the way to establish credibility here, I have a Doctorate in Motor Learning and 27 years of biomechanics, sports performance, and clinical orthopaedic rehabilitative experience. If you’d like to see the whole CV, I’ll attach it in the next post. Now that I’ve bored everyone to tears…
Shawn, I agree with your point, but let’s say that we’re looking at shades of gray within the context of each individual’s needs and capabilities. I don’t think that we can separate one from the other.
There is a very fascinating review article by Kevin Murray (Best Practice & Research Clinical Rheumatology. 20(2): 329-351, 2006) in which he presents evidence surrounding hypermobility disorders in children and adolescents. Most of the complaints involve “growing pains,” lower limb arthralgia, anterior knee pain syndromes, and back pain. He states “much disagreement remains as to the validity of hypermobility as an aetiological factor. What seems clear is that not all hypermobile individuals will be symptomatic or indeed possibly have any risk for specific musculoskeletal disorders in later life.”
Note: I am NOT advocating locking out the joints. Frankly, I’m an experienced kinesiologist and I couldn’t be sure when someone has become fully locked out, with the exception, perhaps, of the elbow, and that happens to be a very stable joint, so it really doesn’t concern me.
How about if we just apply some simple common sense? If it appears that a youngster has genu recurvatum, then don’t push too hard into terminal range of motion. Otherwise, encourage a useful ROM – depending on the task at hand – and focus on developing the movement skill. The rest should take care of itself.
The problem, in my mind, is how inexperienced people, with little scientific background, are apt to interpret and implement absolute rules of conduct. There is, as an example, a very popular movement screen that is used in sports performance centers and health clubs, with very specific rules on how to interpret the movements and positions. I can’t begin to tell you how many false positives I’ve seen from practitioners with little to no scientific background mis-using and mis-interpeting the process. How many of those clients will suffer other issues because of the corrective techniques that will be applied, when none is warranted? In other words, trying to avoid one wrong may induce a whole series of wrongs.
You are absolutely right to be concerned about the joint safety and health of young athletes. What moral person wouldn’t be? I am suggesting, however, that there is a better way to bring these issues to life than to create a rule for others to blindly follow. As you’ve mentioned in previous posts, “Teach, Teach, Teach.” Start at the beginning and cover all of the pertinent issues.
There is a forum here, with avid readers, and a great opportunity to educate people on a great many issues. Let’s not make this about who’s right and who’s wrong, and whose ego is being stoked, and instead, create an environment that encourages free exchange of ideas for all people to grow. It’s not an argument, it’s an opportunity to share experience and learn from one another. Honestly, I was hoping that I might come away a little smarter, because, frankly, I’m not that smart.
I, for one, would be happy to join your panel.
My points were not to say whose right or wrong, but that there is more info needed to distuingish when and if these joint positions are going to be detrimental to the health of the client. I for one have so many more questions than answers. I’m a little newer to this field (12 years) and I was hoping this wouldn’t turn into measuring contest. I’m learning to choose my questions carefully and comments sparingly. I have a masters in counseling psychology, certified Muscle Activation Technique Specialist, and Mastery Resistance Training Specialist. I specialize in the muscles, joints, and exercise mechanics. and try to help people of all ages improve muscle function, but most of my clients have cronic pain, are trying to avoid/recover from surgery , and/or have neurological issues. Most importantly though I’m a student. I’d be happy to be on your panel Dr. Brown.
None of my comments were to say whose right and wrong, but that there is more info needed before one can say whether or not an exercise or position in an exersice is going to be detrimental to the health of the person, no matter what age. There’s just more questions than answers. But sometimes protocols are good if one doesn’t yet know what goes into making sound decisions on how to apply force to someone and for what reasons. This is great that something like a panel may come from this and help us all to learn more. I know I need to keep learning. I have so many more questions than answers. I’d be happy to be on your panel Dr. Brown. Oh, and if it matters, I have been in the field for 12 years, I know a rookie, and have a MS in Counseling Psychology, a muscle and joint specialist , certified Muscle Activation Technique Specialist, and Mastery Resistance Training Specialist. I mostly see non athletes, people with cronic pain, neurological issues, and ages 5-90.
I’d be happy to join as well
Paul, you aren’t Dr. Juris by chance, are you?
I would welcome such a panel. The IYCA was created for many reasons. One of which is simply this – I am a Coach and in so, have always been both cognizant and responsible with my limitations in knowing ‘it all’. I have enjoyed this discussion very much and think that an easy, even and relaxed means of exchanging information is to everyone’s advantage. Too often, our industry is guilty of waging myopic wars in which chest puffing fools forget that the kids/clients should be the most important part of our discussions. Learning so we can better help them. Instead, we cling to what ‘we know’ as correct and defend our ‘turf’ against all invaders. Amounts to little more than narcissistic insecurity as far as I’m concerned. VERY heartened to see that the IYCA is different and that discussion can take place without the need for negativity. Keep at it, my friends…. I’m learning a great deal! BG
Paul, I think I might love you. EVERY point you made above is well taken, AND appreciated more than you could know (not knowing me personally). AND thank you for the ref. You know I will be reading that forthwith.
I could care less about my ego, it’s not what runs my decisions (otherwise I would not have taken the jobs I have). I just want to inform everyone of my perspective. And CV matters, for credibility. We will never get around that. Quite frankly, sometimes people make forceful statements (like me sometimes) without having the background and level of study / understanding to back it up.
And you are that smart, and you DO know a lot, as do others on here. The only reason I ever bring out credentials is so that the perspective can be appreciated. So that people know WHY I’m saying what I’m saying, because I may have considered a problem in a way that you haven’t, or seen it from a perspective that you haven’t. And vice versa.
If I am experienced to boot, this conversation comes from a different place than if someone had just taken a few courses. That’s why I wanted to start the credential conversation.
I hope we never get to the point where education and experience don’t matter at all. Issues are only one part of the equation.
This is what BG and I were hoping for from this blog. An active, passionate, respective dialogue. And we are getting it in spades. I will always argue for my point if I believe it, and will challenge anyone who disagrees. We have to. That’s why you all and I keep asking for the reasons behind things. We will be discussing some panels soon, even if it is informal and I just contact you guys once in a while.
I guess I gave myself away. That wasn’t my intention. I think we should be able to discuss these things without our badges preceding us. But yes, I’m Paul Juris.
I agree. I really want to learn more. I’ve got so many more questions than answers. I was introduced to your material by RTS mastery program. It’s a pleasure.
So, to sum up:
1) Paul’s knowledge of biomechanics and kinesiology is off the charts (certainly superior to mine), and he has challenged this debate to an entirely new level. He has challenged all of us to delve deeper into this question.
2) I still hold the opinion that the potential costs far outweigh the benefits with regard to kids locking joints, or really more importantly (and this is an important distinction), being given the VERBAL CUE to lock joints during lifts. I think Paul shares this opinion.
3) As far as mechanisms and long term costs specific to the knee joint, this will have to be elucidated SOMEHOW in children, though I doubt with ethical concerns we can complete that research with the present technology. A project to be kept in mind for a later date, to be sure.
4) My, how incomplete this discussion would have been without all of you asking questions and challenging me to explain more. My sincerest, and most heartfelt thanks. Some of you might remember a similar debate between Tony Reynolds and I.
5) Look at this whole discussion, make your own conclusions. Then read, study, understand. Challenge us to come up with more answers. When we don’t really have the answer, call us out. PLEASE! This is a very important role for you students out there that CANNOT be overlooked. When a student or teacher challenges an opinion, they must justify where it comes from and the reasoning behind it. This includes a discussion of level of study. It is up to the reader to assess the veracity of claims made.
6) I am more than willing to get my butt kicked up and down in a debate every day if the results are like this: Thoughtful questions, thoughtful answers, respectful debate. It may seem weak to some that are used to T-Nation and such that Paul concerned himself with my feelings and others, but that is a strong position. That shows his integrity and knowledge.
7) Paul you made a grave error in showing your knowledge here. I will be after you to contribute more. Please don’t take offense to any challenge I presented to you here, it is all in the spirit of debate. I needed to draw all that out of you, including your background.
Sorry for the repeat comments above. I did one and it didn’t show up from my phone. They just came up now. I thought they weren’t posting.
All,
Thank you for the thoughtful and respectful comments. I have taken offense to absolutely nothing, and the day that I am offended by a challenging question is the day that I should consider moving on, because I wouldn’t belong here. I once had dinner with Dr. Carlo DeLuca, the great neurophysiologist, and I was peppering him with questions. My classmates were aghast. “What are you doing,” they said, “don’t you know whom you’re talking to?” Dr. DeLuca pulled me aside after dinner and told me that he appreciated my inquiries and that I should never stop asking questions. It inspired me, and I realized if he was open to being questioned, then no one ever has the right to resist it. Even Einstein questioned his own interpretation of the Law of Relativity. Who then should be immune from questioning? Too many respond to challenges by making personal attacks. It’s an indication of a lack of knowledge and integrity, and it’s despicable. Clearly, this is a different environment, and I hope it continues that way.
Dr. Brown, I’ve made no error. First, I’ve found an intelligent forum for discussion and debate. Second, and more importantly, I wouldn’t have joined the conversation if I had no intention of contributing further. I will state plainly up front, however, that I will have far more questions than answers.
Thank you all for your passion and professionalism.
So, what’s the next question?