<h3><b>The Problem - How Can You Tell If Your Client Is At Risk Of A Knee Injury</b></h3>
<span style="font-weight: 400;">You get a new client and wonder where to begin.</span>

<span style="font-weight: 400;">You use the ParQ and ask a few simple questions.</span>

<span style="font-weight: 400;">However, you wonder if this is enough?</span>

<span style="font-weight: 400;">Which exercises are right for them?</span>

<span style="font-weight: 400;">Which might be wrong?</span>

<span style="font-weight: 400;">How would you know?</span>

&nbsp;

<span style="font-weight: 400;">Let’s take a common issue seen in beginners to exercise like poor knee stability. </span>

<span style="font-weight: 400;">Why are they unstable? </span>

<span style="font-weight: 400;">Are they weak? If so where? And which strength moves would be appropriate?</span>

<span style="font-weight: 400;">Every time your client runs or jumps they seem to almost fall over with wobbly knees.</span>

<span style="font-weight: 400;">How can you identify the root cause and then rectify it?</span>

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<h3><b>The Solution - How To Know If Your Client Is At Risk Of Knee Injuries...</b></h3>
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<span style="font-weight: 400;">Well here is a method that is helping PT’s like you, identify if your clients are quad dominant.</span>

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<h3><strong>What do I mean when I say “quad dominant”?</strong></h3>
<b>Biomechanical Issue;</b>

<span style="font-weight: 400;">Quadriceps Dominance</span>

<span style="font-weight: 400;">An imbalance between knee extensor and flexor strength, recruitment, and coordination.</span>

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<span style="font-weight: 400;">Basically, the muscles that surround the knee and allow it to function are either not strong enough and/or lack the ability to move in the right way.</span>

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<span style="font-weight: 400;">Relevance:</span>

<span style="font-weight: 400;">If the peak hamstring torques are down this will de-stabilises the knee. And thus increase the risk of injury.</span>

<span style="font-weight: 400;">The more a person bends their knee, the more the hamstrings engage to stabilise it.</span>

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<b>0 - 30 degrees of knee flexion = </b><span style="font-weight: 400;">quadriceps pull the tibia forward with little opposition from hamstrings</span>

<img class="aligncenter wp-image-5413 size-full" src="https://www.biomechanicseducation.com/wp-content/uploads/2018/03/Quadriceps-Dominance-0-30-degrees-knee-flexion.png" alt="" width="416" height="418" />

<b>30 – 90 degrees of flexion = </b><span style="font-weight: 400;">the quadriceps have comparatively less effect and the hamstrings engage more</span>

<span style="font-weight: 400;"><img class="aligncenter size-full wp-image-5415" src="https://www.biomechanicseducation.com/wp-content/uploads/2018/03/Quadriceps-Dominance-30-90-degrees-knee-flexion.png" alt="" width="404" height="416" />Normal Quads/hams ratio established from </span><span style="font-weight: 400;">isokinetic testing:</span>

<span style="font-weight: 400;">Sprinting/rugby/football = Hamstrings are 70% of Quads</span>

<span style="font-weight: 400;">Long distance runners = Hamstrings are 60% of Quads</span>

<span style="font-weight: 400;">Race walkers = Hamstrings are 90% of Quads</span>

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<h3><b>How To Test For Quadriceps Dominance</b></h3>
So how on earth do you find out if your client is quad dominant? Well, I am not just going to freak you out and then leave you, I have a test for you try today….
<h4><span style="font-weight: 400;">The Test For Quadriceps Dominance:</span></h4>
<span style="font-weight: 400;">Test the ability to leap/hop forwards about 1 metre, land in 90 degrees of knee flexion, with the hips at 45 degrees and then hold this single-leg stance for 3 seconds.</span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">To maintain upright posture (45 degrees at hip)</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">Land in deep knee flexion (90 degrees at knee) </span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">Hold for 3 seconds</span></li>
</ul>
<img class="aligncenter size-full wp-image-5417" src="https://www.biomechanicseducation.com/wp-content/uploads/2018/03/Quadriceps-Dominance-Test.png" alt="" width="279" height="503" />

<span style="font-weight: 400;">Did They Pass?</span>

<span style="font-weight: 400;">YES - Negative Result:</span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">The client passes if they have the ability to maintain stance with deep knee flexion and control = good hamstring control</span></li>
</ul>
&nbsp;

<span style="font-weight: 400;">NO - Positive Result:</span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">The client fails if they have an inability to maintain stance with deep knee flexion indicates quadriceps dominance = poor hamstring control</span></li>
</ul>
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<span style="font-weight: 400;">(Stroup AL, Nance TA, Noyes FR, Hewett TE)</span>

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<span style="font-weight: 400;">Now ask yourself this question </span><i><span style="font-weight: 400;">“if the hamstrings are unable to contribute enough to stabilise the knee upon landing at 90 degrees, what should you do?”</span></i>

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<span style="font-weight: 400;">In other words what exercises would encourage the function of the hamstrings and improve the quads/hamstring ratio?</span>

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<span style="font-weight: 400;">It is very simple….</span>

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<span style="font-weight: 400;">1). You would need to strengthen the hamstrings</span>

<span style="font-weight: 400;">2). Specifically the hamstrings, which means we need to understand their action/s</span>

<span style="font-weight: 400;">3). Then isolate that movement in a resistance exercise...yes I said isolate</span>

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<span style="font-weight: 400;">Remember we all want to be functional but if something (ie the hamstrings) aren’t function’ING’ then you cannot be fully function’AL’</span>

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<span style="font-weight: 400;">The hamstrings assist hip extension (with the glutes) but are really the main knee flexors.</span>

<span style="font-weight: 400;">So consider how many exercises you know that isolate knee flexion?</span>
<h4><strong>Isolated Hamstring Strengthening Exercises:</strong></h4>
<b>Leg Curl Machines </b>

<b>Nordic Leans</b>

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<span style="font-weight: 400;">These are really great exercise examples that contribute to changing the ham to quad strength ratio.</span>

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If you discover that your client is quad dominant, then start building in those hamstring strengthening exercises into their programme.

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<h3><b>Want To Take This Further? </b></h3>
<span style="font-weight: 400;">Usually delivered on our Biomechanics Coach Diploma, Knee &amp; Foot Biomechanics workshop, here we are giving it to you to try out for free to see if it helps. So please get in touch with your results or questions </span><a href="mailto:rachel@biomechanicseducation.com"><span style="font-weight: 400;">rachel@biomechanicseducation.com</span></a>

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<span style="font-weight: 400;">If you would like to know more there is an entire workshop dedicated to assessing knee stability and foot function. This workshop also includes all of the relevant exercises to help you in your session programming.</span>

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<a href="https://biomechanicseducation.clickfunnels.com/biomechanics-coach-split" target="_blank" rel="noopener"><span style="font-weight: 400;">Want more info? Then click here fill in your info and speak to one of the team.</span></a>

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<h2 style="text-align: center;"><b>Imagine Being Able To Do This Type Of Test For The Whole Body…</b></h2>
<span style="font-weight: 400;">If you want to be able to do this kind of analysis for the whole body then you should really check out our full diploma.</span>
<h3 style="text-align: center;">Want to be able to help your clients move better, move more freely and get even better results on their programmes?</h3>
<p style="text-align: center;">Then <a href="https://biomechanicseducation.clickfunnels.com/biomechanics-coach-split" target="_blank" rel="noopener">click here to find out more about our Biomechanics Coach Diploma</a> and how it could help you become an even better personal trainer.</p>
<p style="text-align: center;">Not ready to jump on the full diploma? Then come along to one of our 1 day workshops. You will LOVE these! <a href="https://biomechanicseducation.clickfunnels.com/2018-roadshow" target="_blank" rel="noopener">Just click here to see when and where they are.</a></p>
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