02-05-2016, 11:08 PM
(02-05-2016, 08:04 PM)Doc D Wrote: Try standing more (I'm typing at a standing desk right now). Sitting tends to reinforce a variety of patterns and restrictions deleterious to bodily health and function. When you're standing, make sure to avoid anterior pelvic tilt, and take advantage of the position to fire your glutes as hard as you can (use hands on each side to confirm that you are also contracting the gluteus medius, not just maximus). This is also a great chance to practise locking your core as hard as possible at the same time (the co-contraction is invaluable when squatting etc.).
Standing also gives you the chance to drop down into a deep squat a few times a day and stay down in the hole (30 secs is good - no reason not to do 5 mins or so if you feel like it). Make sure that your knees track out - you can even use your elbows against inner thigh to push out. Learning to create a nice space into which your gut can drop when squatting is a very useful skill...
Training the VMO to fire is, I found, fantastically difficult, esp. in the presence of patellar pain. Petersen step-ups, terminal knee extensions with bands, EMS units etc. - everything that one could try in order to 'isolate' the VMO - was less effective for me than viewing the pain as a systemic symptom. Once the systemic issues have been addressed, it then becomes possible to perform movements in a way that allows the affected area to re-learn correct function within the context of a coordinated muscular effort. It seems counter-intuitive, but over the years, I've tended to find that resolution of a problem in a specific area will depend on identifying causes which lie elsewhere (and often where one would not originally have thought to look). But 'tightness' in gluteus medius is always a good place to start when addressing lateral knee pain...
Thanks Doc, I will try being more on my feet's, do small walk around´s.
I will come back when I have implemented all your guys advices and tell if there was any help.