Adam Meakin's Injury Insights 

Thank you!

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Thanks!!

I don’t think you can contract the VMO independently at rest (at least I can’t). I believe you could probably increase activation relative to VL with practice but I don’t think this would make much difference with knee pain.

I can and know many people who can voluntarily contract their VMO, but sure there’s a co-contraction of the VL of lesser intensity. It’s true that during an exercise it’s hard to tell, but with a « vmo exercice » like the step up I feel the vmo more, though the data sounds against it… but hard to tell with certainty with just emgs. Then, its implication for knee pain… I don’t know, but from experience those vmo exercises work better than just squats and lunges, especially since they are usually outside of painful range unlike squats I also suggest you check out the post from Ido portal from Dec 15. I tried to link it but the comment got deleted hence the fast writing sorry. Cheers !

1. I think ATG works great. I just don’t think it would be better than a myriad of other strength programs with some motor control work included. Ultimately, the benefits come from getting strong and skilled with graded exercise and you can achieve this in many ways. I do agree that if you just did leg press with no motor control work (eg single leg squats/jumping/balance), you wouldn’t get the same benefits. 2. Elite athletes all have DIFFERENT injury prehab protocols! The common ground is strengthening, mobility work, and motor control training. Even within the same sport, different teams do different exercises. If one program was shown to be superior, everyone would do it. … and almost all athletes still get injured. Ie the effect of these prehab protocols isn’t as profound as it’s suggested to be on social media. This does not remove the need for quality S+C coaches. There are many ways to get jacked too and not all bodybuilders do the same program. However, there are some key common principles in effective programs and it’s important for coaches to understand these. 3. I think nordic curls are great, but what evidence do you have that they’re better than other exercises? I think the benefit is largely because it’s such a high intensity exercises (the way most people train them). I suspect if you matched for relative intensity, you could get similar results with other hamstring curl variations. If I had to design a hamstring protocol, I would generally include nordics but I suspect you could get similar results with a combination of other exercises.

I really appreciate the thoughtful reply mate. 1&2 agreed that the basis is progressive overload, however each exercise does have specific effects. Sled pulls increase blood flow, step ups put tension on the tendons in a specific manner and cause different adaptations (on hard to prove..). If it’s true that you can achieve similar results with different programs, I do think certain programmings are superior for specific adaptations. For example, if you want to « bulletproof » knees, an atg program would be more effective than a program with squats and lunges because in the first you send blood flow and load tendons specifically, and in the second you get stronger and get those adaptations as a side effect but maybe not as potently… then again we might not have enough evidence to support this side of the claim, but it doesn’t discard it either totally IMO. Thanks to some innovators like Ben and poliquin that don’t always get things right but that sometimes move us forward. 3 And concerning the nordics or Harop curls, I do think they’re superior exercises because no other matches it in terms of intensity. It would be hard to adapt another hammy exercise to that intensity. Last note, the hamstring bounces on elastic bands is another example of a specific exercise for specific adaptation, here i would call it « reactive strength at end range »