The BIGGEST Key To Healthy Low Backs, Shoulders, & Knees

Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, Knees Over Toes Course, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)

This past weekend I had the great honor to be a presenter at one of the top health and fitness conferences in the world, the Perform Better summit in California. I presented on having a very different look at the role of loaded carries and locomotion that often get overlooked by everyone from fitness professionals to my own fellow clinicians. If there is ONE concept I wanted people to walk away with (of course there were far more than one, BUT if I had to choose) it was the importance of lateral strength training.

If lateral strength is so important (I’ll define more specifically what we mean by lateral strength) then why don’t more people emphasize it in their training? Sadly, we are largely stuck, even those in functional training mindsets, into individual muscle parts. When we talk about the lateral chain of the body, we aren’t talking about 1, 2, or even 3 muscles. We are actually talking about 10-12 different muscles (this is a conservative measure on basic measures) as well as muscles as people don’t always readily think about. I mean, no one goes to the gym thinking about their peroneus longus or intercostal muscles (until they don’t work or get strained THEN you notice). However, all these muscles, plus a few more, are integral to our ability to be strong, mobile, and resilient especially when it comes to healthy low backs, shoulders, and knees.

If we look at the amount of area these muscles cover on our body, it makes sense that they would play a big role in how we move and also show the connection points that would all influence healthy low backs, knees, and shoulders. Is there any real research though that points to ideas like the lateral chain actually accomplishing these goals? Well, you are in luck, there is A LOT, but I will highlight a few…

A 2017 review paper in “Current Reviews in Musculoskeletal Medicine” explained above one of the key factors in preventing ACL injuries in the knee. Renowned spinal expert, Dr. Stuart McGill explains the following…

“Consider a 340 pound NFL lineman, who is strength trained in the weight room on Olympic lifts and power cleans. His coaches believe he is well trained. Yet the athlete has back pain that limits training. Measuring his cutting speed – the ability to take 5 fast strides forward, plant a foot and cut to the right reveals his great weakness and strength imbalance. The pelvis drops on the swing leg side and the spine bends laterally. He reports a twinge of pain. All of his strength training has been performed with two legs on the ground. All of the pulls, lifts and presses never trained the core in 3‐dimensions. The weak link is limiting his performance and causing stress and pain. Addressing this with loaded carrying exercises produced more lateral spine stiffness in his core. His pelvis and spine produce appropriate proximal stiffness (proximal to the hip joint) so that more velocity of all of the muscles that cross the hip joint go to the distal side of the joint resulting in faster leg speed. Further, the spine does not bend, the stress concentration at the joint is eliminated and the pain is gone. This example demonstrates that the hip muscles were limited by a weaker lateral core. Specifically, the gluteal muscles on the stance leg were confined by the lateral core muscles on the swing leg side of the body – in this case the lateral obliques and quadratus lumborum. Good training always addresses the elements that assist and potentiate one another throughout the body linkage. The core is home base.”

So, what do we do? Some lateral lunges, side planks, and carries? Not so fast!

Appreciating Side Planks More

Side planks are a great and powerful exercise, but most people don’t perform them well and actually get more issues rather than building healthy low backs, knees, and shoulders. How do I mean? Follow the coaching that Josh and I give below…

But we don’t want to live on just doing novel side planks and there are those that can not do side planks well for one reason or another (things like fitness level, injury history, are just a few common reasons) so we can use half kneeling as a good progression or substitution depending upon what version we use, but below are some of my favorites.

Can’t be on your knees? That’s fine, split stance work or sprinter stance positions give us tons of options to do much of the same!

Just Lunges?

When it comes to frontal plane training, most people just think of lateral lunges. However, there is a much bigger world of creating progression and movement patterns as you can see below.

Not only does Greg remind us that both hinges and lunges can be used, but how we position the weight on our body is an important variable as is if we slide our foot out (which is easier) than stepping out. Most people don’t know we have so many good options, but we don’t just have to be stepping out to build frontal plane strength that will build healthy low backs, knees, and shoulders. We can resist the movement of the frontal plane, how? See below for some great ideas…

Even carries have the ability to be progressed in WAY better ways than most realize. One of my favorite to build strong feet and frontal plane strength is walking inline. You can put tape on the ground and do this, but I find even being on a small balance beam makes such a difference in the attention people pay to their movement and the accuracy in which they can do so.

You see if we understand the body better, we focus on exercises that can accomplish SO many goals at once!

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