Great example of a lifter that could use a little knot tying, know this guy or girl?
In today’s guest post, physical therapist Aaron Swanson brings us the concept of the FOUR KNOTS. This is a superb analogy for understanding some of the more common dysfunctions seen in lifters. Use Aaron’s great corrective exercises to ensure that all of your knots are properly tied and tensioned. If you enjoy learning about the human body and how to get the most out of CrossFit, then head on over to his blog for even more great information.
With the advancements in the science of fascia, biomechanics, and neuroscience, we now know that everything is much more connected than how it appears in traditional anatomy books. Specifically, we now know the importance of the connection between the core and the proximal extremities (shoulders and hips).
But if you dig a little deeper, you’ll find that eastern medicine figured this out a LONG time ago. They discuss this connection with the concept of the “Four Knots”. The four “knots” are comprised of the hips and the shoulders. These knots connect the extremities to the core and vice versa.
Each knot affects the other 3. It’s a closed-loop system. The amount of tension and pull in one knot will directly affect the other knots. If one knot is too loose or too tight, it won’t function properly and the other knots will have to compensate.
This system can be complicated furthermore by considering the attachment sites of these knots. For example, shoulder patients usually untie their knots from their core and either hyperextend at the lumbar spine, or try to tie their shoulder to their neck. Hip patients usually untie their knots from their core and fall forward into lumbar extension or tightly tie their hips down to the pelvis, limiting motion. While triplanar motion needs to be considered, one common untying in high level athletes tends to happen at the anterior core (abdominals).
We see this in the clinic with athletes that are overextended at their lumbar spine, their ribs flare out (loss of shoulder knots), their pelvis is anteriorly tilted (loss of hip knots), they overuse high threshold patterns, and their prime movers are usually tight from having to compensate for the poorly tied knots.
One way to resolve this problem is to make sure the 4 Knots are properly tied to the anterior core.
There are many ways to achieve this. However, I have found supine kettlebells exercises to be a great place to start for tying down the knots in the athletic population. It’s the easiest posture to kinesthetically learn about the knots relationship to the anterior core.
For shoulders, I use the 90-90 Kettlebell Arm Circles (below). Bringing the hips and knees to 90 degrees helps to centrate the spine/pelvis (ties the hips to the anterior core). Then use a heavy kettlebell and slow circular motion to tie the shoulder knot to the anterior core. The important part of this exercise is to ensure that the athlete feels his or her abdominals working to counterbalance the shoulder motion. If their pelvis or rib cage moves, the knots have come loose.
For hips, I use the Kettlebell ASLR Correction developed by the FMS/Strongfirst guys (below). This is a great exercise not only because of the immediate mobility gains, but it also works to reciprocally tie the knots to the anterior core. Again, the important concept here is to use a heavy enough kettlebell to counterbalance the leg motion through the anterior core.
Once the knots are properly tied to the anterior core in the supine position, the four knot exercises can be progressed by changing posture and/or changing the plane of stability (Plank Progressions, TGU, Hollowed Hangs, etc.) After resolving dysfunction, these exercises can become valuable warm-up exercises to help centrate the spine and the proximal extremities.
Quick Bio of the Author, Aaron Swanson, DPT, CSCS
Aaron Swanson, DPT, CSCS is a physical therapist practicing in New York City. Aaron was first introduced to the world of movement and rehab as a student Athletic Trainer for the University of Tennessee Lady Volunteers. After completing his degree in Exercise Science, he attended NYU for his Doctor of Physical Therapy degree. Since graduating, Aaron has worked in private orthopedic clinics that focus on movement restoration through manual therapy, neuro-based exercise, and strength training. Aaron has a strong interest in the holistic approach to movement patterns and the integration of performance training into the rehab setting.
Photo credit (left) http://fitfinity.net/wp-content/uploads/2010/09/shoulder-press21.jpg
Photo credit (right) http://games2010.crossfit.com/blog/2010/04/LouiseHodge_SecondinCAEast,271/