Here is an article written by a friend of mine who understands common overuse injuries with athletes as well as special operations training programs with regard to knee tendonitis that can shatter a military person’s Special Ops dreams. Learn how to strengthen the legs / hips to help prevent nagging injuries such as Illiotibial Band (ITB) and add some lateral leg movements to your training.
The most common complaint of pain for a BUD/s candidate it pain stemming from the Iliotibial Band (ITB, or I Tried BUDs). The ITB starts at the crest of the pelvis above the hip joint and runs to the outside of the knee. Attached to the ITB are the Gluteus Medius, Quadriceps and Hamstring muscles. Common issues with the ITB lead to lateral knee, hip and low back pain. A common issue with tight quads is pain under the knee cap and tight hams often lead to low back pain.
The main cause of knee, hip and low back pain is well developed and tight quadriceps, hamstrings and glutes. These muscle groups become tight due to increased development from high frequency of running, running on unstable surfaces like sand and weight lifting. These movements allow the hip to move forward and back but not side to side. The lack of side to side hip movement leads to muscle imbalance in the ITB and Glute Medius. The Quads and Hams are strong but the ITB and Glute Medius is weak.
The Glute Medius is the stabilizer of the pelvis. Weakness is acerbated by running on soft sand. This may not only lead to ITB syndrome but also low back pain within the Sacro-iliac joints (SI joints).
Stretching these muscles as well as strengthening as part of a well-rounded leg and glute program will go far in prevention and treatment of ITB, knee and SI joint pain.
The Hamstrings, Glutes and Quads all need to be stretched. A standing quad stretch and hamstring stretch should be performed at the beginning and or end of your workout. 2 sets each for 30 seconds each set daily. The IT band needs to be stretched. The standing figure 4 stretch and standing scissor stretch are best here. Again 2 sets of 30 seconds before and after your workouts daily. Please see the links here for demonstration of each stretch.
Ham Stretch link https://www.youtube.com/watch?v=h0v6WbjbTMo
Quad Stretch link https://www.youtube.com/watch?v=CZBKSOtyssM
Abductor Stretch link https://www.youtube.com/watch?v=1d80z3hBSh0
Perform Monster Walks with exercise bands wrapped around the lower legs. Monster Walks with a weight held overhead and a squat while pushing the knees out against the band each rep 3 x 30 reps.
Standing abduction against a resistance. Wrap a cable from a machine around the ankle and under a controlled movement perform 3x20 abduction exercises.
Lying on your side wrap the exercise band around your ankles and perform lateral hip raises. Keep the knee and foot facing forward during the entire movement. And finally performing abduction exercises against a resistance of an exercise machine. Please see the attached link for demonstration. Monster Walk link http://www.youtube.com/watch?v=rtpJ-A7A-V4
Finally, the last issue a BUD/s candidate is likely to experience is SI joint pain. The SI joints are the joints which attach the pelvis to the spine on each side of the lower back. The Glute Medius muscles attach from here and insert into the ITB. These muscles stabilize lateral movement of the pelvis. Instability here can not only lead to ITB but also SI joint pain. Many people whom get ITB will also experience lateral knee pain and SI joint pain.
To prevent SI joint pain the Monster walk exercises previously mentioned are great for strengthening and stretching. However, if the instability and pain are already apparent strengthening may only hold the pelvis in an unstable position. You do not want to strengthen a misaligned joint. If you are experiencing SI joint pain I recommend a Chiropractor for treatment before strengthening the stabilizers. Once the SI joints are aligned correctly then a course of stretching and strengthening should begin. SI joint link http://www.youtube.com/watch?v=1iwmcCw4bAw
About the Author
Dr. Stephen Erle is the training director for SEAL Training Adventures, Strength and Conditioning Coach and team physician for a Virginia University. In addition Dr. Erle instructs tactical athletics, sports medicine, nutrition and tactical combat casualty care medicine (TCCC). He can be reached for comment at Steve@SEALTrainingAdventures.com