Former Eastern European Coaches and Knees

[Mo]

Discussions have been coming up recently about fencers and their knees. It seems that many former Eastern European coaches have students who are plagued with knee problems from over lunging or lunging incorrectly or by just plain overuse.
My daughter has fitness classes in her club. There are quite a few kids who don't want to take them due to knee problems developing after fitness classes. My daughter takes classes outside of the fencing gym for fitness training and it seems to work for her.
There has to be a cycle for training and stretching/icing/rehab that a lot of coaches are convinced is hogwash and they do as they please anyway.It involves rest and recooperation time especially when flying overseas.
For the past three years my kid has spent 85 bucks a week going to a doctor who works on her knees. He does a great job and tells her what to do and not to do.
When she relays the information to her coach, he of course says that guy doesn't know what he is talking about. He is the trainer for the Nike Track team and will be going to Bejinng for the Olympic Track team. He must know something.
Any suggestions on what to do to keep the body up and running or more importantly how to get the coach to listen?
The Momster

[VorpalCat]

Any suggestions on ... how to get the coach to listen?
The Momster

Get a list of the knee doctor's medical schools, certs, etc. and when the coach says Dr. Knee doesn't know what he is talking about, ask the coach for his comparable list of medical training. (Especially in joint-related areas.) Okay, coach sounds like the type that would blow that off, too. ('I'm right because I'm ME.') Had to be said, though.

Seriously, if any of the other athletes under his care have knee issues and your daughter doesn't, that should be a sign to the coach. Sometimes the hardest three words in the world to say are, 'I don't know,' or 'Maybe you're right,' but if he truly has his athletes' best interest at heart, he needs to learn them -- and mean it.

Kudos to you and your daughter for taking care of her knees despite the coach's opinion on Dr. Knee! They're only two joints but they're two pretty darned important ones.

[Phincer]

Seriously, if any of the other athletes under his care have knee issues and your daughter doesn't, that should be a sign to the coach. Sometimes the hardest three words in the world to say are, 'I don't know,' or 'Maybe you're right,' but if he truly has his athletes' best interest at heart, he needs to learn them -- and mean it.

(My bold)

I think this coach has HIS best interests at heart. Whatever it takes for him to be beside the strip at the Gold Medal bout. Egomaniac.... reminds me of a famous former Soviet gymnastics coach that pushed his gymnasts to the limit. I just saw one of them in a knee replacement commercial the other day...hmmmm.

A coach that truly had the interests of the athlete in mind would have been working with Mo, her daughter and the doctor from the beginning to keep her daughter healthy and fencing pain-free.

[Allen Evans]

One of my favorite jokes at club is to mimic a strong European accent, point at a tired student student and say:" This one is broken....get me another!"

High level fencing is hard on the body. Things are going to break through being pushed too hard and too long. The fencers you see at the top of their game for many years (like Podnizkov) have a combination of good training, good genetics and probably some smarts about what they do and how far they can push themselves.

Seeking regular advice from a doctor (and following it) is probably the smart answer to your first question on keeping the body up and running. As far as communicating this to the coach? It can be very difficult. European coaches often assume a level of physical conditioning that American's don't always bring to the sport (at least, initially). Many foreign coaches came from programs in which they didn't see fencers until the end of a long weeding-out process. This meant that they continually had strong, healthy fencers in their program. If the fencer "broke", there was another one to replace him or her. As a result, many of these coaches are not very savvy with injury prevention or training during recovery from an injury. Their programs did not seem to deal with injured athletes well (in my limited experience).

Some of this is dependent on the age of the coach...I find the older ones have a lot of very unsound conditioning practices and don't follow advances in sports science in turns of training and recovery (if you read Sergei Golubitsky's book, you'll see that he was often injured, probably as a result of not being allowed to recover from very hard training camps). they often also tend to ignore advice, even if it's sound.

As with every contentious issue when dealing with coaches, the message has to be given with a certain amount of diplomacy and respect. If push comes to shove, perhaps a note or letter from the doctor about specific concerns?

PLEASE NOTE that I have a great deal of respect for a number of the foreign coaches in the US. Many of them are my friends, and are very smart, well educated people. Some of them are medical doctors or physical trainers in their own right and I know that they would never put an athlete in harms way, and they are quick to seek out expertise in areas where they might not have a lot of knowledge. We can talk about "Eastern European" cultural issues, but many attitudes among coaches are true if they come from Europe, Africa, the Middle East....or California.

AE

[rudd]

Any suggestions on what to do to keep the body up and running...
The Momster

With regards to your first question: When I returned to fencing after a long hiatus I almost immediately started to suffer from hip and knee issues. The following has helped. Obviously I'm not doing everything at once.

Strength training for the lower body, especially single leg work. This is a link to very good article on anterior knee pain that describes some of these exercises.

Core work and stretching especially yoga and Pilates. I'm lucky in having free and regular access to the latter. However I've been poor in taking advantage of this. Fencing is asymmetric muscle development is unbalanced. Working on balancing the musculature around the knee and hip should be a priority.

Soft tissue work either self treatment with foam roller etc or deep tissue massage.

Some good info on both foam roller work and pre and post exercise flexibility work here.

Regular checkups with a physical therapist. I've seen sports massage therapist, physiotherapist, chiropractors and osteopath. I've found that it's more important to find a good practitioner rather than the actual modality they practice. It's helps if they have a sporting background and even better if they have some knowledge of fencing

Cleaning up my diet. The less crap I eat the better I feel in general. This also includes my joints. certain supplements for joint pain may help, MSM, fish oils, glucosamine etc.

Orthotics and more supportive shoes. I've only started using both in the last three weeks and have seen a reduction in post training knee pain. Also the foot drills outlined in this article could be helpful.

Working on technique and form. This is a no brainer.

Post workout recovery, things like contrast showers, ice baths, epsom salt bath, icing the painful joint, NSAIDS etc.

Sorry for the rambling nature of the post. Hopefully some of it will be appropriate and helpful.

[D+F+P=Hadouken!]

This is an interesting topic.

I suffered from knee pain for two seasons.

What made it better was heavy barbell squats. I know that sounds totally contradictory, given that squatting large amounts of weight does put strain on the knees. I believe it improved my knees because the number of muscles groups and motor units recruited in heavy squatting increases the amount of growth hormone that your body releases. Growth hormone is released by the pituitary gland, and has been nicknamed "the fountain of youth", for its wide range of benefits, one of which is improved tendon and joint health. It gives enough of an advantage that most athletic organizations have gone so far as to ban synthetic HGH amongst their athletes.

I'm not the only one to witness the healing power of squats. I consulted and advised another fencer with debilitating patellar tendon pain to use a similar program to mine, and he's since greatly improved his knees, as well as his overall fencing performance.

[Hauptman]

I think it depends on what caused the knee pain in the first place. I had significant knee problems that were actually cured by fencing. In my case the pain was caused by a weakness in some of the support muscles that became stronger after fencing. BUT this is not the case for everyone!!

If you are experiencing pain do not put more stress on the area without being checked by an experienced specialist. What works for one person could end up seriously damaging another person.

As for the starting topic, I worked with a Russian coach for awhile who loved to do a wide range of calisthenics and other moves to develop strength and agility. And while I loved it in theory, some of those moves were just downright dangerous involving enormous stress on my knees and hips. I wouldn't do them, but I was old enough that he didn't make an issue of it.

[Mo]

If you are experiencing pain do not put more stress on the area without being checked by an experienced specialist. What works for one person could end up seriously damaging another person.

And when she and the other kids are checked out by experienced, EXPENSIVE professionals, and given a plan to help them recover and work better, the coach says they don't know anything.
The Team ART Therapist for Nike "doesn't know anything." The orthopedist and his physical therapist, "doesn't know anything" and are the WRONG DOCTOR.
The right doctor would do surgery on her a fix the problem.
Yeah right....
I am so tired of the fencing situation where we are.
The rest schedule is not followed, recovery periods from overly long camps 18 solid days of camp, are not followed. Rest after an event for a day is not followed, instead they get back on the plane and fly for anywhere from 10 to 20 hours including lay overs.
This year will be different.
The MOMSTER

[JEC]

As I indicated before Mo, a second professional opinion from a US Team Sports Medicine physician might be helpful. The other and truly most important thing is: Is she having fun fencing? Does she need mental flossing?

[fatfencer]

In decades of training I have never seen the kind of bull**** I witness in fencing in re knees.

Fencing is an unnatural sport. I've never felt so OLD as after this sport. TKD, bagua, name any martial art and it is much more holistic, and healthy for you.

Keys to staying healthy:

Stretch!!! Your IT bands, hams and your quads need you to stretch them daily. Fencers get some serious glutes too. Glutes are the thickest, strongest muscles in your body and can pull you out of spinal alignment which affects your body positioning and thus, your knees.

Alignment: We have a hardfast rule in MA: control two joints to destroy one. So if your hips and ankles are misaligned or incorrectly moving your knee, the joint in the middle, will suffer.

Orthotics: Keep your foot aligned to do its proper job.

RICE!!!! I tend not to eat wheat as much as possible. When I do I notice that inflammation is worse. Watch for food allergies.

Proper movement: hips open, lunging knee bends over the foot and not over towards the inside. but tucked in, not jutting outward

RICE: ok ok rest , ice, etc. good stuff. I do it daily.

I REALLY recommend Pavel Tsatsouline for these kind of things. Having his books remind me of things to do on a daily basis.

A flexible body is an adaptive body is a safe body is a healthy body.

A good coach doesn't do what has been described.

Fatfencer.

PS: Mo, want me to whupp on him People need a good whupping to remind them this is all about the kids, not the parents OR the coaches, but about the KIDS. I used to teach teach kids too so I have a great deal of sympathy for you.

[Phincer]

PS: Mo, want me to whupp on him People need a good whupping to remind them this is all about the kids, not the parents OR the coaches, but about the KIDS. I used to teach teach kids too so I have a great deal of sympathy for you.

You're first in line behind me.

[VorpalCat]

If Mo does endorse said whuppage, I simply ask that video be posted for those of us unable to travel to the event.

[bruisedfleche]

I don't know about the coach, but I'd definately rethink the doctor. Three years of weekly treatment? I would think after that long of a time you would want either results from this doctor, or a second opinion from another doctor.

Actually, this sounds more like a chiropractor than an MD. You have to be very careful with chiropractors. Some are good at treating you and making you feel better. Other are good at treating you, making you feel okay (not "cured" but not worse), and keeping you (and your wallet) coming back. These are the ones that don't want you trying anything they themselves haven't suggested. They want to see you weekly, twice weekly and convince you that without regular treatment, you'll get worse.

I don't say that to be cynical, I say that because I ended up in a hospital for a week not being able to walk because of a chiropractor. I will still see a chiropractor for when I feel "twisty" so I'm not totally against them.

A coach can tell you what you SHOULD do, but it's up to the atlete to know what they CAN do. You are the one spending the money, so your word is the final word.

[VorpalCat]

I don't know about the coach, but I'd definately rethink the doctor. Three years of weekly treatment? I would think after that long of a time you would want either results from this doctor, or a second opinion from another doctor.

If her daughter were Joanna Sunshine, liver of the Life Mundane and whose only strenuous exercise was running down the stairs so she doesn't miss 'American Idol' I would agree with you. But you have to remember that her daughter is a high-level athlete who is constantly in training and competition, i.e. her knees (and the rest of her body) are under near-continuous use and abuse.

I'm overstepping my bounds here and speaking way out of turn, I know, but I also think I'm not incorrect in saying that the doctor is instrumental in keeping Mo's daughter's knees able to hold up under that rigorous schedule. In other words, the doctor isn't 'fixing' an average knee problem. The doctor is keeping her knees ahead of the stresses induced by training and competition. (Or is keeping her fixed as fast as fencing keeps trying to break her, depending on how you want to look at it.)

Mo, my apologies for jumping in. Berate me if I've oofed and I'll suffer my thwappage accordingly. (And keep my fingers out of things in the future!)

(What can I say? I'm actually a bigger fan/admirer of Mo and spouse than of their talented daughter -- and I admire the heck out of their daughter.)

[Mo]

The doctor is keeping her knees ahead of the stresses induced by training and competition. (Or is keeping her fixed as fast as fencing keeps trying to break her, depending on how you want to look at it.)

Mo, my apologies for jumping in. Berate me if I've oofed and I'll suffer my thwappage accordingly. (And keep my fingers out of things in the future!)

(What can I say? I'm actually a bigger fan/admirer of Mo and spouse than of their talented daughter -- and I admire the heck out of their daughter.)

Jump in anytime Vorp!! We wuv you too. Well maybe, I think I know who you are but am not sure.
The ART guy is keeping her fixed almost as fast as she is breaking.
Again, prudent use of healing time would be a lot better than the hysterical over training now the norm.

The Momster
PS everyone send a congrat to Rudd. He and his wife are the proud parents of a new baby named Annabelle. She was born yesterday I think.
M

[Capt. Slo-mo]

A coach can tell you what you SHOULD do, but it's up to the athlete to know what they CAN do. You are the one spending the money, so your word is the final word.

Think if you engraved that in a marble frieze, they'd hang it over the door leading into the Former Eastern European Fencing Coaches Hall of Fame?

[journalmom]

Actually, this sounds more like a chiropractor than an MD. You have to be very careful with chiropractors. Some are good at treating you and making you feel better. Other are good at treating you, making you feel okay (not "cured" but not worse), and keeping you (and your wallet) coming back. These are the ones that don't want you trying anything they themselves haven't suggested. They want to see you weekly, twice weekly and convince you that without regular treatment, you'll get worse.

I don't say that to be cynical, I say that because I ended up in a hospital for a week not being able to walk because of a chiropractor. I will still see a chiropractor for when I feel "twisty" so I'm not totally against them.

OUCH OUCH OUCH!!!!!! My ego is bruised from your statement since I AM a responsible chiropractor who goes ballistic whenever someone trashes my profession. But I hear what you're saying. Of course, this can happen with ANY HEALTH CARE PROFESSIONAL....Misdiagnosis, negligence, malpractice, unethical practice, you name them, I've seen them all.

But I have to say, in the end, you, the patient, have to be the one who has to make the final decision. Research and research some more about the condition, talk to SEVERAL doctors, check out their credentials, and talk to other people for referrals. Don't go to the first one in the yellowpages because he takes your insurance. I can tell you numerous MD's that I've visited over the years who recommended surgeries that weren't necessary. So MD's are not angels either. I don't mean to be cynical either but my experiences as a patient haven't been that great dealing with any healthcare practitioner, MD's and Chiropractors included.

MO, we spoke about the knee problems so I think you know where I stand on that but, kids and sports these days can be a bad combo if they are abusing their bodies with over training, especially with bad biomechanics. It takes a trained professional to notice that and address it. Coaches, in general, have only one thing in their minds; WINNING!

[Allen Evans]

Coaches, in general, have only one thing in their minds; WINNING!

I'm not sure if I should be happy that you qualified that statement with "in general".

AE

[journalmom]

I'm not sure if I should be happy that you qualified that statement with "in general".

AE

I say that because from what I hear, some coaches are in it for money whether the fencer wins for loses. But there are coaches who want their fencers to win regardless of money or injuries. You know what I mean?

[Allen Evans]

And I thought it was funny that you posted a defense of your profession against a generalized statement (and rightly so) -- and in the process -- managed to make an indirect, generalize slam against another profession!

No harm done.

AE