patellar tendonitis

Internal Program Review: Strength Programming For a CrossFit Athlete with Patellar Tendonitis – Day 1

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Since our Internal Program Review Series has been getting consistently positive feedback, I’m going to continue today with a look at a Day 1 from one of our comprehensive programming athletes. This particular client is a CrossFit enthusiast and upland hunter who has been regularly supplementing his training with Ruthless Performance programs for some time.

Though this is more of a general look at the Day 1 of his strength programming, we’ll be addressing some modifications we’ve made along the way with regards to the patellar tendonitis.

From the perspective of the training lay-out, we’ve cut back his strength programming to 3 days (which has been as high as 4-5 days in the past). We’ve also supplemented with some training that’s been inspired by our in-house Posture Restoration & Injury Prevention Training protocols. The athlete can choose to perform those and forego his traditional strength programming in the case of a day in which there’s a high prevalence of knee pain. 

Those supplemental workouts consist largely of stretches, mobility drills, and activation drills of varying intensities designed to enhance kinesthetic awareness and proprioception while minimizing the impact and input required of the affected joints.

Furthermore, the Day 2 workout consists of a lower body dominant day, with exercise designed to keep knee strain to a minimum, while encouraging blood flow for a more expedient recovery. Day 3 is a full body day designed around the primary goals of maintaining size and enhancing strength even under the reduced workload of this phase. The athlete is still undergoing 3-4 CrossFit workouts / week with various exercise modifications designed with his knees in mind; namely substitutions for the olympic lifts, plyometrics, and burpees. 

But now onto the subject of today’s Internal Program Review, Day 1…

 

1. Stimulation through Antagonistic Training 

Internal Program Review - Day 1-1

We’ve all seen programs before with two antagonist exercises paired together (i.e. push & pull, bi’s & tri’s, etc…), this is a time-tested way to get more work into a shorter period of time, while building some muscle. To take this a step further, we’ve manipulated the rep range of the Floor Press in such a manner that we’ll see a quick adaptation and supercompensation to the exercise. This will make for enhancements in strength while still stimulating growth.

What we’ve also done here with the A2 is add a contralateral stance. So not only is our athlete getting some good lat work in, but he’s also stabilizing and strengthening the musculature of the foot on the support side.

As opposed to a regular unilateral band row, a contra-lateral band row implies that the athlete is standing with his weight resting on the non-working side. This further enhances trunk activation, glute development, and more. Adding a contralateral position to various exercises where feasible (much like adding the half-kneeling position for hip mobility) can serve to achieve these secondary goals.

 

2. Make Glutes not Low Back Pain

The Tall Kneeling position is something we don’t use all that much at Ruthless Performance. In fact, Tall Kneeling Overhead Press is one of the select few exercises we advocate in this position. The tall kneeling, when added to the overhead press helps engage the glutes, as the skeletal system can’t so passively stabilize as it may otherwise be able to do from standing.

As far as the reps are concerned on the Tall Kneeling Overhead Press, we are keeping the volume rather high. The reps here are the primary variable that we are manipulating. This does a few things that we find rather advantageous to performance and longevity: the extended time under tension further enhances gluteal stimulation, contributes a greater degree to resting posture (as the shoulders and traps tend to respond better to higher reps), and also takes some strain off of the shoulder when compared to higher loads and lower reps.

Load on this may remain consistent for the entirety of a 4-week cycle. This will more than likely be the case here as this comes with a particularly steep influx of repetitions throughout the cycle (going from 2×10 to 4×20 in a matter of 4 weeks)…

Since we are so concerned with the athletes on-going knee issues, we’ve directed most of our lower body strength work to be hinge-dominant. With this in mind, we’ve gone out of our way here to design this ‘B’ set to lessen the requirements of the low-back. Though the B1 (Tall Kneeling Overhead Press) will require some low-back involvement, we’ve moved the B2 into a split stance position; this is a rather universal modification to help lessen the requirements of the low back in most exercises.

The Face Pulls are a constant in most of our training programs. The high volume of work on these is nothing special, as we’re constantly trying to stimulate that mid-back and undo some of the damages of daily sitting during commutes, work, and even downtime.

 

3. A 3×8 Protocol is Rarely Ideal on Supplemental and Single-Joint Exercises

Corrective exercise is frequently thought of as unfamiliar and even bizarre body contortions meant to pull and stretch soft tissue from the bone… Very frequently, particularly in the CrossFit world, some very common exercises can be highly corrective. Humeral abduction in the frontal plane can stimulate the rotator cuff in some ways that are rarely replicated in a traditional CrossFit WOD. 

With this DB Lateral Raise as a stand-alone exercise, we’re targeting the deltoids for hypertrophy in a manner that happens to be conducive to not only rotator cuff function, but posture as well. This makes for a very efficient exercise choice when we’re trying to help an individual move better while adding some strength and size.   

We’ve told the athlete to start with a weight in which he could complete the totality of the reps in approximately 3 sets. The goal here is to progressively do more reps in the same amount of sets as the weeks go on. Ideally this is with the weight remaining consistent from week 1. As many coaches that advocate these high rep ranges for shoulder exercises will point out, athletes that most commonly have large shoulders are those who train the shoulder with a very high frequency and to fatigue like in swimming or gymnastics. 

 

CrossFit is a Sport, Treat it as Such

Many coaches and athletes from the strength sports are quick to assume that since strength is implicit in their sport that they do not need outside strength and conditioning (in this case more specifically outside technique correction and individualized programming). CrossFit participants looking to attain a high level must realize that the highest levels of performance in CrossFit come from highly individualized programming, with CrossFit WODs being a sport-specific skill rather than a fitness challenge (take Fran for example, this should be viewed as an event, not a series of exercises). By customizing training to the needs of the athlete and matching that with the demands of CrossFit as a sport, we can enhance athletic performance far beyond what we can expect with the existing standalone CrossFit model.