How Upper Body Pulling Protects Runners' and Hikers' Knees

You're listening to the Restoring Human Movement podcast. Thanks for joining the movement, movement. I'm Sebastian Gonzales, show curator and head clinician at Performance Play Sports Care in Southern California. This show's for active people, those who refuse to let pain and injury get in the way of their life and how they want to live it. Trails and trips, fields and courts, whatever moves you. Each episode features rotating host, expert guest, and real clinical conversations that help you move better and trust your body again. Here we go. If you're a runner or hiker, this is going to be a good show for you.

We've been doing a short series on resistance training. Recently, I did one on the benefits of resistance training and why pretty much everybody should be doing some form of resistance training, whether it be for performance or just longevity. I covered also how to apply it with some general principles and how I did it with my own knee just recently. And also we covered hip dominant patterns, such as deadlifting, hip thrust, single leg RDLs, etc. And we did squatting as well, squat patterns in relationship to knees. Now, the ones that we didn't really cover yet are going to come, are the push, the pull, and the carry.

I'll probably touch on things, or if I haven't already, I don't recall. There's also a category called other or accessory. And these are the things that are really not super important, but people tend to like doing them anyways. And that's perfectly fine, but they're not really part of the major categories. So, I've been listening to a few great podcasts recently. I want to highlight the ones that I think did a really good job. There's one called Well Beyond 40 with JJ Virgin. I think she did a fantastic job of laying out some general guidelines of what good training and conditioning principles are.

They've been changing a little bit over the years, and I think she made a really good point in one of the podcasts I heard today where she said that in the past, and I've seen this a lot, is that there's been on social media where people are talking about lifting extremely heavy. And it just scares people. I do agree with that. There's no reason to lift heavy for everybody, but certainly some people can lift heavy, and they do lift heavy. But for people like our recreational runners, our hikers, our active individuals that we see here at Performance Place, you don't really need to lift super heavy, but there are kind of like general amounts that we want, like doing one push-up is not enough.

Like you should be able to do generally 25. So there are like general competency levels that you can look up online, and there's a range, but generally we can kind of see if we're in a certain range to see if we have a good competency within that lift. So the lift we're going to talk about today is going to be the pull, or the row, if you will. And exercise is called a row. You don't have to do a row. There's also pull-downs and lat pulls, et cetera. But generally it's a pull category. Now, the reason why pulling is important is because, as I tell most of the people that we see at Performance Place, even with our telehealth, is the more you can strengthen your appendages, the more benefit you get with performance, but also the more it spares you from having fallout with having spine issues.

In this case, for upper body, a lot of times it is actually related to a lot of groin pain conditions, front crease of the hip that people tend to have, but also to some of the upper extremity things like neck issues, upper trap tightness, tension to the elbows or tennis elbow, even if you play tennis or not, like lateral elbow pain, even tingly to the hands, the more you strengthen the arm or the appendage, the less your spine has to work. That is a good general principle to follow. And the pull category and push are good staples for that. Now, the pull category, if we're going to relate this more specifically to running, I know we've been talking about knee pain, there is a kind of a direct relationship.

We see it in how the lat, which is part of the muscle in the backside of the body, into the search into the shoulder, the way it wraps around like a sling and attaches directly to the lumbosacral fascia, which also connects into the glute max. The glute max inserts directly into the IT band. And the IT band is known as a lateral stability tool for people with knee pain, with various different types of sports, non-trauma based. So this is what we call the lat glute sling. And it's, some literature calls it the posterior sling with the push pattern we'll cover later in a different podcast. That is the anterior sling.

Muscles really don't work necessarily in isolation. They work in slings. You've probably heard of the posterior chain. That is a chain of muscles that work together. And this is kind of the same thing, but in a sling, upper body, lower body perspective. Now, I've seen a lot of people running and I always look from far away, like when I'm over at the beach and I see somebody inevitably not moving their arms. They don't really have arm drive. And what this does is, it doesn't really help you get into the hip extension that you may need. As we learned from some of the podcasts that Dr. Mandy Riehl did, as a runner, you need hip extension and you need to have a fair amount of it.

You have to have, I think the estimate is, I think, and don't quote me on this, I want to say it's about 15, 20 degrees. You don't want to have zero. Like zero is like basically standing straight up. Like you got to have more than that. And that decreases the probability of you having knee conditions and back ones. I heard a podcast recently, I forget the exact one, but it's a running podcast and there was another doc, it was a PT, talking about these types of conditions that runners experience like hip or glute pain, knee conditions, et cetera. And so they mainly focused on this narrative with hip conditions, but they said hip conditions and I totally agree with this.

Majority of hip conditions like glute ones and even high hamstring ones that runners and hikers will experience, especially runners, is going to be lumbar spine mediated. Like the lumbar spine has a ton of influence of what is happening there. And most of it is just simply referred pain from the spine. The person went on to say that the reason why this occurs is because people have limitations in hip extension. When they have limitations in the hip extension, they force the extension required to do the task, which is running, which I talked about tasks before with the dynamic system theory. The task requires extension somehow.

Extension can come from the back or the hip or both. Now, you don't have to limit your low back from extending. That's not the answer, but it should be shared. It's called load sharing. So what helps out in that process is being able to get arm drive and being able to have a strong, capable shoulder and upper extremity helps out in that process. Now, exercises that I really like for runners and hikers to do are pull patterns with single or double arm. I like both. I prefer them to do both and with different slots of effort. Now, before I talk about the slots too much, let's talk about the power slot.

The power slot is what I demonstrate to a lot of people that we see into like where should I put my elbow? Should it be close to my body? Should be flailing in the air and so on? And so I usually just give them like a rope that we have at the office and I hold it and they hold it and I say, I'm going to pull you. Don't let me. And so naturally, they kind of turn their body a little bit and drop their elbows into the rib cage and they hold on for dear life. And I said, I'm going to pull you over and they pull hard and they drop their elbows further. They lock it in. It's like a power position. So a power pull.

And so nobody elevates their elbows when they're really under a lot of force like that. Everybody tends to assume the same position because with that amount of force, there's really not a lot of options. So they pick the one which is the most powerful. So with that being said, most people fare well with some form of elbow towards rib cage or in and around their type of slot. Some of the old principles of bodybuilding, people would say, I put my elbows up and when I do that, I'm going to get different parts of the delt and so on. That doesn't matter. What matters is if you challenge the pull pattern in a way that feels powerful.

So I like to give people a power slot to do most of their work in. Now, when we talk about angles or different lines of drive, those are the other types of slots we can take. And this goes for our pull patterns or our push patterns as well. There's an exercise called a like a T-bar row that some of you may be familiar with. The T-bar row is where you kind of lean over a fixed bench or a fixed chest support. And then you start pulling and it's called a T-bar row because the bar is formed like a T. This is what we call a horizontal row. Typically it has two handles on it. One handle is horizontal, which guides your elbows into a more upright position.

And there's ones which is downward, like kind of downward, a facing downward, and your hands are kind of like in a position where you're like holding a candlestick. This allows you to get into the power slot. Now, with that being said, some of the weights or implements that you pick in the pull will guide you into having a power slot or not. Now, I'm not saying you can't do elbows up position ever. I'm just saying for most people they fare better with elbows down to some degree. Now, if the bar is horizontal, such as a barbell row versus doing a dumbbell which can turn and allow your hand to go into a more vertical holding candlestick type of position, the one that's horizontal will guide you into an elbow up position.

That's just how it goes. It's the hand orientation which does guide where the shoulder tends to orient itself and the elbow follows along. The elbow is essentially kind of like the knee. We talked about the knee is at the will of the joints around it and it's the same thing here. Now, for a quick pause before we keep going. Hey, everybody. It's Sebastian. If what we've been describing in the show so far sounds very familiar and you've been dealing with some ache, pain or stiffness that keeps coming back no matter what you do and no matter what you try, we're offering a free discovery call today where we brainstorm with you what has been working for you, what hasn't been working, and we also try to unravel what is a critical part of the puzzle that you've actually been missing that's keeping you from full recovery and getting back to full activity.

The link's in the description. It only takes a few minutes to fill out the form. Okay, back to the show. So I'm a fan of just finding the most comfortable, most powerful grip that you can do and we're going to challenge that. The vectors of force, though, those are based upon the exercise or the machine that you pick. Now, we just talked about a horizontal double arm row, bench, chest supported. So that one's fine, but what about a single in the same direction? So that is a horizontal single arm row, in this case, chest supported. I'd probably pick something else, but just for an example. Another example of this is a single arm dumbbell row with knee on bench.

There's another one which is called a three-point pull or like a tripod position where two feet are on the ground, one hand on bench. So bench supported, single arm row. They're both the same thing, just different. In case you're wondering, of all these exercises I talk about with all these podcasts, which ones are the best, which one feels the easiest or simplest to perform for you, especially for a beginner. I don't really care. It's the one that gets the job done. There's literally thousands and thousands of exercise variations you could do if we account for different implements and different weights.

But it's really whatever feels right to you. and all of them may have some merit at some point. But these are examples of single arm horizontal row. Now, we have a two-arm row already and we have a single arm row horizontally. What about vertical? Like overhead? Like lat pulls? That's a good choice. I love lat pulls. But that's also a pull-up. Right? They're both the same. And so how about just hanging? How about a one-arm thing, which is like so impossible? And for those of you who like devices like TRX or suspension trainers, are those viable? Sure they are. In that case, you're moving your body.

You're not moving the device. And those are doubles. You can also do those with singles too. So I also love kneeling. Like we call them half kneeling rows. I like half kneeling because it's in a split position and it makes it easier for people to not arch their back and lean forward too much. But you can do two knees down, which is going to be a tall kneeling or a low kneeling row. You usually use it with a cable device. So you're pulling horizontally across the room. It's like you're pulling the cable across the table versus the other horizontal row, which was a, you're looking kind of down at the ground, which is a single-arm dumbbell row.

But they kind of do the same thing, right? Like we kind of see the arms in the same slot. It's a single-arm row. Like it's kind of the same thing, but it's different. And that's called a variant. Now, you can do standing ones too. I love cable machines. So you can load those babies up and start pulling. Usually it's going to be a single-arm row with a cable. It's just the most seamless. There's another double-arm row, which is a seated one, almost like you're rowing a boat, which is a popular one at the gym. But also, because of this, because you're locked in two feet, two hands, a lot of people flex their spine with it.

And they have some of the same low back fallout or hip referred from low back fallout as people who are deadlifting who do it with poor form. So there are considerations in safety nets that you need to be considerate of with certain lifts. That's why having a personal trainer, a strength coach, or someone who knows what they're doing in coaching form is really important. And if you listen to the other podcasts I mentioned, we had Dr. Mandy Riehl who was interviewed on Blueprint to Ultra. They had form concerns and I totally agree. If you don't know how to lift, don't take unnecessary risks just yet.

It's in your best interest to invest in a strength coach so when he can guide you through the exercises, no writing a list of exercises down is not the same thing as being coached. We also look for something called retention. So retention and this goes for all the exercises that we're talking about. Retention comes down, it's easier on certain exercises but it's how well you retain the form between sessions, not really within session. Like if I have to coach you all the time putting your elbows towards your ribcage, etc. and you have to do it every single rep, that's pretty low retention because you're failing to keep form even between reps.

So I as a strength coach need to make sure that I'm giving you better cues. Cues are an example of things to think about when you're doing the lift or the exercise. I want you to drag the handle past your ribcage. That'd keep you pretty low, right? Versus I want you to pull the handle over my hand which in that case could be right next to you. In that case that would keep your elbow pretty high. So retention between sessions is really important because if we're trying to create some autonomy with lifting it's a lifetime event so don't assume that someone is going to be following you around for the rest of your life and showing you how to do it unless you have the money and the resources to do that.

I know a lot of us don't but certainly taking like a crash course on lifting and then working on retention with good cues can really go far in life and you'll benefit from all the great things that lifting provides other than just performance and we talked about knee conditions etc. Like that's that's important but really with strength training what you'll get the benefit of is all the metabolic benefits like the chance of having osteoporosis is so much lower you're decreasing your risk factors for diabetes and various other things they go on and on with these other podcasts and there's a ton of documentation or literature that supports it I'm not saying cardio doesn't do some of this for you as well but strength is like the engine muscle is the engine and really the way to build that is resistance training so everybody should do some part of it I think I covered this in other podcasts as well but I know runners will probably and hikers will probably just want to do lower body lifts I completely understand that that's like you think it's related to the activity related to your sport or sport specific training there is no sport specific training that is not really correct strength training is strength training and there's good exercises that you can choose from and then do them for a very long time and then provide some variation over time to get stronger you bring strength to your activity and that means you need to challenge all of your appendages not just the lower half okay so I think I need to rewind a little bit I got a little off track we're talking about retention so this I can't stress this enough good coaching and cuing is extremely important there's a book that if you all want to get nerdy about it it's called The Language of Coaching it's written by Nick Winkleman it goes over all of the literature and simple cues that can be used that are stickier than ones that are where you're thinking about your body parts one of the classic ones that we see with people with squatting I don't have a good example with rowing ones necessarily but they usually with lower body lifts especially with squatting people say knees out next week they come back knees out oh I gotta watch this video knees out we call that an internal cue so you're focusing on what your body is doing not what your body is doing to the environment and for as much as I'd love to say exercises need to be complicated they really don't running doesn't need to be that complicated either or hiking what are you thinking about when you're sorry I've asked just a few people before and it's kind of like slapped me in the nose because when you run or when you sprint you should generally probably think about not much unless you're being coached and the coach has a specific cue for that time but if I was sprinting away from an animal I'm not thinking about anything when I'm sleeping I'm not thinking about how to sleep when I'm breathing I'm not thinking about how to breathe when I'm walking I'm not thinking about how to walk if you are you're internalizing and it's making it a little bit more complicated if you're thinking about it you're stinking okay so exercises or weight training is kind of the same at least later on as I mentioned yeah in the beginning for performance purposes you may have to be coached and cued cue is what you should think about in the exercise itself but beyond that once you know it most of it is very automatic I went to the gym a few months ago and I remember I had to do a phone call with a friend and he was just talking and I I said you know what I'm just I'm not gonna wait I'm just gonna lift it was the most brainless lift that I've ever done I didn't even know what exercises I was going to do I walked in and stared at the machine and I stared at the weights and I said you know what I'm just gonna start moving some weights I did not think about a single thing in fact I barely even remember what I did I remember where I was standing but you don't need to think that hard and if you are thinking that hard and you're thinking about your body parts according to a lot of the literature the more you think about your body parts especially in the in the focal point in the exercise the harder it's going to be for you to retain form because our goal is to help you retain form so you can keep doing this for a very long time to help your performance to help your body composition to help out with being mobile at an older age like all these things are important yes we love we love to help our runners get back into running we love to hike get our hikers get back into hiking but really what a lot of people really need later in life is they just need to be able to get up and downstairs and be independent if anything in today's episode resonated with you visit the link in your podcast player there you'll find any free resource that we mentioned in the show any guest links and a link for a free discovery call with us we're licensed to work with our outdoor active people via telehealth across many states in the u.s. at this point in fact we cover almost half of the population in the u.s. and we add more states every year thanks for listening subscribe to the show and we'll see you in the next one