Getting access to the REP Biomechanics Lab in Bend, Ore., is like being granted a golden ticket inside Willy Wonka’s Chocolate Factory. This is where the real magic happens. We all see the pros toeing the starting lines, looking unbelievably fit and ready to race for the win, but for many athletes what goes on in the weeks and months before a race is no longer just miles in the saddle. Much of a professional triathlete’s life is still spent outside putting in the mileage, but the hard truth is that the smart athletes are also spending an impressive amount of time on “pre-hab”— basically a trendy word for injury prevention and biomechanical efficiency training. For the Bend-area pro athletes at REP Lab (Linsey Corbin, Matt Lieto, Jesse Thomas, Chris Horner, Ryan Trebon, Lauren Fleshmann and Carl Decker just to name a few), pre-hab goes beyond just lifting a barbell or foam rolling for five minutes a day. Under the tutelage of physical therapist Jay Dicharry, they are building their bodies from the ground up, using his three principles of fitness: strength, mobility and stability. “More often than not, when someone gets an overuse injury it’s not necessarily caused by just a weakness of a muscle, it’s because of instability within a joint,” says Dicharry.
When it comes to the common overuse injuries Dicharry most often sees among triathletes, he estimates that anterior knee pain (runner’s knee), shoulder impingement and low back pain are the clear winners. For part one of our series with REP Lab’s Dicharry, we’ll look at a fast way to diminish knee pain in one week:
Anterior Knee Pain Causes
According to Dicharry, triathletes, runners and cyclists are prone to anterior knee pain because of repetitive motion in the sagittal (forward) plane. “Overdeveloped quads can pull the patella (knee cap) out of it’s normal movement pattern which causes the pain.” While dealing with knee pain at REP Lab means finding the root cause of the problem, Dicharry first helps his client stop the pain with some ART techniques before diving in to see what muscle weakness, joint instability and mobility issues are causing it to begin with.
ART Techniques For Anterior Knee Pain
Getting rid of knee cap pain is relatively easy, says Dicharry, but once the pain subsides he recommends you work with a physical therapist to determine what your particular movement patterns are, and work with them on developing stability, mobility and strength throughout your body for peak performance. But, if you’re in the middle of training and you don’t want to be sidelined indefinitely, Dicharry recommends ART of your “supra patella pouch” to release the tightness that is causing the kneecap to track inefficiently. The tool Dicharry uses most often for ART releases can be found at your local sports equipment store: a lacrosse ball. Place the lacrosse ball roughly 1.5 inches above the knee cap (see photo above) and lie down on your stomach so that you feel the pressure of the lacrosse ball in the ground (Ed Note: you know you’ve found the right spot when it is REALLY uncomfortable). Gently roll over the ball (up and down, side-to-side) for three minutes, then repeat on the other knee. “If you are diligent and do this five-to-six days a week, you should be pain-free in roughly one week,” says Dicharry.
Stay tuned for our next REP Lab Tutorial on shoulder impingement. To learn more about Jay Dicharry go to reporegon.com.