How To Maintain Healthy Knees In Athletes? Part II

How To Maintain Healthy Knees In Athletes? Part II
Published: 2022-07-08
5/5 Average rating
Please sign in in order to rate the blog.

Last time, we talked about how lack of motion and weakness can add to an alteration of force absorption and increase risk for knee injuries and negatively impact performance.  We often think if we use a brace, neoprene sleeve or tap, this will take care of the issue.  However, when you remove those things, the root cause is still there and is not being addressed.  Therefore, we must get to the root cause that is causing the pain.  In the majority of cases, this can be traced back to lack of motion and/or dysfunctional motion. 

Last time we started to talk about certain motions that we look for that can guide us on training and help to elevate these risks.  In an effort to keep performing the sport we love and to keep our knees healthy and performing better, there are some simple movements we can look at and evaluate to see where our athlete is at and use that to get to a root cause.  This will allow us to create better and more effective programming to address, mitigate risk for injury and improve athletic performance.  

After assessing 40,000+ athletes, we now know what some of these predictive movements are, what we should look for and more importantly, how we use that information to create better programming to improve. 

Some of the key movements we look at can be assessed by any coach, parent, or athlete.  These include:

  • Plank & side planks – the ability to hold a plank and side plank for 1’ has been shown to reduce risk for knee and ACL injurie (1).

  • Single leg Squat, Single Leg Hop, Single Leg Hop Plant – ability to control your knee from going in an out reduces risk for injury and improves performance. In addition, inability control of the pelvis during performance has been shown to be associated with increased risk of injury (2).

  • Squats – equal distribution of weight through right and left throughout the motion has been shown to reduce risk and improve power output (3).

Specific things we look for is:


Planks & Side Planks – we are not only looking at the ability to sustain the position for one minute but also the ability to do so without dropping, without rotation or raising up out of the start position.

  • Squats – we are looking at the ability to perform full range of motion of squat. Looking for:
    • Ability to perform 20 reps
    • Able to perform to good depth without excessive trunk flexion or heels coming off the ground
    • Equal distribution of weight throughout performance of the squat. We don’t want to see the athlete shifting their weight excessively to the right or left (called a lateral shift).
  • Single leg squats, single leg hop, and single leg hop plant
    • Single leg squat – performing single leg squat to 30-45 degrees with opposite leg behind you. Looking for:
      • Ability to perform 10 reps on each side
      • Assessing –
        • Depth of motion
        • Ability to control motion at the hip
        • Ability to prevent the knee going in toward midline and if does, controlling rate of speed at which occurs.
        • Limiting loss of balance – touching down with opposite foot to get balance
      • Single leg hop – jumping up as high as you can without squatting down first. Looking for:
        • Ability to perform 10 reps on each side
        • Assessing for:
          • Depth of motion
          • Ability to control motion at the hip
          • Ability to prevent the knee going in toward midline and if does, controlling rate of speed at which occurs
          • Controlling number of losses of balance.
  • Single leg hop plant – jumping in the following sequence; forward, backward, lateral (out) and medial (in). Performing those 2 times for total of 8 reps.  Looking for:
    • Ability to perform 8 reps on each side
    • Assessing for:
      • Depth of motion
      • Ability to control motion at the hip
      • Ability to prevent the knee going in toward midline and if does, controlling rate of speed at which occurs
      • Controlling number of losses of balance.

With the ability to measure these movements in 40,000+ athletes, we have also had the ability to see what exercises work the best on improving performance during these tasks and movements.  This is actually less complicated than you think.  If poor performance on these movements have been associated with increased risk of injury, then improving performance on these movements should decrease risk.  This is exactly what we have seen. 

The sequence in which these movements are done is important and we will talk about that in the next blog. 

  • (Jeong et al Am J Sport Med 2021; DeBlaiser et al Am J Sport Med 2019)
  • (Johnston et al Am J Sport Med 2018; Owusu-Akyaw et al Am J Sport Med 2018; Kristinaslund et al Am J Sport Med 2013). (Markstrom et al Am J Sport Med 2020)
  • (Atkins et al J Strength Cond Res 2013; Wisloff et al Br J Sport Med 2004)

Read more:

How To Maintain Healthy Knees In Athletes? Part I

How To Maintain Healthy Knees In Athletes? Part II