In part one of this series, we discussed a few things that are essential to building a bulletproof foot. We looked at the stability and strength of the intrinsic foot musculature and how it relates to stability of the medial arch. This strength and stability are essentials to proper loading up the kinetic chain. Proper use of the arch in the foot will inhibit over-pronation and allow the knee and hip to track properly for the best torque and strength output.
RECENT: Tissue Load vs. Tissue Capacity: Increasing Tissue Capacity While Altering Training Load
Next, we looked at the need for adequate and available internal tibial rotation. If we recap, this is necessary to keep dissociation between the hip (femurs) and foot via the tibia. If this is lost we end up rotating the feet too much externally and then the tibia follows, as well as the femur. This puts everyone into a linear top-down position and we lose the ability to generate torque. Loss of torque means loss of stability in the hip via the gluteals, and we lose strength and power. Tibial internal rotation is also essential for hitting squat depth. Without it, we end up compensating via bending of the lower back and caving in at the knees or at the feet. This, for obvious reasons, is not good.
For the remainder of this article we will discuss the following:
- Accessing and owning hip internal rotation
- Keeping knee valgus to a minimum
- Integration and loading exercises for progression
Hip Internal Rotation
If there is one missing link I most often see in clinic, it’s the limitation of hip internal rotation. Hip internal rotation is essential for a healthy hip, knee, and foot. Hip internal rotation is the ability of the femur to rotate internally (think femur rotation in toward the midline of the body). The motion is not what’s essential; it's the muscles that complete the action that are a priority. The gluteus medius and gluteus minimus are the main activators. Synergist muscles (think neighbors) like the tensor fasciae latae and adductor brevis and longus are responsible as well but tend to be more active than the glute muscles listed above. This is a problem because the total tissue area of both of those muscles are very small and get overloaded quickly. If you’re squatting a lot, this becomes a tissue capacity versus tissue loading problem. Lastly, the hamstring muscles (semitendinosus and semimembranosus) aid in internal rotation as well. This is often non-existent.
So why is it important to have adequate hip internal rotation? You obviously are not squatting in hip internal rotation — you wouldn’t go very far. It has more to do with the arthrokinematics of the hip. If the hip internal rotators aren’t working in the squat then the hip external rotators are doing twice the amount of work. This means the adductors, hamstrings, and associated gluteal musculature are not stabilizing the pelvis and femur while squatting. This is needed especially when hitting depth, an essential part of powerlifting. When we have an excess amount of hip external rotation, this places the femur in a more forward position in the hip. This can cause hip impingement and labrum issues if constant and not corrected. When the femur can't move in the hip to hit depth, you often end up rounding elsewhere to create room.
The last little part has to do with integration — all parts working together to create the most stability within the hip for the best results. If you don't have proper motor control of these patterns and the ability to own them, compensation occurs. Distribution of the forces across as many muscles and tissues throughout the full range of motion will leave you squatting healthy for a long time. So enough of the boring shit — how do we fix it?
Quadruped Hip Internal Rotation Drill with Resistance Band
You do not have to add the upper body band if you do not want, but it is a great way to integrate trunk stability.
Breathing is the body’s way of allowing access to ranges of motion it previously has been unable to access. It is essential to breathe diaphragmatically in a forceful manner to allow the trunk musculature to work and allow movement to happen in the hips.
- Keep the ankles dorsiflexed and limit external rotation of the feet outward.
- Access the internal rotation by driving your knees into the foam roller and pushing the outset of your ankles into the band.
- Keep your pelvis in a slight posterior tilt (just don’t allow anterior tilt).
- Reach your first wall (limit of internal rotation) and breathe for approximately 10 full inhalation-exhalation cycles. Again, do this forcefully and with perfect intent. You can use a balloon to capture the true pressure of the breath needed.
- Relax and repeat to a new wall for cycles two and three.
- Once you can no longer access any more range of motion, the mobility drill is done.
If you have a unilateral imbalance where one hip has more internal hip rotation than the other, use this 90/90 hip internal rotation drill to fix the effected unilateral side. The same principles apply as above.
Banded Eccentric Knee Valgus
Knee Valgus has been beaten to death more than a redheaded stepchild. I’m not going add too much to that ass-whooping. What I will say is this: for beginners, it’s probably more beneficial to limit this as much as possible and work on developmental motor patterns including hip torque, foot stability, and proper pelvic and trunk positioning and bracing. Once you have developed the above foundational principles and you have recouped years of good movement patterns and a solid training age, you can begin to build tissue and muscles that will change your power advantages.
In terms of using knee valgus as a tool, we want to control the ability to pull the knee in and out of valgus. The foot is static in the squat. We will address one specific exercise in a static position and another in a more dynamic position. Since bodybuilders, powerlifters, and most strength sports other than strongman are dominant in one plane of motion, it never hurts to train in movement. Again, the body does not understand what “muscles” are; it only understands movement and the ability to resist that movement.
Knee valgus is something that is natural in athletic movement, especially jumping and landing sports. Powerlifting and bodybuilding training are static most of the time, meaning this is not 100% present. However, if you are experiencing knee valgus and it is causing you pain, looking at the below exercises will help.
Our focus here is to access the end range of your knee valgus and train from that point eccentrically. Controlling the ability to move in and out of that range will increase our ability to absorb force. This is the key to preventing injury at the knee.
- Begin the movement by placing a band at knee height. Get into a squat position and first find the end range (limit) of knee valgus by letting it dip in slow while your foot remains in full contact with the floor. Once you have established this range, do not let it get bigger. Your goal is to challenge the end range, not increase it.
- Begin stepping over the band in a forward stepping manner, allowing the banded knee to be eccentrically pulled into valgus. Control the valgus position and, as you step back, drive the knee out of the valgus position and repeat.
- You can increase the degree of difficulty (stability) by crossing over the body more and reaching if you so choose.
- Reps and sets are not essential. Getting good at controlling the movement is what is essential. If I had to give a recommendation, I'd say three sets of 10 reps. Make the movement continuous.
Knee Valgus Step-Downs
This is our dynamic knee valgus exercise so when you super heavyweight bodybuilders and powerlifters step off something you do not blow out your knees.
- Begin by taking a position on a small step, plate, or exercise step. Take a natural step off the box and allow the front traveling knee to hit end range of your already-established knee valgus.
- Perform a cross-body reach to place load on the front leg and work the movement harder.
- Return to the starting position by stepping back and driving off the front knee. Repeat back and forth. Challenge the movement by creating different reach paths: up and down, further left or right, etc.
- Complete both legs for three sets of 10 (if I had to prescribe sets and reps).
It is important to understand that the knee is a “tweener” muscle, as I like to call it. Its main job is to react to the joints above and below. The ankle and hip control the knee. That is why it is essential to have stable feet and arches when loading knee valgus. It is also why foot arch training was presented first, because it is most important. If the mid-foot position does not have the ability to absorb load or force, the knee will absorb what the foot can’t. If you have not trained that position or movement, you get the gift of injury. Having a strong, healthy foot (especially the mid-foot, and rear-foot), and the ability to absorb force at the foot will allow the knee to be safe if it falls into valgus. The two are exclusive. You cannot focus on one without focusing on the other.
Loading, Integration, Progression (LIP)
The last part of this two-part series will look at integrating all the information presented previously through various exercises that you can use to progress from a shitty foot to standing up with whatever you want.
The foot, for all intensive purposes, is endurance-based. Its endurance needs to be high to withstand constant force absorption and recruitment during the gait cycle. For that reason, I am particular to time under tension for training. This can be done in either static or dynamic fashion. In the first article, there were a couple beginner (activation) exercises used to recruit the intrinsic foot muscles. However, progressions are key. Here are my favorite progressions to build endurance. The first is static and the second is dynamic.
Static Gait Swings
There are multiple benefits to this exercise — too many to list. Start with one minute per side for three sets. Build by 30 seconds at a time. Points of emphasis:
- Keep your short foot solid by driving your big toe pad, pinky toe pad, and heel into the ground.
- Keep your hips in extension and pelvis neutral.
- Imagine your belly button is a flashlight and keep it pointed forward.
- Swing the weight in opposite directions, maintaining an upright position and slightly forward leaning torso.
- Breathe forcefully from your belly and out through your mouth.
Loaded Short Foot Walking
Essentially, you are walking in a short foot position. This is not a regular absorbing force foot strike. You are creating a short foot (bottom foot arched) and walking on it without allowing it to over-pronate. Points of emphasis:
- Approach this as if you were doing a loaded carry, with the same upper body position and stiffness throughout your trunk.
- Keep the knee slightly bent always so the short foot is placed under more force during walking.
- Do this for distance or time.
- Strike from heel to toe while keeping the arch stiff and slowly load the medial long arch.
Once you have developed some endurance, you can move to unilateral leg training. If you can't train or lunge on one leg, what makes you think you can train on two?
Single-Leg Rear Foot Elevated Split Squat
This has a short foot focus. This is similar to your regularly executed rear foot elevated split squat, but we are going to place two very thin 2.5-pound plates under our feet. One goes under the heel and one under the front footpad. This will leave the medial arch exposed and “forced” to work harder.
- Complete sets of 10 with progressive weight increases as you would regular exercise.
- Increase eccentric or concentric time under tension to increase intensity.
- Use explosive reps to progress force absorption of the bottom foot arch.
Front-Loaded Piston Squats
This is a front-loaded kettlebell or weighted squat in which we limit hip movement as much as possible by keeping the torso as upright as possible. This pushes the knees forward and places more force on the feet. If at this point you don’t understand the benefit of this, re-read the articles.
- Keep the hips from moving too far into flexion or extension.
- Keep the knees over the toes. (No, this will not hurt your knees, provided you have the available ankle dorsiflexion)
- Focus on driving the top of the foot up by squeezing the bottom of the foot, making it “short.”
- Keep your internal tibial rotation focus by keeping your shin in line with your second toe while driving your knee out and creating torque.
- Your time under tension here will most likely be based on your quadriceps endurance, because there is a large demand placed on them in this exercise. Base your time on that.
Single-Leg Step-Up with Short Foot
This is very similar to the setup of a regular step-up exercise, but you are going to leave your foot on the box the entire time. Start with a box height under 90 degrees of knee flexion and progress from there. It's your choice on whether to load this via a kettlebell, barbell, or unilaterally.
- Keep your hips underneath you and drive the knee forward while stepping up.
- Keep the short foot solid as you step up and hinge down and back into the starting position while eccentrically loading the foot.
- Keep your internal tibial rotation solid by keeping your shin in line with your second toe and drive your knee out, creating torque at the hip and ankle. Think of your line of drive going out to in, focusing on driving through the middle of the foot arch without letting it collapse.
Once you have adequately built the strength in single-leg loading exercises, it is now time to progress to regular squats and load via whatever program you are currently using. If you get under the bar and you find you still have one side that is not as strong as the other, regress back to the single-leg exercises or further back and build more from there.
Take It Home
Let's wrap this puppy up. It is important to build individual toe strength (anterior extension of the toe, foot, and shin musculature) and recruitment to start building true arch strength. You must be able to move it independently first before you can load it. This will take up a majority of your time in the beginning but is essential to master.
Use the big toe extension and anti-extension (other toes) exercises from article one to start. Next, begin learning the importance of tibial internal rotation and how it is essential for proper arch loading. Its importance is discussed in detail in article one. As we build from the bottom up, we now hit hip internal rotation. This is essential for proper hip arthrokinematics and distributing force equally across the gluteal musculature. It is essential for hitting depth (powerlifting) and getting deep to build massive quads (hypertrophy). Once you begin to master these individually, start loading single-leg exercises to work on any imbalances. Once these are fixed you can begin loading the squat in any manner you see fit.
I hope this two-part article has opened up your mind to understand the importance of proper foot mechanics, loading, and strength. If you have any individual questions, please feel free to reach out at performanceandrecoverysystems@yahoo.com, or if you are in the Chicago area and wish to discuss in person, please visit the website and schedule a free assessment!
