Unfortunately, this movement pattern is all too common in our athletes. We may think we may only see this in the untrained or lower level high school athlete. The reality is that we see this across the entire spectrum from high school athlete, to college, to Olympic to professional athlete. Part of the reason we often don't see it is that we are not assessing for it or recognizing it during training.
The severity of the of the frontal plane motion (both amount and speed) can dictate how much this will impact an athlete's risk and the impact that this will have on performance. So as the increase in magnitude or speed of valgus increases, so does the risk and the impact on performance. The impact of frontal plane control is not only determined by how much and how fast the athlete moves into valgus but at which point during your assessment.
For example, compare the following athletes.
- Athlete A starts to fall into valgus on rep one
- Athlete B starts to fall into valgus on rep one at a high rate of speed
- Athlete C starts to fall into valgus at rep 8
- Training needs to include single limb training - ensuring to put the athlete in positions that allow them to successfully control frontal plane motion. If this is a single leg squat in a stride stance or single leg squat with contralateral leg in the athletic position or single leg plyos doesn't matter. As long as the athlete is controlling frontal plane motion. When they can no longer control that frontal plane motion, then should move to a lower level of the exercise to allow them to keep training while controlling that motion.
- If there is high amounts of valgus and at high speeds, then there is the need to make sure to include core training and focusing on maintaining control at the hips. Control of the hips means we want to prevention the athlete from falling into a trendelenburg, retro-trendelenburg or cork screw.
- We need to train for some level of fatigue in single limb training. We know that fatigue impacts lower extremity mechanics and force attenuation in runners (Weist et al Am J Sport Med 04) and there is an increase in frontal plane motion with fatigue (Brazen et al Clin J Sport Med 10). Therefore bringing fatigue into the equation is needed and to keep them training in this fatigued state with good mechanics. This ensures that when they are fatigue in competition or practice that they are moving better and at decreased risk for injury.
- Train in the athletic position. There is a trend to train folks in a pistol squat position or with the leg in the forward position (Position A). Studies show that this is an effective position for strengthening the quads. However, this is not the position that athletes injure themselves in competition. The core, the limb and center of mass are positioned in a different position. Therefore, from a specificity, it makes sense to train in more of an athletic position (Position C). This position has a lot more core, pelvic and glut activation.