Re: Improving Active Flexibility

[Guest guest]

Rajinder Johal wrote:

<Can anyone recommend a training or therapeutic method to enhance

the active range of motion of the hamstring when performing a leg curl? Since

a knee injury I have been unable to achieve parity with my

right leg despite various stretching and training protocols. I

consulted " Supertraining " but it is more concerned with improving flexibility

of the muscles in an extended rather than flexed range. >

Mel Siff:

< Of course " Supertraining " is concerned with range of movement

when the muscle is nearing its limits of full extension! How on earth can

flexion of a joint produce flexibility in the muscles which flex the joint??

If you wish to increase the range of movement in a leg curl, then you can

only increase it by moving into full EXTENSION. Anyway, research from

physical therapy is revealing that there appears to be a correlation between

leg curls and hamstring injuries, so that leg curls are not the most

effective and safest way of conditioning or 'stretching' the hamstrings.

What makes you conclude that you do not have sufficient knee

flexibility in flexion? >

Rajinder Johal :

Regardless of whether I am in a standing, seated, or prone position I

am unable to bring my left heel as far back towards my buttocks as I

can with my right leg. The difference between legs amounts to 4 or 5

inches. However if I initiate the leg curl using a ballistic movement

I can achieve a greater ROM. I can also bring my heel to my buttock

if I use my hand on my leg to complete the leg curl.

<What do you mean by 'flexed range', anyway? >

Rajinder Johal :

Whilst I appreciate the need to be flexible as muscles reach full

extension, my situation is comparable to a bodybuilder who can fully

straighten both arms but when he performs a biceps curl is unable to

bring one arm as high up as the other.

<Your problem is not really clear. >

Rajinder Johal :

Since undergoing knee reconstruction on my left knee, I have had a

problem with knee ligament laxity which apparently cannot be helped.

However my physio who has worked extensively with various

professional sportsmen and celebrities feels my main problem is an

inability to rapidly recruit the left hamstrings as measured using an

isokinetic machine and ultrasound scan, and as I say, having a

smaller active ROM when contracting the left hamstring.

These two problems are clearly associated along with the fact that

the short head of my biceps femoris is only half the size of my right

legs. All these factors impinge on my dynamic stability and strength

levels but despite training for some time with him I have not really

made the progress I would have wished.

Your suggestion to improve hamstring flexibility in an extended range

to improve ROM in a leg curls is one which hasn't really worked for

me though.

[As far as I know, I have not suggested that you do anything yet. I was

simply questioning your diagnosis that your major problem has to do with

'flexion flexibility'. You should have judged from the tenor of my response

that I was doubting that this is the source of all your problems. Mel Siff]

Similarly isometric holds whilst curling my left leg as

far as I can has done little to improve the ROM in the leg curl. Any

suggestions or advice would be much appreciated.

[before I suggest anything, try this question for size: What other hamstring

exercises have you used or considered using? Have you decided to rely

more on isolated hamstring training or more integrated hamstring, gastrocnemius

and glute development using standing or running exercises on land and in water?

Answering these questions will help guide you in a better direction. Mel Siff]

Rajinder Johal

London,UK

[Guest guest]

Rajinder

Have you tested the flexibility in your quads. If they are tight it might inhibit you from flexing your knee. We often use bum flicks or standing knee flexion to assess a possibility of tightness in the knee extensors.

As I am sure you know, the quads can shorten after knee ops and injuries.

I hope that this is of assistance.

(where in London are you based)

Stephon Healey

London UK

[Guest guest]

Rajinder Johal wrote:

> <Can anyone recommend a training or therapeutic method to enhance

> the active range of motion of the hamstring when performing a leg

>curl? Since a knee injury I have been unable to achieve parity with my

> right leg despite various stretching and training protocols. I

> consulted " Supertraining " but it is more concerned with improving

>flexibility of the muscles in an extended rather than flexed range. >

Mel Siff:

<Of course " Supertraining " is concerned with range of movement

when the muscle is nearing its limits of full extension! How on

earth can flexion of a joint produce flexibility in the muscles which flex

the joint?? If you wish to increase the range of movement in a leg curl, then

you can only increase it by moving into full EXTENSION. Anyway, research

from physical therapy is revealing that there appears to be a

correlation between leg curls and hamstring injuries, so that leg curls are not

the

most effective and safest way of conditioning or 'stretching' the

hamstrings.

What makes you conclude that you do not have sufficient knee

flexibility in flexion? >

Rajinder Johal :

<Regardless of whether I am in a standing, seated, or prone position

I am unable to bring my left heel as far back towards my buttocks as

I can with my right leg. The difference between legs amounts to 4 or

5 inches. However if I initiate the leg curl using a ballistic

movement I can achieve a greater ROM. I can also bring my heel to my buttock >

if I use my hand on my leg to complete the leg curl.

<What do you mean by 'flexed range', anyway? >

Rajinder Johal :

<Whilst I appreciate the need to be flexible as muscles reach full

extension, my situation is comparable to a bodybuilder who can

fully straighten both arms but when he performs a biceps curl is unable

to bring one arm as high up as the other. >

<Your problem is not really clear. >

Rajinder Johal :

> Since undergoing knee reconstruction on my left knee, I have had a

> problem with knee ligament laxity which apparently cannot be

> helped. However my physio who has worked extensively with various

> professional sportsmen and celebrities feels my main problem is an

> inability to rapidly recruit the left hamstrings as measured using

>an isokinetic machine and ultrasound scan, and as I say, having a

> smaller active ROM when contracting the left hamstring.

>

> These two problems are clearly associated along with the fact that

> the short head of my biceps femoris is only half the size of my

> right legs. All these factors impinge on my dynamic stability and

> strength levels but despite training for some time with him I have not

> really made the progress I would have wished.

>

> Your suggestion to improve hamstring flexibility in an extended

> range to improve ROM in a leg curls is one which hasn't really worked for

> me though.

Mel Siff:

<As far as I know, I have not suggested that you do anything yet.

I was simply questioning your diagnosis that your major problem has to do

with 'flexion flexibility'. You should have judged from the tenor of my

response that I was doubting that this is the source of all your problems. >

<Similarly isometric holds whilst curling my left leg as

far as I can has done little to improve the ROM in the leg curl.

Any suggestions or advice would be much appreciated.

Mel Siff:

<Before I suggest anything, try this question for size: What other

hamstring exercises have you used or considered using? Have you decided to

rely more on isolated hamstring training or more integrated hamstring,

gastrocnemius and glute development using standing or running exercises on land

and in water? Answering these questions will help guide you in a better

direction. >

--------------------------

Well I certainly appreciate any advice you can offer. To briefly

recap, I incurred a major knee injury on Feb 1997. By June of that

year, after becoming impatient with the advice of a hospital

appointed physio I hit the weights room. Gradually, over three years

I probably tried every method of training around to stabilise the

laxity in my joint and improve hamstring strength/ " flexion

flexibility " . This included copious amounts of deep squats,

deadlifts, stiff-legged deadlifts, uni-lateral curls, one-legged

squats, and one-legged deadlifts. Despite gaining some strength, my

problems remained.

Of note is the fact that when performing deep squats I would have a

problem recruiting my left hamstring since the bottom of the squat

would correspond with the hamstring being maximally flexed -a

position where I have no strength whatsoever and would be unable to

reach unsupported,i.e. without the weight of my body bringing my

buttocks to my heels in a squat. I should add that my leg work, bar a

period of two months in 1999 still took place within the parameters

of a normal resistance training program with legs trained every five

days.

Since November I have been seeing a new physio recommended by a

sports doctor. He initially placed me on a high volume program of

resistance training working 3 x a week. Virtually all the work was in

partial ranges of motion using machine exercises working all the

major muscle groups of the leg in a uni-lateral manner. Since January

the intensity has increased although the frequency has increased to 4

x week. He has increased proprioceptive work such as hopping

exercises using bands and in the pool initially, and recently

encouraging the use of basketball sessions 2-3 x a week.

I also managed to persuade him that I should work the hams in their function

as extensors through the use of deadlifts although he does not want

me to go heavy and lose form. These deadlifts are currently the only

full ROM exercises I am doing for the hamstrings, the rest being

partial work, specifically when the knee is bent between 80-120

degrees as in a leg curl. He has allowed me to implement light

squatting but advised me not to go deep to avoid aggravating my PCL.

Instead he has advised squatting between 70-90 degrees, I believe to

avoid excess compressive forces on the knee.

Despite all of this, my flexibility in a flexed range for want of a

better description remains poor and the difference in the speed of

recruitment between the left and right hamsrings is marked, perhaps

because of the fact that the short head of the biceps femoris on my

left leg is markedly smaller than the right leg. Interestingly, not

only can I not curl my left leg as far back as my right leg through a

voluntary muscle contraction, but even lying on my back with my knees

bent above my chest, the right leg will naturally curl further back

than my left despite me not contracting the muscle in either leg,

instead allowing the knees to bend under the weight of my calves.

Although my original injury was severe (torn ACL, LCL,ilio-tibial

tract, biceps femoris tendon, plus collateral damage to the lateral

side of the knee, and partial tear of the PCL) examination via MRI's

and ultra-sound show relatively little problem with calcification and

scar tissue, most of which is on the lateral side of the knee. Oddly,

both my sports doctor and physio have identified the PCL as being the

most unstable of my ligaments, perhaps due to my emphasis on deep

squatting.

It is the complexity of my injury which led me to seek a

consultation with yourself, Dr Siff, when you lecture in Wales later this year.

Failing that, I would be grateful if there is someone you could

recommend in England who you feel could help. I would even consider

travelling to Denver if I felt there was a legitimate chance at

regaining full function in the left leg. In the meantime any

suggestions you may have would be gratefully received.

Rajinder Johal

London,UK

[Guest guest]

Rajinder Johal wrote:

> <Can anyone recommend a training or therapeutic method to enhance

> the active range of motion of the hamstring when performing a leg

>curl? Since a knee injury I have been unable to achieve parity with my

> right leg despite various stretching and training protocols. I

> consulted " Supertraining " but it is more concerned with improving

>flexibility of the muscles in an extended rather than flexed range. >

Mel Siff:

<Of course " Supertraining " is concerned with range of movement

when the muscle is nearing its limits of full extension! How on

earth can flexion of a joint produce flexibility in the muscles which flex

the joint?? If you wish to increase the range of movement in a leg curl, then

you can only increase it by moving into full EXTENSION. Anyway, research

from physical therapy is revealing that there appears to be a

correlation between leg curls and hamstring injuries, so that leg curls are not

the

most effective and safest way of conditioning or 'stretching' the

hamstrings.

What makes you conclude that you do not have sufficient knee

flexibility in flexion? >

Rajinder Johal :

<Regardless of whether I am in a standing, seated, or prone position

I am unable to bring my left heel as far back towards my buttocks as

I can with my right leg. The difference between legs amounts to 4 or

5 inches. However if I initiate the leg curl using a ballistic

movement I can achieve a greater ROM. I can also bring my heel to my buttock >

if I use my hand on my leg to complete the leg curl.

<What do you mean by 'flexed range', anyway? >

Rajinder Johal :

<Whilst I appreciate the need to be flexible as muscles reach full

extension, my situation is comparable to a bodybuilder who can

fully straighten both arms but when he performs a biceps curl is unable

to bring one arm as high up as the other. >

<Your problem is not really clear. >

Rajinder Johal :

> Since undergoing knee reconstruction on my left knee, I have had a

> problem with knee ligament laxity which apparently cannot be

> helped. However my physio who has worked extensively with various

> professional sportsmen and celebrities feels my main problem is an

> inability to rapidly recruit the left hamstrings as measured using

>an isokinetic machine and ultrasound scan, and as I say, having a

> smaller active ROM when contracting the left hamstring.

>

> These two problems are clearly associated along with the fact that

> the short head of my biceps femoris is only half the size of my

> right legs. All these factors impinge on my dynamic stability and

> strength levels but despite training for some time with him I have not

> really made the progress I would have wished.

>

> Your suggestion to improve hamstring flexibility in an extended

> range to improve ROM in a leg curls is one which hasn't really worked for

> me though.

Mel Siff:

<As far as I know, I have not suggested that you do anything yet.

I was simply questioning your diagnosis that your major problem has to do

with 'flexion flexibility'. You should have judged from the tenor of my

response that I was doubting that this is the source of all your problems. >

<Similarly isometric holds whilst curling my left leg as

far as I can has done little to improve the ROM in the leg curl.

Any suggestions or advice would be much appreciated.

Mel Siff:

<Before I suggest anything, try this question for size: What other

hamstring exercises have you used or considered using? Have you decided to

rely more on isolated hamstring training or more integrated hamstring,

gastrocnemius and glute development using standing or running exercises on land

and in water? Answering these questions will help guide you in a better

direction. >

--------------------------

Well I certainly appreciate any advice you can offer. To briefly

recap, I incurred a major knee injury on Feb 1997. By June of that

year, after becoming impatient with the advice of a hospital

appointed physio I hit the weights room. Gradually, over three years

I probably tried every method of training around to stabilise the

laxity in my joint and improve hamstring strength/ " flexion

flexibility " . This included copious amounts of deep squats,

deadlifts, stiff-legged deadlifts, uni-lateral curls, one-legged

squats, and one-legged deadlifts. Despite gaining some strength, my

problems remained.

Of note is the fact that when performing deep squats I would have a

problem recruiting my left hamstring since the bottom of the squat

would correspond with the hamstring being maximally flexed -a

position where I have no strength whatsoever and would be unable to

reach unsupported,i.e. without the weight of my body bringing my

buttocks to my heels in a squat. I should add that my leg work, bar a

period of two months in 1999 still took place within the parameters

of a normal resistance training program with legs trained every five

days.

Since November I have been seeing a new physio recommended by a

sports doctor. He initially placed me on a high volume program of

resistance training working 3 x a week. Virtually all the work was in

partial ranges of motion using machine exercises working all the

major muscle groups of the leg in a uni-lateral manner. Since January

the intensity has increased although the frequency has increased to 4

x week. He has increased proprioceptive work such as hopping

exercises using bands and in the pool initially, and recently

encouraging the use of basketball sessions 2-3 x a week.

I also managed to persuade him that I should work the hams in their function

as extensors through the use of deadlifts although he does not want

me to go heavy and lose form. These deadlifts are currently the only

full ROM exercises I am doing for the hamstrings, the rest being

partial work, specifically when the knee is bent between 80-120

degrees as in a leg curl. He has allowed me to implement light

squatting but advised me not to go deep to avoid aggravating my PCL.

Instead he has advised squatting between 70-90 degrees, I believe to

avoid excess compressive forces on the knee.

Despite all of this, my flexibility in a flexed range for want of a

better description remains poor and the difference in the speed of

recruitment between the left and right hamsrings is marked, perhaps

because of the fact that the short head of the biceps femoris on my

left leg is markedly smaller than the right leg. Interestingly, not

only can I not curl my left leg as far back as my right leg through a

voluntary muscle contraction, but even lying on my back with my knees

bent above my chest, the right leg will naturally curl further back

than my left despite me not contracting the muscle in either leg,

instead allowing the knees to bend under the weight of my calves.

Although my original injury was severe (torn ACL, LCL,ilio-tibial

tract, biceps femoris tendon, plus collateral damage to the lateral

side of the knee, and partial tear of the PCL) examination via MRI's

and ultra-sound show relatively little problem with calcification and

scar tissue, most of which is on the lateral side of the knee. Oddly,

both my sports doctor and physio have identified the PCL as being the

most unstable of my ligaments, perhaps due to my emphasis on deep

squatting.

It is the complexity of my injury which led me to seek a

consultation with yourself, Dr Siff, when you lecture in Wales later this year.

Failing that, I would be grateful if there is someone you could

recommend in England who you feel could help. I would even consider

travelling to Denver if I felt there was a legitimate chance at

regaining full function in the left leg. In the meantime any

suggestions you may have would be gratefully received.

Rajinder Johal

London,UK

[Guest guest]

> Rajinder

>

> Have you tested the flexibility in your quads. If they are tight

it might

> inhibit you from flexing your knee. We often use bum flicks or

standing knee

> flexion to assess a possibility of tightness in the knee

extensors.

Well if I understand what you mean by bum flicks I can flick my bum

using my right leg if I use momentum at the top of the movement. I

can almost do likewise with the left. In a lying position I can flick

my bum using both legs, but again only if momentum is used. In a slow

movement the difference between legs is marked. I raised the issue of

inflexible quads/psoas limiting my ROM with my physio but since I

don't feel them being stretched whilst I perform a curl he discounted

the notion.

>

> As I am sure you know, the quads can shorten after knee ops and

injuries.

I wasn't aware of that. If anything my hamstring appears to have

shortened. My left ankle is also relatively inflexible since injury

but flexible enough to perform deep squats unhindered.>

> I hope that this is of assistance.

>

> (where in London are you based)

Thanks for your input. I'm not really based full-time in London until

later this month when I'll be moving to Islington. For the past few

months I've been living in Wembley, Chiswick, and lately Halifax. My

physio is based in Chiswick though and I'll be seeing his assistant

for electrotheraphy tomorrow, and seeing him properly on March 13.

Are you also a physio? Whereabouts in London? Thanks again for your

input.

Rajinder Johal

London,UK

>

> Stephon Healey

>

> London UK

[Guest guest]

Rajinder

Have you tried one legged medicine ball pick ups? We use them as part of a

functional warm up for the hamstrings.

Standing on one leg, elevate your other leg behind you and lean your torso

forward and aim to get horizontal. Pick up the medicine ball and simultaneously

move your leg and torso to an upright position whilst contracting the hamstrings

to assist the movement.

This can be done with numerous variations in weight and foot placement.

When you get to London you must contact me and come to the clinic.

Stephon Healey

London UK