Anterior Cruciate Ligament Injuries

anterior cruciate ligament injury tear

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Knee is the largest and most complex joint of the body. There are 4 primary ligaments (with their muscles and tendons) and secondary ligaments for the knee to function properly. Here are the ligaments of the knee : there are 2 ligaments on the side the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) and two crossed ligaments in the center of the knee, the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).

Anterior cruciate ligament connects the front top part of the shine bone to the back bottom part of the thigh bone and keeps the shin bone from sliding forward.

anterior cruciate ligament

Injury

anterior cruciate ligament injury tear

There are several ways to have an injury to the anterior cruciate ligament :

  • The injury can be done because of a direct hit on the knee, which often happens in team sport.

  • The injury can be done without contact with an object in a situation where the knee forced to be in a abnormal position, which causes a tear in one or more ligaments of the knee. Or when an athlete in the race change direction. Or when an athlete make a hyperextend of the knee when landing a jump, which often happends in agility sports.

Diagnostic

In the majority of cases, the doctor is able to identify what is the injured ligament. But the knee can also be injured at the joint on the surface and in this situation, it’s more difficult to diagnose because of knee swelling. To make an accurate diagnosis, it will be necessary to use a MRI scan or arthroscopy.

Prevent

There are several fast, powerful movements that lengthen (eccentric phase) and shorten (concentric phase) a muscle. These prevention programs are for injuries without contact. These exercises are to improve the nerves/muscle control of the knee. These prevention programs use plymetrics, balance and strength/stability exercises.

Plymetrics

It’s a fast, powerful movement that lengthens (eccentric phase) and shortens (concentric phase) a muscle. The concentric phase increases the muscle power. Here is an example, an athlete who jumps from a box and immediately jumps into the air after touching the floor.

Balance

Balance exercices are done with the wobble or balance board. It’s also possible to perfom exercices by throwing a ball with a partner while balancing on one leg.

Strength/stability

To improve single-leg core strength and stability, there are excellent exercices such as jumping and landing on one leg with the knee flexed and momentarily maintaining this position.

Surgical treatment

In the past, there was a technique that consisted of stitching the ligament together but it was rarely successful. Currently, the technique involves reconstructing the anterior cruciate ligament by building a new ligament from tissue taken from one of the other tendons around the knee or from on organ donation. This tissue passed through drill holes in the thigh bone and the shin bone, and then ancored in place to create a new anterior cruciate ligament. Over time, this transplant becomes mature and becomes a new living ligament in your knee.

Recovery

recovery

Rheabilitation of the knee after the reconstruction of the anterior cruciate ligament requires time and work. To have a complete function, this can last between 6 weeks and 6 months depending on the severity and level of activity. Rehabilitation rate may take time depending on the specific requirements of the sport/physical activity of the individual.

The overall success rate of the anterior cruciate ligament surgery is very good. A lot of study show that more than 90% of patients are able to return to sport without symptoms of knee instability. It’s true that some patients complain of stiffness and pain after surgery, that is why it’s necessary to make an aggressive rehabilitation until the new surgical technique to reduce these problems.

Statistics

  • One of the most commonly injured ligament in the knee

  • Female athletes participating in basketball and soccer are 2-8 times more likely to suffer anterior cruciate ligament injury.

  • Athlete who suffer anterior cruciate ligament injury at increased risk of arthritis development later in life.

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-Steph

Add a Reference Line

reference line tableau data science

I have just enrolled in a Data Science course on Udemy  and I learned good stuff.

In the previous article we learned how to work with aliases. We will learn how to add a reference line in our bar chart.

Before I start, I’ll show you a trick in Tableau.

In our bar chart we can see the labels in this order : percentage and below : « Stayed » or « Exited ».

We will reverse this order. You go in this rectangle.

reference line tableau data science

And you place the label « Exited » above the label « SUM(Number of Records ».

reference line tableau data science

Look, the label « Stayed » is above percentage.

reference line tableau data science

With that, we can understand the bar chart more easily.

Let’s add a reference line, let’s go . But before, I think you’d like to know why I’m talking to you about a reference line.

A reference line helps us to compare bar chart results with a benchmark. This benchmark is represented by this reference line.

In our case, the benchmark is the percentage of clients who left the bank in our sample of 10 000 people.

The first thing to do is find this percentage in our bar chart. To be able to do that, remove « Gender » from « Columns ».

reference line tableau data science

Boom, we have a new bar chart.

reference line tableau data science

Look, we only have the percentage of clients who left the bank and the percentage of clients who stayed in the bank.

We see that on our sample of 10 000 people, there are 20% of the clients who left the bank and 80% of the clients stayed in the bank. This means that the churn rate (client departure rate) is 20%.

What we’re going to do is we will add this churn rate in our A/B test. To return to our A/B test, press 2 times on Ctrl+Z or Command+Z or you can click 2 times on the « Back » button in the menu bar.

reference line tableau data science

Now we know that the average clients who left the bank is 20%.

We will add a horizontal line in the Y axis (Y = 20%) to compare the 20% of the churn rate and the 2 categories male and female.

Let’s go. Right-click on the vertical axis (Y axis) and select « Add Reference Line ».

reference line tableau data science

A window appears with several options.

reference line tableau data science

You have the choice to add a line, a band, a distribution or a box plot.

We will use the line for the entire table.

Click on the « Line » button and activate the « Entire Table » checkbox. In « Value » selects « Constant ».

reference line tableau data science

The constant is 20%, so it’s necessary that you put 0.20 in « Value ».

reference line tableau data science

It’s possible to put a label on this reference line. For example, if the line reference corresponds to a formula, the label displays the formula. But for our case, our constant is 20% and it’s already displayed on the vertical axis so we will select « None ».

reference line tableau data science

For the format of the line, select the continuous line and click on the « OK » button.

reference line tableau data science

We have our reference line is added to our chart.

reference line tableau data science

Here is what we can see. Female clients are more likely to leave the bank than average clients. Male clients are less likely to leave the bank than average clients. 

In our case, it’s obvious to see that because there is only 2 categories, men and women.

Now you know how to add a reference line in a bar chart.

Share this article if you think it can help someone you know. Thank you.

-Steph

How To Do Box Squat

box squat

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Box squat is often used by powerlifters to gain strength to do squat.

This exercise involves doing a squat sitting on a bench for 1-2 seconds and returning to the standing position .

In classic squat the tension accumulated in the muscles during the negative phase when you get down (as a stretched elastic ) and this tension restored during the positive phase when you get up. With box squat, sitting on the bench relaxed thighs muscle, there is not tension accumulated when you get down to be used when you get up.

For the same weight, quadriceps should provide more effort for box squat than classic squat. It’s a great exercise to target work on thighs.

This exercise can be included in a training program for people who have long legs and don’t feel their quadriceps work with classic squat.

box squat

Starting squat in sitting position allows push automatisms for the classic squat which has the effect of having the positive phase to get up faster and more powerful.

Attention : It’s necessary to be careful for this exercise in controlling the movement to get down to sit gently on the bench. If get down too fast, the butt crash on the bench and this can create serious trauma due to shock and excessive compression of spinal joints.

Note: There are special benches adaptable for different morphologies with a very padded seat to limit the risk of spinal injuries and the possibility of adjusting the height. To have a good execution of the movement, it’s necessary to have your back slightly incline. If your back is too vertical at start of the bench, the exercise will be impossible to do.

Share this article if you think it can help someone you know Thank you.

-Steph

Squat Correctly (Part 3)

squat

Classical errors

I read a Nerd Fitness article  and I learned good stuff.

Click here to read Part 1 and Part 2 

Squat is a movement that we make since baby, it’s a basic movement. But when I started to do squat with weight, I make mistakes and I’m going to talk about the classical mistakes we make when we’re newbies.

Put all the weight on your toes

You need to have your heels glued to the floor throughout squat. This is important for spreading your bodyweight and weights on the barbell.

You also distribute part of the weight on the balls of your feet but it’s not the total weight. You should be able to move your toes in all directions during the squat.

The total weight (your bodyweight + weight on the barbell) is divided between the ball of your fee and your heels.

Don’t squat down too low

Your squat should go down at least until your hips joint are below your knee (parallel).

Maybe you have a special training that asks you to make a lower squat, it’s up to you to see. But making a parallel squat is enough to work your muscles well.

When you do a partial squat , so you have a squat above the parallel, you’ll work more your quadriceps than your hamstrings, in addition you put a lot of stress on your knees. The more you squat down, the less pressure you put on your knee.

Very, very often, people make a connection between squat and knee problems. Unfortunately, it’s a negative myth, a lie that makes people afraid of squat. For exemple, a gym member saw me with my knee wrap and said : « Be careful when you squat, you’re going to hurt yourself ! ». But does he know that my knee wrap increase my squat’s performance by 5-10 % ? I don’t think so. Here are some interesting articles here  and there .

The more you squat down, the more you work your glutes. But when we squat down, we have to go back up. And more we go down and more it’s harder to go up (strength and flexibility). The squat in parallel (your hips joints below your knee), it’s enough.

If you have trouble to squat down at the parallel, it could have several causes : little mobility to your ankles, to your hip flexor or your hamstrings ; weak glutes ; poor pelvic alignment (among many other things).

Knee position

squat knee position

To do a good squat, you must have your knees aligned with your toes. As the body of every human being is unique, the position is slightly different from one person to another but your knees shouldn’t be too much outside or too much inside. Your knees are more or less in the center.

Back position

squat back position

During the whole squat, you need to have your torso up and your shoulders back. This position allows you to have your spine in a « neutral » position. This avoids having your back in hyper extend and not having your shoulders rounded forward.

Head position

squat head position

There are people (even personal trainers) who will tell you to look up or down. Let’s test it right away with an anatomical version.

When you look at the ceiling, your cervical spine is in an unsecured position and when you add weight, it becomes dangerous. Look at the ground is not better.

You need to have your head in a « neutral » position. To be able to do this, look straight in front of you. Focus on a point in front of you so that you’re able to hold a tennis ball between your chin and your torso.

Too much weight on heels and inside/outside of the feet

Often, when we’re beginners, we are so focused on putting the weight on the heels and having a good position with the knees we forget to keep the ball on the floor. You need to divide some of the total weight on the ball of the feet because it’s very difficult to keep the balance when all the weight is on your heels.

It’s the same for the inside or outside of your feet. As you put the total weight on your heels, you try to keep balance with the inside and outside of your feet. Keep the ball of your feet on the floor to distribute part of the total weight and it will be easier to keep the balance.

Complex

complex

Don’t worry, I also had difficulties to do a squat with a good technique. I’ll explain to you something I used to learn the technique. Using a box or a bench is also useful for people who have knee problems and can no longer do bodyweight squat.

Using a box/bench is great for learning to squat down by distributing well the total weight between the ball of your feet and your heels rather than on your knees and toes.

Find a box/bench that allows you to be in parallel with your squat when you’re sitting on it.

The lower the box/bench is, the more it will help you to have stronger hips. If the box/bench is exactly parallel, it will help you to have stronger quadriceps. If you’re a squat beginner, don’t worry, a box/ bench at the right height for you to be in parallel or a little below when you squat down is perfect.

Let’s go to do bodyweigth squat. Put the box/bench behind you and do one step forward.

Inspire, throw your butt back, keeping your knees aligned with your toes and squat down until your sit completely on the box/bench. Keep your body contracted and control movement.

When you seated, don’t move and study your position. Is your back and core contracted ? Is the total weight distributed between the ball of your feet and heels ? Is your head in a neutral position ? Once you answered these questions, you can get up by using you hips up. Don’t shift the weight forwards on your toes to help you get up. Use your heels, keep your shoulders back with your chest up and keep your knees aligned with your toes.

After some sets, you’ll understand how to better use your body and you’ll be able to make the movement in a fluid way.

You’ll know when you’re doing a good squat. This is when you’re in the low position of squat and when you get up, you don’t swing forward but you put the weight on your heels.

Long life to squat

Squat is cool

Ok, the majority of people say that squat is bad for knees but the truth is that it’s the safest movement and one of the best to improve your knees health (when the squat is done with a good technique). This help to strengthen your knees, improve your stability and reduce the risk of injury. This is valid for people over 60 years old.

If you already have a knee problem or have pain with squat and think your do squat with a good technique, you need to see a doctor or a physical therapist to check your knees.

What are your difficulties when you try squat ?

Share this article if you think it can help someone you know. Thank you.

-Steph

Back To The Source Of Equipment (Part 2)

source water river

I read a Nerd Fitness articles  and I learned good stuff.

If you didn’t read the part 1, click here

Racks Et Machines

To do squat, there are differents equipements, we name it « racks ». Let’s go.

Squat stands

squat stands

It’s 2 pieces standing, next to each other to hold the Olympic bar. It’s handy because it’s portable and you can do squat outside. But in a gym, it’s not great because you can’t put heavy weights, it’s too fragile.

Squat rack

squat rack

It’s 2 bars that are standing tied with horizontal bars. With the Squat racks, you can put heavy weights.

Power rack

power rack

It’s my favorite. It looks like a large rectangle with poles in vertical and horizontal. The Power racks have holes for placing J-hooks to adjust the height of Olympic bar. What is cool is that you can do several exercices with like pull-up, bench press, overhead press and dips.

Smith machine

smith machine

Smith machine looks like Squat racks except that the bar is guided.

Gym staff will tell you that it’s a machine to do squat safe. I don’t advise to use this machine because it forces your body to make unnatural movements. This scientific study (https://www.ncbi.nlm.nih.gov/pubmed/19855308 ) shows that you have better results with a squat with free weights.

The difference between Squat racks and Smith machine is that the bar where you put weights is fixed on Smith machine.

Weight machine

plate loaded machine weight pin loaded stack machine weight

Weight machines are in 2 categories : Pin loaded (stack machine) and Plate loaded. Pin machines have a rectangular weight stack with a hole to put the pin. More the pin is low, more the weight is heavy to lift. What is cool with this machines is that you don’t need to look for weights anywhere in the gym.

With Plate loaded, there is no weights attached to the machine. You put weights on the machine yourself. Plate loaded machines have a wider range of motion than Pin loaded.

Cable machine

cable machine

No matter the size or design of the cable machie, it will always be a pin loaded (stack machine). A handle is at the end of the cable and you can pull or push in different directions. Cable machine can be an alternative for some exercices you do with dumbbells or barbells. Cable machine has a wider range of motion.

Pull-up Bar

pull up bar

You know in most gyms, there is no real pullup bar (like in my gym). If you don’t find a freestanding bar, there are several alternatives like power rack, smith machine or the top of the cable machine.

Dips station

dips station

Usually dips station is integrated into the power rack or the cable machine. You can find some that are freestanding.

Assisted Pullup /Dip station

assisted pull up

It’s a Pin loaded (stack machine). You choose a weight and you put yourself on the platform. The weight you choose will help you to do pullups or dips. For pullups, I advise you to do Lat pulldown and the day where you can lift your bodyweight, you do freestanding pullup.

Bench

adjustable bench

Ajustables benches and standard flat benches are types of benches you will see in a gym. To do incline and decline exercices, ajustable bench is perfect. Benches are the equipement the most use in a gym, especially on Monday. I don’t know why but Monday is the international chest’s day and it’s hard to find a bench that day.

Bench press

bench press

Squat stand and Squat rack are use to do bench press in small gyms and Crossfit. In big gyms, there are special bench press with a stand attached.

Equipement items

Now you know the main gym’s equipment, I will show you small equipement items.

Collars/Clips

collar clip

There are several collars/clips designs but they have the same purpose that is to keep weights safe on the bar.


Weight plates

weight plate

There are several type of plates :

  • Standard metal plates/ rubber encased weight plates

    They’re made of metal and they shouldn’t be thrown to the ground. There are circle with the denomination of weight on. Depending on the weight, they have different diameters.

  • Bumper plates

    They’re made of rubber and can be thrown to the ground for above your head (clean and jerk).

Plates can have a denomination in kilograms or pounds :

Kilogramme : 1, 1.5, 2, 2.5, 5, 10, 15, 20 et 25kg

Pound : 2.5, 5, 10, 25 ou 45lbs.

You can also find plates with a combination of metal and rubber that can be thrown to the ground but not from aboe you head.

Kettelbells

kettelbell

This is looks like a cannon balls with handles. Most gym don’t have the same weight repertoire than dumbells but it’s possible to find kettelbells of 24kg (53lbs) and 31.75 (70lbs) and more.

GHR/GHD Machine

ghr ghd machine glute ham raise developer

The translation is « Glute Ham Raise » or « Glute Ham Developer ». With this you can do glute ham raise, back extension or sit ups.

Prowler/Dragging sled

prowler dragging sled

Put weights on a prowler and push or pull while you run.

Strongman equipment

strongman kegs yokes hammers tires atlas stone

If you don’t intend to make a strongman competition, kegs, yokes, hammers, tires and atlas stones are good to do from time to time.

Plyo Boxes

plyo Boxe

These boxes have several size. You jump on and off of.

Bands

band

Those are big rubber bans to work mobility and speed lifts.

Gear

It’s funny because people ask me often : « What do I wear ? ». I noticed in gyms, it’s often a fashion show. It’s for this reason beginners are impressed. Unless you have an injury, clothes don’t matter. When I started, I took some clothes that I rarely used and I always do that. Sometimes I see people with cool clothes and I say to myself : « Wow, I have to buy it » and when I see theirs performances I say to myself : « Pffff, show-off ! ».

Clothing

Gym isn’t a fashion show. You’re not going to win a prize because you’re well dressed. We’re here to sweat so wearing comfortable clothes. You know, my clothes and shoes are torn and the funny thing is that people ask me, if they can train with me because they see my body evolve.

Shoes

squat deadlift shoes classic converse chuck taylor all star

It’s important to have a good pair of shoes to do deadlift and squat. A good pair of shoes allows you to put your weight on your heels to be as stable as possible. Running shoes don’t allow you to do this because their soft soles. If you don’t have the budget for this type of shoes, the classic Converse Chuck Taylor All Star works well and is what many top powerlifters still wear.

Personally I use my Converse Chuck Taylor All Star for my strenght training and my Puma to run.

Gloves

Gloves are used to protect hands from callouses. At the beginning, I wore gloves and I still had callouses and sometimes my hands slipped inside gloves because of the sweat. I notices that gloves could also mess up your grip and technique. I don’t use gloves and I don’t recommand to have gloves.

Knee/Wrist wraps

knee wrist wraps

Wraps allow you to have support and stability when you lift heavy weights (squat/deadlift).

Straps

straps

Straps allow you to hold the bar longer in your hands. Straps are wrapped around the bar which relives your grip. It’s excellent for intermediate and advanced lifters. Beginners don’t need to use it.

Weightlifting Belt

weightlifting belt leather weightlifting belt velcro

There are 2 type of weightlifting belt : leather or velcro. It’s very usefull for intermediate and advanced lifters. I use my weightlifting belt only for deadlift and squat.

Stop, stop, stop, I see you start to worry about buyiing all this. Don’t panic, the most important thing to have is a good pair of shoes to get started. It’s simple, let’s go my friend.

Whats’s the biggest mistake you made when you started lifting ?

Share this article if you think it can help someone you know. Thank you.

-Steph

From Exercise Machines To Free Weights

machine free weights

I read a Nerd Fitness article  and there is good stuff.

Very often in gym’s advertisements, we watch a lot of high-tech machines to do exercises and the free weight zone is a small hidden room.

What I see in my gym, it’s people start their training with a little bit cardio and they use machines. They do this because it’s easier and this look more secure. Unfortunately, this is not the reality. The Matrix trap us with these machines.

Attention : If you have a medical prescription or you need to use machines for a special reason, continue to follow your training program prescribed by your doctor or physiotherapist.

Why

why

The truth is that machines force muscles and joints to make movements that aren’t natural.

Machines force your body to move weights in a single pattern (up – down or left – right). Our bodies naturally don’t move like it, this is the problem. Movements or our bodies aren’t straight lines, it’s rather « S ». The result is that machines develop our muscles in a way that isn’t balanced and they endanger our joints and spine.

Like you can see, machines don’t put your body in safety and in addition, they don’t work your stabilizing muscles. Don’t work stabilizing muscles is very bad for everyday activities.

When you bent forward to take something on the floor, you body use a dozen and a dozen muscles at the same time. But since you no longer work your stabilizing muscles because of machines, your muscles don’t know how to work together so your body uses a muscle.

Study case

« Smith Machine » is famous to do squat in safety so it protects your back. Lie ! This machine is perfect to destroy your back and compressed your spine because this machine force your body to move only up and down. The real squat allow to do the fundamental movement and when you do it, you notice that your body doesn’t do a straight line from up to down. With the real squat you do a natural movement.

Do exercise with weight or with bodyweight is more efficient to burn calories than machines.

Full body

full body

All exercises classified in 2 categories : pull and push

I remember, I did a full body training program for 1 year before lift weight. This is what my Taekwondo’s teacher advised me and he was right (wow, Korean wisdom). A full body training program, 3 times per week is more efficient than a machines training program, 5-6 times per week for beginners. If you want to train more, you can do Tai-Chi or walking during rest days.

Full body is important

With full body, you learn to each body’s muscle to work together, you synchronize you body. This is allow you to be healthy, avoid using too much a muscle and avoid injury due to a weak stabilizing muscle. To maximize your body, eat healthy and you’ll burn more fat, build muscle and build a body of which you’re proud.

What is great with a full body training program, it’s when you skip a training day, it doesn’t matter. You’ll not have certain muscle more developed than any others because each training session work all body’s muscles

Bodyweight (full body)

bodyweight training

Mastering basics movements with bodyweight is perfect to prepare you for a training with weights.

It’s primitive movements therefore natural that allow you to become stronger without material.

The best example are gymnasts. Look gymnasts body, it’s amazing, impressive and the majority of their training are with bodyweight exercises.

Basic exercises

  • Push = push up, dips, handstands

  • Pull = pull up, body rows

  • Legs = bodyweight squat, pistols squats, lunges, box jumps

For each exercise, you do 2-4 sets of 8-10 repetitions.

No it’s too simple  ! => Do this training program and if it’s too easy, increase the difficulty. You can do push up with one hand or pull up with one hand (like my friend Inti). You can also add more set ou repetition.

No it’s too difficult => Do this training program and if it’s too difficult, decrease the difficulty. You can do sets of 3 repetitions. The principle is you progress to do 4 sets of 10 repetitions. Take your time but be regular.

No I want abs => When you do squat, push up and pull up, you keep your core tight and by this way you work your abs. But if you want to do an exercise specially for abs, you can to plank and side plank.

Strength training (full body)

strength training

It doesn’t matter whether you’re a man or a woman, dumbbells and barbells are your friends.

Basic exercise

  • Push = Bench press, Overhead Press

  • Pull = Deadlift, Bent Over Row

  • Legs = Squat, Deadlift

For each exercise, you do 2-4 sets of 8-10 repetitions.

No I don’t like squat => Do you think squat is an useless exercise ? I advise you to read the book of Mark Rippetoe. If you seriously want to train, this book is for you !

No I afraid of weights => Don’t panic. Most people in free weights section are too busy to look at themselves in the mirror, they will not look at you. You can use a barbell or dumbbells for each exercise to improve your pure strength. I advise you dumbbells.

No I’m afraid of being ridiculous => Everybody don’t care if you life a dumbbell of 4kg (8.8lbs) or you squat 181kg (400lbs) because everybody struggle to do their training program. Forget people, stay focus and do you training program until the end.

But if I do bad => At the beginning use light weight to do movements with the good form, the good technique. When you’ll stronger, you’ll can add weight slowly each week to reach your limit. You can hire a personal trainer for 1-2 sessions to learn and improve basic exercises techniques or form.

No I want only lose weight => It’s simple, you do basic exercises and you eat less. The training is the same for lose weight or gain muscle. It’s diet that make the difference ! It’s a science :

  • Eat more calories than you burn = gain weight

  • Eat less calories than you burn = lose weight

Your physical condition, it’s 80 % diet and 20 % training. If you want bulk, you need to have a specific diet to do this.

Track and adjust slowly your training program and your diet to see your progress.

No matter what you do, don’t be afraid of the free weight zone. Remember than 90 % of people inside are focus to do their exercises by looking in the mirror therefore don’t worry. Do your exercices, become better and become stronger.

What do you feel when you train with free weights ?

-Steph