Knee-Deep in Pain

Client: Elyce

Personal Trainer: Justin Price, MA,
Co-owner of The BioMechanics

Location: San Diego

Ray of Light. When Elyce first went to see Justin Price, MA, 2006 IDEA Personal Trainer of the Year and co-owner of The BioMechanics, she was experiencing significant knee pain. An avid tennis player, exercise enthusiast and fitness professional, she feared that the pain would eventually sideline her from the activities she enjoyed. “I wanted to be able to play tennis and to exercise for the rest of my life,” she states. “I attended Justin’s presentation, ‘Integrating Corrective Exercise,’ at the 2007 IDEA World Fitness Convention^™ in San Diego. This was the most interesting session I had attended in years, and I felt his approach could help me personally.”

Assessing the Situation. “Elyce came to see me because her knee pain had forced her to stop playing tennis and had inhibited her from participating in her preferred exercise programs,” says Price. Elyce’s primary goals were to continue to play tennis with friends and to avoid the progression of pain.

During the first session, Price led Elyce through a complete structural and movement assessment process to determine the root of her problems. He had her perform specific activities that initiated pain flare-ups such as squats, step-ups and lunges. He also asked her to video-record herself playing tennis from the front, side and rear views, which helped him to better understand her “in the moment” movement patterns. One of the many benefits of acquiring video (or photographs if video is not an option), says Price, is that you can take your time viewing it postsession. Outside the training period, you can really study the images or movements and pick up on imbalances you might miss if you felt rushed to analyze it in the client’s presence.

Program Adherence. Once Price figured out the issues that inhibited optimal movement patterns, he met with Elyce to determine the best method for moving forward. According to Price, program design and timeline must be appropriate to the client’s level of motivation and time constraints. “When I work with someone like Elyce, I get her to first tell me how much of a time commitment she has in her day to devote to exercise, and then I design the program,” Price explains. “At that point, I am clear about how long it will take.” This allows the client to take greater responsibility for her own success, he adds. With regard to Elyce, Price suggested that she take a complete break from tennis for 3 weeks with the promise that she would soon be able to return to the sport—and even play more frequently. “She agreed to the program, which meant the onus was on her,” he says. Once she agreed, they were ready to get to work.

Breaking It Down; Building It Up. The assessment process helped Price determine that Elyce could not activate her glutes properly and experienced difficulty decelerating movement owing to restriction in her quadriceps. These faulty movement patterns caused disruption in her kinetic chain, which contributed to her knee pain.

During the first two sessions, Price sought to address the chronic adhesions in her body through myofascial release and trigger-point work. Once the adhesions were minimized, primary focus turned to mobility exercises to help
increase gluteal and quadriceps activation. As Elyce progressed and pain was reduced, she went from weekly to biweekly meetings, worked to strengthen the connective chain and made improvements in reactive and plyometric capacity. “We got the body prepared for the sport-specific ranges of motion and made sure her muscles were ready to absorb the load,” says Price.

Game. Set. Match! After about 10 sessions, Elyce’s pain disappeared and she returned to the activities she loved. What’s more, she now hits the ball harder, has
improved her endurance and even has dropped some body fat. “My tennis game has improved more from the biomechanical changes that occurred in my body than from the years of taking tennis lessons,”
enthuses Elyce. “Justin’s program was very different than anything I had been exposed to before. It is very precise, and you cannot move on until everything is ready.”

It is the focus on simplified, specific progressions, client responsibility and
attention to detail that lead to both client and trainer success, adds Price. n

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