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Garrett McLaughlin, MS, ATC, CSCS, ART

Functional Training // Injury Rehabilitation // Running Analysis

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‘In the Spotlight’ with Jennifer Blindert

January 10, 2021 · by Garrett McLaughlin

In this edition of ‘In the Spotlight’ let’s talk with Jennifer Blindert. Jennifer is a recent participant and co-winner of the RunStrong Challenge. This is no easy feat as she completed each and every task asked of her over the 6-week time period. When it comes to creating reliable results that impact your running, consistency is at the top of the list.

Jennifer and I first started working together to troubleshoot and alleviate persistent hip flexor fatigue/tightness. Hip flexors and hamstrings can commonly feel tight and fatigued for a myriad of reasons. So it’s important look more closely at running form, flexibility, strength, and a handful of other areas.

Over 2-3 months, we were able to make strong improvements to resolve this “tightness” by following a consistent and focused strength training and corrective program. Luckily, Jennifer is hardworking, consistent, and a very good communicator which creates a great situation when it comes to working with clients virtually during the craziness of COVID.

Without further ado, let’s shine the spotlight on…

Jennifer Blindert

Q: Where are you from?

A: “I grew up in Michigan and that is where I currently reside but I lived in Colorado for 7 years.”

Q: What are some of your favorite hobbies?

A: “Running, skiing, swimming, SUPing, gardening, and spending time with my animals (dogs, chickens, and budgies (parakeets)).”

Q: If you could live anywhere in the world where would that be? Why?

A: “Somewhere without ticks! I like Michigan and the seasons but I do not like ticks!”

Q: Is there something unique about you that most people don’t know?

A: “I really like hanging out with my chickens (but most people know that). I also played the trumpet for 12 years but have since focused on my other hobbies.”

Q: Tell us a little about your running background and what is your favorite moment to date?

A: “I started running in middle school when I didn’t make the softball team. I did have some previous experience running from playing soccer. My mom is also a runner, so I grew up in the running community. I ran cross country, indoor track and outdoor track in high school and college. My primary event was the mile (or 1500m) in track but I would occasionally drop down to the 800m and 400m in 4×4 relay. After college, I continued to run road races and have done countless 5k’s, some competitive miles, a couple of 10k’s, and a few half marathons.

One of my most memorable races (and probably my favorite race) was the Bolder Boulder 10k in Colorado. I  trained specifically for the race and my goal was to break 40 minutes because you got a special shirt that said ‘sub 40 club.’ During the race I went through the 5k at 19:58 and thought to myself, “I can’t slow down AT ALL!” Miles 3-4 are always the hardest for me and this race was no exception. I felt awful. Then somewhere in mile 5, I starting feeling better and said to myself “I trained to hard all year for this race to not break 40.” I pushed harder that last two miles than I ever have. It was probably the best mental race I’ve had. I went across the finish line and looked at my watch and saw the :16 and I was disappointed that I came so close and then I realized there was 39 in front of it…39:16! I was so shocked that I broke 40 minutes by over 40 seconds!”

Q: When you first started working with Garrett, what were the goals you wanted to achieve?

A: “I wanted to strengthen my hip flexor muscles because I had been having problems for a while with fatigue and pain in the hip and upper quad area. I wanted to become a stronger runner overall as well. I also wanted some more variety in my workouts to break up the repetitive exercises I had been doing.”

Q: At this point are you still feeling the same hip flexor pain/tightness and how has that changed after modifying your strength training program and adding the RAILs component?

A: “I have not had the hip flexor pain/tightness since the challenge. I have continued the strength training and RAILs which have made a big difference with my balance and mobility and helped train me to engage my core. All of these improvements have taken the stress off hip flexor muscles, so I haven’t had any of those old issues. Yay!”

Q: Oftentimes, the process of progressing a strength training program isn’t always smooth and linear, were there any setbacks along the way? And if so, how did you deal with them?

A: “Yes, my hips were very weak and I tweaked my posterior hip muscle (while washing the dogs). It took a long time for the pain to subside. I wasn’t able to do some of the exercises in my program for a few weeks because of the pain, but Garrett was able to modify my workouts so my muscles could heal and then I able to progress the difficulty of my exercises once again.”

Q: How did your strength training program change after working with Garrett?

A: “I’m not just lifting to ‘check the box’ anymore.  Lifting more weight isn’t necessarily my goal, but being focused on proper form. I do a lot more balancing exercises now, single leg/arm. I also engage my core with every exercise not just the abdominal exercises.”

Q: What is that one thing you dislike the most but continue to work on because you know it will help?

A: “Ugh, planks. I still do them multiple days a week because they really target my weaknesses but they are hard, especially the side variants.”

Q: What are the most noticeable improvements you’ve seen so far with your running?

A: “I have a stronger core (canister-like) and feel more stable and strong during my runs. It’s not noticeable in my running necessarily, but I couldn’t do one push-up before the challenge and now I can do a couple sets of ten!!!”

Q: You were a co-winner of the Fall 2020 RunStrong Challenge and achieved a perfect score… How did you enjoy that program and what contributed to your success in being so consistent over the 6-week time period?

A: “I really enjoyed the challenge. It was great to get a running analysis and a personalized workout plan all from the comfort of my home.  It was also fun to ‘meet’ some new people during such an isolated time and to be able to interact through the Facebook group.

I was determined to not miss any points especially for things that were in my control such as water intake, posting challenge videos, and completing my workouts. Even if I didn’t feel like doing something, I did it anyway because I didn’t want to be out of the running for grand prize, especially for something I could have done. It was the competition that kept me on my toes. I knew the other competitors were not going to miss any points so I couldn’t either! My advice is to not fall behind on anything especially with water intake. I pulled a couple ‘chug at 10 pm’s’ and that’s not fun at midnight…2am…4am….”

Q: Looking ahead, do you have any new goals/races you are working towards?

A: “I would like to run more road mile races again and I plan on doing the Detroit Free Press International Half.”

Q: If you could give advice to the 18 year old you who is getting ready to run in college, what would you tell her?

A: “Work with Garrett first (haha). Or find a college program that has a good strength training coach. It’s so important to get a good base with core strength and overall stability and strength before moving on to more miles or faster miles.”


Thank you for reading this ‘In the Spotlight’ segment. And, a big shout out to Jennifer Blindert. To learn more about the Healthy Running Program, please click here!

Achilles Tendinopathy: Loading Strategies to Restore Pain-Free Function

April 7, 2020 · by Garrett McLaughlin
| Article written on April 7th, 2020 at 12:37pm | Follow Garrett on Facebook and Instagram |

Achilles tendinopathy is a general term used to signify pain, tenderness, and chronic changes to the tendon. On a regular basis, I see a lot of new running clients who enter the Healthy Running Program that display lingering symptoms which have not been fully addressed to resolve the injury process. Symptoms are most commonly seen at the mid-portion of the tendon, although insertional tendinopathy where the tendon and calcaneus meet is also possible. Pathology is often caused by degeneration as opposed to inflammation, and can be developed even before the onset of symptoms. That’s why a progressive and structured strength training program for runners can be valuable to maintain the integrity of this tissue as an injury prevention strategy.

Click here to connect with Garrett about your achilles pain.

Numerous studies have looked at exercise, therapeutic modalities, soft-tissue therapy, braces and splints, and injections as a way to resolve achilles tendinopathy. Exercise consisting of isometrics, eccentric, eccentric-concentric, and heavy slow resistance loading have been popular and continue to be highly regarded and debated as strategies to address overuse tendon injuries. The debate comes from mixed research showing people who respond favorably while others who may not respond quite as well. However, as a form of conservative management, loading the affected tissue should be a priority early within the rehabilitation process before considering other options.

Let’s define the four types of loading strategies…

  1. Isometric loading is when the calf complex is contracting but the achilles is held in a position where it’s length remains constant. This can vary from shortened, mid-length, or lengthened positions depending on your specific needs and presentation.
  2. Eccentric loading consists of an isolated and slow lengthening of the tissue. Do not confuse this with static stretching, as the calf muscle and achilles tendon are shortened and then actively lengthened through their range of motion. Think of assisting yourself up to the top of a calf raise and then emphasizing a slow and controlled contraction on the way down.
  3. Eccentric-concentric loading consists of actively shortening and lengthening of the tissue. During a calf raise, the achilles and calf are used to actively raise up and lower down. This requires equal parts eccentric and concentric contraction.
  4. Heavy slow resistance (HSR) more replicates a strength training type exercise where a greater degree of load is placed on the tissue. Instead of performing a bodyweight only movement, HSR utilizes external resistance to load the calf raise with a barbell or dumbbells.

With each of these types of loading to directly address the achilles tendon, repetitions, sets, rest periods, duration of movement, duration of time held in the lengthened position, and external load are all factors which need to be considered for the best results. In addition, Alfredson et al recommends stressing the tendon to the point where pain is evoked. Therefore, an aggressive approach that takes into consideration the “24-Hour Rule” might be necessary in resolving overuse tendon injuries.

The “24-Hour Rule” is a general rule of thumb we use to determine the appropriate amount of stress to place on an injured tendon. Basically, you want to stress the achilles tendon in a way that evokes pain but does not exceed a 3/4 out of 10 on the pain scale. If pain continues after you finish the exercise, it should resolve completely within 24-hours. This is an important concept to understand with tendon pain. A certain degree of pain is acceptable and might be needed to elicit the desired response from the tendon. However, if your pain exceeds these parameters then modifying certain variables, such as the exercise, tempo, load, rest period, and position might be warranted.

With all of this talk about pathology of the achilles tendon, it’s important to also understand how running biomechanics can be linked with injury. In research articles by Azevedo et al and McCrory et al, the factors which were shown in runners suffering from achilles tendinopathy compared to a healthy control group were…

  • Decreased range of knee flexion between the foot strike and midstance phases
  • Decrease in pre-foot strike muscle activity of the transverse abdominis
  • Decrease in post-foot strike muscle activity of the rectus femoris and gluteus medius
  • Muscular weakness of the plantar flexors while eccentrically controlling dorsiflexion
  • Larger inversion angle at foot strike and increased rate of pronation
  • High and inflexible arches

Therefore, in addition to incorporating specific exercises to improve the tendon’s ability to tolerate load, modifying running biomechanics is often warranted. If pain is manageable while running and doesn’t last more than 24-hours after, I usually recommend continuing to run or implementing a run/walk interval so running mechanics can be addressed. Despite overloading the tendon being a main reason which contributed to the injury in the first place, resting often leads to less than desirable results unless compensation and disability result from activity.

If you’re interested in scheduling a virtual or in-person running analysis click here to contact me directly.

In the following section, let’s cover a progressive loading protocol that I often use when rehabilitating achilles tendinopathy. Of course, there are multiple ways to load the achilles as shown in the research. But, I often find starting with isometrics and progressing to eccentric-concentric and then heavy slow resistance or plyometrics is reliable since it provides multiple options depending on the response from the tendon. Use the “24-Hour Rule” as your guide to determine where to start and progress as tolerated from there.

Isometric Calf Raise

The Isometric Calf Raise is usually a safe starting point if you are suffering from a reactive achilles tendinopathy or hesitant to load the tendon. What this does is place the tendon under load for a given duration to begin stressing the area very conservatively. The variables that can be modified are duration, position of the ankle, and double leg vs. single leg. Complete this exercise for 2-3 sets of 20-60sec.

Calf Raise

The Calf Raise is the entry point into isotonic achilles loading. Isotonics is a term that refers to the muscle/tendon moving from a shortened to lengthened position. When incorporating this exercise, the variables to take into consideration are sets, repetitions, tempo, and range of motion. Complete this exercise for 2-3 sets of 10-20 repetitions.

2-to-1 Calf Raise

The 2-to-1 Calf Raise is used within this progression to segue from bilateral to unilateral loading. Since the achilles needs to withstand a great degree of stress during running and different sporting activities, it’s important to utilize single leg variations to replicate that and introduce a higher degree of load. Simply, raise up on both legs and then isolate the lengthening of the injured achilles tendon with a slow and controlled eccentric contraction. The variables to modify depending on how you respond to this exercise are sets, repetitions, tempo, and range of motion. Complete this exercise for 2-3 sets of 10-20 repetitions.

Single Leg Calf Raise

The Single Leg Calf Raise is essential to help resolve an achilles tendinopathy. One big problem I see is that runners stop with Calf Raises or 2-to-1 Calf Raises since pain begins to stabilize allowing them to return to activity. Unfortunately, the absence of pain does not equate to a fully healed tendon and, therefore, more loading with harder variations is recommended. The variables to modify depending on how you respond to this exercise are sets, repetitions, tempo, and range of motion. Complete this exercise for 2-3 sets of 10-20 repetitions.

Ankle Hops

With any tendon, the end goal needs to improve it’s ability to store and release energy. If you stop short of achieving this, you will have a situation where the capacity to be loaded has been improved but not with rapid and explosive movements. That’s a main reason why most runners suffer from recurrent tendon issues year after year. Ankle Hops is a very simple and important low level plyometric movement. Essentially, it is an explosive Calf Raise that improves the elasticity and shock absorption capability of the tendon and calf complex. Complete 2-3 sets of 5-10 repetitions while increasing intensity.

Now that you have a better understanding about achilles tendinopathy with different exercises to address the injury, it’s important to start simple and determine your starting point. Reflecting back on the “24-Hour Rule,” try to find the most challenging exercise above which creates a mild degree of pain but resolves within 24-hours. Continue to progress in terms of exercise, sets, repetitions, tempo, and range of motion, while being mindful of how you respond.

I hope this article has helped you better understand achilles tendinopathy, as well as recommended strategies to reduce pain and increase function. As always, it’s important to consult with a trained healthcare professional to be properly diagnosed and understand the underlying factors which may be contributing to your injury. Please take a second to click here so we can create a structured plan to resolve your achilles pain once and for all.

By: Garrett Mclaughlin, MS, ATC, CSCS, ART

Sources:

  • Etiologic Factors Associated with Achilles Tendinitis in Runners by McCrory et al
  • A Treatment Algorithm for Managing Achilles Tendinopathy: New Treatment Options by Alfredson et al
  • Achilles and Patellar Tendinopathy Loading Programmes : A Systematic Review Comparing Clinical Outcomes and Identifying Potential Mechanisms for Effectiveness by Malliaris et al
  • Chronic Achilles Tendinopathy Treated with Eccentric Stretching Program by Verrall et al
  • Biomechanical Variables Associated with Achilles Tendinopathy in Runners by Azevedo et al 
  • Achilles Pain, Stiffness, and Muscle Power Deficits: Mid-Portion Achilles Tendinopathy Revision 2018 by Martin et al
  • Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments by Li et al

Loading Strategies to Resolve Patellar Tendinopathy

March 7, 2020 · by Garrett McLaughlin
| Article written on March 7th, 2020 at 1:17pm | Follow Garrett on Facebook and Instagram |

Anterior knee pain is common amongst runners, athletes, and the general population. In this article, I will attempt to explore different considerations regarding patellar tendinopathy specifically and provide various loading strategies for rehabilitating the knee back to full function.

Click here to connect with Garrett directly about your knee pain.

The patellar tendon is located directly at the front of the knee and connects the quadriceps, patella, and proximal tibia. Pain is usually localized to the inferior pole of the patella and during movements that load the quadriceps. Cook et al reports that approximately 1/3 of athletes who presented with patellar tendinopathy were unable to return to sport for more than 6-months. Therefore, early detection in less severe stages is crucial, as well as the acceptance that resolution of symptoms could take an extended period of time.

Anterior view of the knee joint and patellar tendon.

What’s important to realize about an injury to the patellar tendon is that we are dealing with a dense fibrous connective tissue that connects muscle to bone. According to Thorpe et al, the main function of tendons is to “transfer muscle generated force to the bony skeleton, facilitating movement around a joint, and as such they are relatively passive, inelastic structures, able to resist high forces.” Despite being able to resist against high forces, as in running, jumping, and many sporting activities, tendons are susceptible to injury based on various scenarios…

  1. The force placed upon the tendon exceeds the tissue’s load capacity
  2. A series of small and repetitive forces are applied for a duration long enough to cause tissue breakdown
  3. Other biomechanical factors are creating compensation elsewhere throughout the kinetic chain which ultimately increases load on the tendon

Regardless of which scenario proves to be true, the end goal of any tendon rehabilitation program is not the absence of pain, but return to full, pain-free function. Like with most injuries, rest is important and will allow the injury to calm down temporarily. However, tendon pain will likely resume when load is re-introduced to the area if the capacity of the tissue is not restored.

In the research article, ‘Current Concepts in Biomechanical Interventions for Patellofemoral Pain,’ Willy et al describe a homeostasis model first created by Scott Dye in 2005. This model suggests that the injury process can be stimulated in response to sudden bouts of increased training loads or stressors. For example, a runner or athlete that is conditioned for a specific distance or intensity but decides to increase one or both of these factors before the tendon is ready to handle the increased workload. That’s why I recommend all runners follow a structured and progressive training program which increases mileage in a safe and effective manner to build tissue tolerance.

Willy et al states that once homeostasis of the tissue is disrupted, sudden increases in training loads may no longer be able to be tolerated even if these are routine daily activities. Therefore, once the tissue is in a pathologic state, the ability to load without pain decreases significantly. The goal now becomes to re-establish this homeostatic relationship to stabilize the tissue, then progressively restore the loading capacity to be more tolerant to the forces it will encounter. Basically, excessive loading created this situation but it will also be a key factor in resolving it for long-term success.

Now, before we cover the loading strategies to resolve patellar tendinopathy, it’s important to touch on cadence, aka step rate, and it’s impact on the knee while running. Overstriding (image B below) is a term that refers to the foot landing too far in front of the body’s center of mass at initial contact. What this does is create a braking mechanism and thus increases energy absorbed at the knee.

Progressively loading the quadriceps and patellar tendon will certainly make the area more tolerant to the forces of running. At the same time, increasing cadence by just 5-10% has been shown to decrease energy absorbed at the knee by 20-34%.

Running at a higher cadence reduces stride length, disperses the amount of force over more steps, and allows the foot to land closer underneath the body’s center of mass. A combination of both approaches is important to consider in order to reduce the likelihood of injury and/or return to running following patellar tendinopathy. Click here to read a more in-depth article that I wrote on the topic called, ‘The Impact of Cadence on Running Mechanics.’

When incorporating the following loading strategies, it’s important to keep in mind the 24-hour rule. Basically, you want to stress the patellar tendon in a healthy way that limits pain to nothing above a 3 out of 10. And if pain lingers, it should resolve completely within 24-hours. This is an important concept to understand with tendon pain. A certain degree of pain is acceptable and might be needed to elicit the desired response from the tendon. However, if your pain exceeds these parameters then modifying certain variables, such as the exercise, tempo, load, and position might be warranted.

Decline Squat Progression

The Decline Squat is a fantastic exercise that utilizes a slant board or elevated heel position to increase demand on the knee. Like with all of these progressions to rehabilitate patellar tendinopathy, it’s important to understand the dose and response relationship before increasing the intensity in anyway. What I mean is, start simple and progress slowly after seeing how the tendon responds to the added load, tempo, and number of repetitions. The different variations of this movement allow you to gradually increase load on the knee joint in a progressive manner. In this video, I demonstrate the bodyweight, goblet, and 2-dumbbell Decline Squat progression.

Spanish Squat Progression

The Spanish Squat is a somewhat newer exercise that I’ve only used for the past 2-years or so. Like with all of these progressions to rehabilitate patellar tendinopathy, it’s important to understand the dose and response relationship before increasing the intensity in anyway. What I mean is, start simple and progress slowly after seeing how the tendon responds to the added load, tempo, and number of repetitions. The different variations of this movement allow you to gradually increase load on the knee joint in a progressive manner. In this video, I demonstrate the bodyweight, goblet, and 2-dumbbell Spanish Squat progression.

Lateral Step-Up with Counterbalance

Since the knee is largely influenced by stability at the foot, ankle, and hip, it’s important to successfully complete one of the bilateral exercises mentioned above and then move on to a single leg variation. The Lateral Step-Up with Counterbalance allows the body to be held in a position that loads directly into the knee joint. Like with all of these progressions to rehabilitate patellar tendinopathy, it’s important to understand the dose and response relationship before increasing the intensity in anyway. What I mean is, start simple and progress slowly after seeing how the tendon responds to the single leg position, load, tempo, and depth of the step. This exercise is usually recommended after laying the foundation with the two bilateral progressions demonstrated above.

Despite showing you two different loading progressions to properly rehabilitate patellar tendinopathy, it’s not my intention for you to complete both of these. I would start by determining which is the best starting point for you and following that path to create a more tolerant and pain-free knee. Once that’s achieved, the Lateral Step-Up with Counterbalance is a suitable next step to incorporate single leg loading and stability. This is especially important if your goal is to return to running or a change of direction sport.

I hope this article has helped you better understand patellar tendinopathy, as well as recommended strategies to reduce pain and increase function. As always, it’s important to consult with a trained healthcare professional to be properly diagnosed and understand the underlying factors which may be contributing to your injury. Please take a second to click here so we can create a structured plan to resolve your knee pain once and for all. 

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Considerations for Maintaining Optimal Knee Health

March 27, 2019 · by Garrett McLaughlin
Article written on March 27th, 2019 at 03:55pm | Follow Garrett on Facebook and Instagram |

The knees endure tons of stress during running, athletics, lifting weights, and other daily activities. That’s why it’s important to implement the correct approach to optimizing knee health within your strength training and movement program.

In many instances, runners strengthen the muscles surrounding the knee joint in an attempt to resolve a knee injury and/or prevent a future one from occurring. Building strength and resilience is always welcomed since it creates somewhat of a protective shield around the joint. However, from a biomechanics standpoint, the knee joint is greatly influenced by the hip and medial longitudinal arch. Therefore, solely increasing strength is a short sighted approach to reducing pain and improving function.

Like I mentioned previously, the hip and medial longitudinal arch are key players when it comes to proper knee health. Stability and control at these joints ultimately dictate how the knee will be positioned during movement. This is especially true with running and single leg stance.

Poor stabilization at the hip and arch cause what’s commonly known as, valgus collapse. This means the knee joint is tracking inwards and the alignment of the entire lower limb is no longer in a vertical position. The greater the degree of this collapse, the more stress placed on the patellofemoral joint and knee as a whole. It’s important to realize that this is not a knee strength issue but rather a positional issue.

So, what’s the solution?

Assuming structural issues have been ruled out, implement a thorough and progressive corrective/loading program to build stability, control, and alignment in the lower extremity. This should include exercises that target hip/foot activation AND stability and alignment.

Next, improving the knee joint’s ability to withstand higher loads and ground reaction forces with landing-based plyometrics is a must. Teaching proper jumping, landing, and positioning of the joint during loaded activities will build the resilience needed to return to running with better long-term success and less incidence of future injury.

The following video will reinforce several key considerations when targeting optimal knee health…

I hope this article has helped shine some light on the “other” areas which contribute to proper knee health. I highly recommend seeking an evaluation from a qualified healthcare professional so you can be properly diagnosed and put on a daily corrective program. If improving your knee health is a priority, click here to contact me directly so you can work towards achieving a pain-free and healthy lifestyle.

By: Garrett McLaughlin, MS, ATC, CSCS, ART

In the Spotlight: Michelle Martelle

October 15, 2018 · by Garrett McLaughlin

In this edition of ‘In the Spotlight,’ let’s talk with Michelle Martelle. Michelle was enrolled in the Integrative Approach to Movement program for the past 6-months which includes an orthopedic approach to movement training. Due to the long-term nature of these chronic injuries, a patient and progressive approach needs to be taken in order to respect the body’s healing process. Luckily for me, Michelle was awesome to work with and I enjoyed every session!!

I started working with Michelle because she was suffering from a challenging case of plantar fasciitis and patellofemoral pain. When aches and pains linger for years, it’s an uphill battle getting to the point where things are manageable again. And in the case of overuse injuries, it may actually take 6-12 months for that to happen. Luckily, despite many frustrations throughout our time together, Michelle was able to prevail by working hard and being patient.

We regularly spoke about the rollercoaster ride she was on and how looking at improvements from a wider lens allows us to view those details which are impossible to see day to day or even week to week. It was also important to re-evaluate the baseline testing protocol to provide a more objective look at progress.

Without further ado, let’s shine the spotlight on…

Michelle Martelle

Q: Where are you from?

A: “Charlotte, NC”

Q: What are some of your favorite hobbies?

A: “I love boating and being on the lake. I also love hiking, especially around waterfalls.” 

Q: If you could live anywhere in the world where would that be? Why?

A: “First and foremost, I would always want to live close to my children. I would hope that would be in a place that is warm all year round near crystal blue water.”

Q: When you first started working with Garrett, what were the goals you wanted to achieve?

A: “I was referred to Garrett when I was buying new tennis shoes. I was having terrible knee pain and had plantar fasciitis. I thought that new shoes would help. I was telling the salesperson that I used to love to run but haven’t been able to for the past four years. I also told her that I was starting PT for my knees and foot. She recommended Garrett because he had helped her work through an injury and get back to running. She said he would be able to help me too. So, I went to see Garrett for a consultation. He was so impressive and had all the confidence in the world that he could help me with my physical issues. So, I chose to work with Garrett versus a conventional physical therapist. It was one of the best decisions I have ever made! My first and most important goal was to get rid of my knee pain and foot pain with the ultimate goal of being able to run again without pain.”

Q: How long have you been experiencing pain and were there any strategies in the past that provided relief?

A: “I have been dealing with plantar fasciitis from mild pain to severe pain for at least eight years. I have spent a lot of time stretching and rubbing my foot to get rid of the pain. It would go away slightly, but never healed completely. I had been dealing with knee pain for three months prior to working with Garrett. My knees have always had a small amount of pain, but not the extreme pain that I had been dealing with over the three previous months. I could barely get up the stairs at my house. Nothing I was doing was making it better.”

Q: What are the most noticeable improvements you’ve seen so far?

A: “Since working with Garrett, my foot pain is almost completely gone. It only hurts very mildly if at all and that is typically only right when I wake up. I am so excited about this progress! And my knees are so much better! I can go up and down the stairs with no problem. I can even run up and down the stairs now! I can sit on the floor Indian style and get up without my knees buckling on me!”

Q: Were these improvements easy to achieve? And, tell us a little bit about any struggles along the way.

A: “It took six months of working with Garrett to get to the point where I am now. It definitely wasn’t easy. I have always worked out, but I basically had to start over with certain exercises to build up the strength in my legs. It was very humbling. From the beginning through around four months, I was always in pain for a day after working with Garrett. I was having to learn new exercises and re-learn some of the exercises that I had been doing forever. I didn’t realize that the way I was doing some of the exercises before working with Garrett was incorrect and probably creating some of the issues. There were days that I didn’t want to go meet with Garrett because I was in so much pain and that made me super grumpy! He wouldn’t let me give up though. He made me push through and after six months, I feel so much better! I actually feel better than I have in years!”

Q: If you were having a conversation with someone who was experiencing the same aches/pains as you were, what would you tell them?

A: “I talk to people all of the time that are dealing with the same pains that I have had. I always say the same thing – go see Garrett! He has been great! I tell them all about my struggles with the pain, my training with Garrett for the past six months, and how much better I feel because of working with him.”

Q: What was your favorite part about the corrective exercise sessions?

A: “My favorite part about the corrective exercise sessions was seeing the improvements that I made and the strength I was building. I will be the first to say that I didn’t love all of the exercises because they were hard for me. But seeing where I am now versus six months ago makes it all worth it. I would do the exact same thing again if I had another injury. And honestly, working with Garrett was my favorite part! He was always so positive and upbeat! He has a great attitude and outlook on life! It’s hard not to leave smiling after training with Garrett!”

Q: What is that one thing you dislike the most (exercise, stretch, etc.) but continue to work on because you know it will help?

A: “What I have learned along the way is that my hamstrings are my achilles heel. They are the cause of a lot of my issues because they are super tight, especially my left one. I REALLY don’t like the supine ball curls! My hamstrings cramp up almost immediately. But Garrett has taught me that I need to focus on using my glutes, not my hamstrings. Maybe it is actually a weak gluteus maximus that is the cause of all of my issues! 😛 I still do the daily exercises he gives me and try to do the weight training he taught me twice a week.”

Q: If there is one piece of advice that you could provide to yourself when you first started this program, what would that be?

A: “At the beginning of my time working with Garrett, I would have told myself to be patient and that there will be times that you will feel like giving up. I would have told myself to remember that I would need to work through it slowly. Thankfully, Garrett reminded me of that!”

Q: How do you feel Garrett’s services may differ from other professionals in his field?

A: “Garrett is the first trainer I have ever worked with. He is very educated in what he does. While I was training with him, he attended several continuing education seminars. Also, he works with a lot of people to rehabilitate them after injuries. I had sought help in many different ways for the pains I was dealing with and Garrett has been the only one who was able to “fix” my physical issues. I believe that his ART certification makes him stand out among his peer group.”

Q: Looking ahead, do you have any new goals you are working towards?

A: “I am working hard towards running again. I am not a marathon runner, just a simple 5k runner. I really enjoy it and would love to be able to run without having any pain or injuries. Also, I would really like to do a mud run again. They are so much fun!”


Thank you for reading this ‘In the Spotlight’ segment. And, a big shout out to Michelle Martelle! Please feel free to comment below with any questions or feedback.

Using Frontal Plane Movements to Promote Optimal Knee Health

March 15, 2018 · by Garrett McLaughlin
Article written on March 15th, 2018 at 8:04am | Follow Garrett on Facebook and Instagram |

The knee joint is very simple in it’s design. A hinged joint that primarily moves in flexion and extension. There is also some motion that occurs just below at the tibiofemoral joint (internal and external rotation) that needs to taken into consideration during lateral and rotational movements.

Even though the motion at the knee is relatively simple, it is greatly influenced by the joints above and below. This includes the foot/ankle and hip. Because ultimately, function at those joints largely dictate positioning of the knee.

As someone who has formerly dealt with knee pain, I know how debilitating it can be. Just because pain is experienced at the knee doesn’t mean the knee joint needs to be the sole focus of your intervention. And doing so would be a shortsighted approach to resolving knee pain.

When progressing through a corrective exercise program to restore function and resolve pain at the knee, incorporating sagittal plane movements are a good starting point. This includes any movement where the body utilizes flexion and extension, and never moves laterally or rotates. For example: squat, split squat, deadlift, reverse lunge, etc. From a knee standpoint, it’s main job is to flex and extend with little rotational demand at the joint.

Sagittal plane movements, although basic on the knee joint, require stability and optimal control from the foot and hip. Because these joints have the capability of multi-planar movement, they must now stabilize to ensure the knee is tracking properly. That’s exactly why programs created to improve knee health need to take into consideration the joints above and below.

But, what’s the next step? Oftentimes, people stop with sagittal plane movements because they are unsure how to progress and continually challenge the knee.

The frontal plane can be a suitable next step and often needs to be executed with care for those with previous history of knee pain. With the addition of lateral-based movements, the knee joint has a tendency now to move from it’s safe, aligned position, to a position that can surely place more stress upon it. This includes into internal and external rotation at the tibiofemoral joint which increases stressed inside of the joint.

Several exercises that are a great starting point in the frontal plane are lateral step ups and lateral squats. Both require contribution from the foot and hip and add a new stress on the knee with the lateral-based movement. But, care must be placed on where the knee is positioned, especially early on. Deviations from pure flexion and extension can cause internal rotation and subsequent valgus at the joint. This is where caution needs to be taken to promote optimal positioning of the knee.

In the following video, let me walk you through how the lateral step up can be used as a progression to promote optimal knee health…

By: Garrett McLaughlin, MS, ATC, CSCS, ART

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