Gray Institute® has come up with many words, phrases, and sentences. One such sentence is in reference to the all-important knee:
“The knee is caught in the middle with few places to go and no place to hide!”
Since I am talking about sentences, how about this one (that, of course, Gray Institute did not come up with):
“A happy wife is a happy life!”
Believe it or not, this second sentence sets us up to better understand the first sentence. Why? Because a happy knee is a happy foot and a happy hip. Therefore, a naughty knee is a naughty foot and/or a naughty hip.
While the knee is primarily known as a Sagittal Plane joint, it does move in the Frontal Plane and the Transverse Plane. In fact, it is in the latter two planes of motion that are more important (if we were to rank the planes of motion at the knee). Think about it … the knee has the most freedom (range of motion) in the Sagittal Plane, yet the subtlety of the Frontal Plane and Transverse Plane motions tend to create injury.
So what, who cares? Well, the knee cares a lot! Furthermore, it cares to not get injured – it wants, it craves, to perform at a high level, at a functional level, at a safe level. “The knee is caught in the middle with few places to go and no place to hide!” So let’s work backwards on that sentence. It has few places to go, yet needs to have great range of motion in the Sagittal Plane (primarily with flexion). It also needs to have range of motion in the Frontal Plane (with abduction and adduction) and in the Transverse Plane (with internal rotation and external rotation).
If the knee needs to have these ranges of motion available, it is because the knee is supposed to go through all three planes of motion (yes, function dictates this happens). Therefore, the idea of keeping the knee over the foot (in more of a neutral position in the Frontal and Transverse Planes) is ludicrous. It doesn’t need to stay in neutral; it needs to go through neutral in all three planes of motion!
“The knee is caught in the middle with few places to go and no place to hide!” In the middle of what? The leg … with its northern neighbor, the hip, and its southern neighbor, the foot. The knee is constantly influenced (positively or negatively) by what its neighbors do and are capable of. That is why 3DMAPS® (3D Movement Analysis & Performance System) is so complete and beneficial – one can see how the knee performs, relative to how the foot and how the hip perform.
In the six Chain Reaction® movements of 3DMAPS, it is inherently clear that the knee is dependent on the foot and the hip, as follows:
- Knee extension depends on ankle dorsiflexion and hip extension;
- Knee flexion depends on ankle plantarflexion and hip flexion;
- Knee abduction depends on subtalar eversion and hip abduction;
- Knee adduction depends on subtalar inversion and hip adduction;
- Knee external rotation depends on subtalar abduction and hip external rotation; and
- Knee internal rotation depends on subtalar adduction and hip internal rotation.
How can one expand on the above motions and abilities of the leg (and the entire body) so the knee performs at a high level? Through the Performance System movements of 3DMAPS and beyond. The “beyond” portion could be to utilize 36-360s. 36-360s is a plyometric progression for performance that challenges the knee by engaging the entire body and facilitating all motions at the feet, the knees, and the hips to replicate function. In this case, it looks like a great progression for a basketball player, a volleyball player, and others.
Here is a quick breakdown of 36-360s for jumping (two feet to two feet):
- Jump forward twice; then
- Jump (and rotate 90° to the right) and jump to the left; then
- Jump (and rotate 90° to the right) and jump backwards; then
- Jump (and rotate 90° to the right) and jump to the right; then
- Jump (and rotate 90° to the right) and jump forward; then
- Jump (and rotate 90° to the left) and jump to the right; then
- Jump (and rotate 90° to the left) and jump backwards; then
- Jump (and rotate 90° to the left) and jump to the left; then
- Jump (and rotate 90° to the left) and jump forward.
From this baseline, many tweaks can be made to further challenge the body, to challenge the knee (in a safe and successful manner, due to the practitioner’s expertise). Three great tweaks to do to the above are as follows:
- Jump Out-of-Sync in Sagittal Plane;
- Jump Out-of-Sync in Frontal Plane; and
- Jump Out-of-Sync in Transverse Plane.
Overall, the goal is to best serve the knee and to protect it. The strategy is to let its friends assist in the process, because that is what happens in the real world.