Last week, we caught up with a number of pro athletes in the Exos training facility just outside of Dallas.
I noticed that one of the athletes had been instructed to do “quad sets,” but was having a difficult time activating the quad, due to a few common compensation patterns that set in after knee surgery.
Quad sets are probably familiar to anyone who has gone through the ACL rehab process, as they are commonly used early on to rebuild the neuromuscular system’s connection to the quadriceps muscle.
You simply sit on the table with your leg extended and contract the quad as hard as you can.
Even with an exercise that’s so simple, there are plenty of ways for the body to cheat. And when we cheat, it means we aren’t spending our time rehabbing as efficiently as possible. We aren’t getting the most out of every rep, every minute of the rehab process to ensure we come back as quickly and safely as possible.
We are cheating ourselves. And we might not even know it.
The thing is… most trainers and PTs are so busy, they can’t always take the time to watch each rep or coach you on how to know when the body is cheating.
As I watched the athlete on the table perform a few reps, I noticed he was getting very little quadriceps activation, and the reps performed weren’t providing much benefit.
Because the body was cheating.
The body believed it had one task: to straighten the knee.
It didn’t care (or know) whether it was using the quadriceps or not.
So, how did it figure out a way to cheat?
First, the athlete’s body was twisting the hips to put more body weight into the knee. Rather than straightening the knee with the quadriceps, he was forcing it to straighten with body weight.
When I saw this, I quickly reviewed the anatomy of the quadriceps with the athlete and pointed to each part of the muscle.
“It has “tie-in” points around the knee and on the very front of the hip. If your goal is to fully activate the quadriceps, you need to keep the hip back and focus like heck on activating it all the way up at its closest point to the hip. Even if it feels like it WON’T activate, the practice of focusing on achieving a great rep will serve you far better than allowing the body to cheat.”
The athlete attempted to a few more reps… and this time with no twisting in the hips.
Much better, but still not perfect. The body had figured out another way to cheat.
Now that he was keeping his hips square, he was lifting them off the table and pushing into the knee with his upper body to straighten it.
I gently pointed this out and he corrected quickly.
He continued to try to activate the quadriceps – this time being armed with the information of HOW his body would try to cheat and the ability to resist against those temptations.
After a few attempts, the quadriceps started activating more fully, from the tie-in at the hip all the way down to the knee.
The exercise went from one in which he was “just going through the motions” without much benefit to one in which he was TRULY re-training the quadriceps to activate.
If I hadn’t taken those few minutes with him, how many reps of quad contractions would he have performed without knowing how to get the MOST out of every single rep? How far would that have set him back in his recovery?
We don’t know the answer, and we never will. Most athletes have no idea if they are doing everything correctly throughout the rehab process – they just hope things go smoothly.
When the rehab process takes a little longer than expected, they get the same canned response – “everyone’s different.”
Is that really what you want to chalk your rehab process up to? Everyone’s different?
Or are you going to make sure you uncover every small detail that can help you get the most out of every minute of the rehab process? At the end of the day, are you going to be 100% CERTAIN there was nothing else you could have done to ensure the best recovery possible?
This is an example of the promise upheld by Accelerate ACL to every athlete we work with. You get a coach that will be with you every step of the way to make every minute of the rehab process count.
Since we work with a limited number of athletes each month, you can be assured no detail will go unturned throughout the recovery process.
If you have questions about this blog or would like us to review the form of your exercises, send an email to firstname.lastname@example.org.