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How To Bulletproof Your 
Knees 
Dr. Brian Tiu & Dr. Erick Harada 
www.elitechironw.com 
www.irgpt.com
Reason Why WE Are Doing This 
1. “Every single human being should have the 
ability to take care of themselves” 
2. Use US as a “Health Resource”
Knee Statistics 
1. Most common age group for 
knee injuries? 
2. What is the MOST common 
injured tissue in the knee? 
3. What is the percentage of 
runners that will become injured? 
4. What is the percentage of knee 
injuries in runners?
Knee Anatomy
How Do We Protect It?
Nutritional Support
Hydration
Movement = THE BIG IDEA 
FIX broken movement first 
It’s not the “bad” shoes. It’s bad FORM.
Dynamic 7 Warm Up 
1. Piriformis/glute Release w/ball 
2. Rollovers into V sits 
3. Fire Hydrant Circles 
4. Mountain Climbers 
5. Groiners 
6. Frog Jumps 
7. Static hip flexor stretch
Piriformis/Glute Release
Rollovers Into V-Sits
Fire Hydrant Circles
Mountain Climbers/Groiners
Frog Jumps
Single 
Russian 
Deadlift
Single 
Leg 
Squats
3-D Step 
Downs
POSE Running 
What is Pose 
running?
Mobilize = YOUR Goal 
IDENTIFY dysfunctional tissue 
and 
MOBILIZE it 
“UNGLUE and FLOSS”
Why Trigger Point Therapy?
Trigger Point Therapy - UNglue 
1. Top to Bottom approach 
2. Front to Back 
3. Quads 
4. Suprapatellar Pouch 
5. Gastrocnemius 
6. Soleus 
7. Anterior/Posterior 
Tibialis
How To Mobilize - Floss 
1. Floss hip (front/back) 
2. Floss knee 
3. Floss ankle joint 
4. Mobilize ankle/achilles 
5. Mobilize soleus
Weight Training & Cross Training 
1. Increase and improve hamstring strength 
2. Squats 
3. Deadlifts 
4. Lunge 
5. Calf Raises 
6. Cross Train 
7. Bands - banded tke, quarter leg squat single, single leg 
lateral tension
Case Study 
1. 45 yo female, reports lateral knee pain with 
sudden onset after increasing mileage over 
the past 3 weeks 
2. 32 yo female, weight trains/crossfitter, low 
back pain x 6 mos on/of, R knee pain, 
sudden onset, 2 wk duration

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How To Bulletproof Your Knees

Editor's Notes

  1. Thank you for coming out tonight. Let me tell you why I’m here, and what I’m not going to do. I am going to give you some insight into a topic that should be important to all of us: “How To Bulletproof your Knees.” Brief background: NON-traditional chiropractor focusing on a branch of chiropractic called SCS or structural correction of the spine. Education: University of Toronto - RN - ICU Logan College of Chiropractic - St Louis MO
  2. I am doing this for a couple of reasons. The first reason is that I am guy that believes that everyone should have the ability to care for themselves before spending money to see a doctor. The second reason is that doctors are there to get the job done when these simple tools have failed. It’s the duty of the doctor to take on tough cases. I would like you to look upon me as a resource. If and when a challenging health issue comes up it is my hope that my name will be the first thing that you’d think of when you are chit chatting about a health issue. Here’s what I am NOT going to do: Unlike some of my other healthcare colleagues that beg to do health presentations. I am not going to hit you with any special offers or pressure you to sign up for a “once-in-a-lifetime” special. At the end of my presentation, I am going to give you a “thank you” gift for letting me speak to you. These goodie bags include a sport bottle, tshirt, our latest newsletter and a gift certificate for savings off our structural chiropractic examination fee.
  3. Knee Stats: Most common in the 15-45 yrs of age According to UCSF and AAor Ortho surgeons: Most common injured tissue is ACL and rising 250,000 cases/yr ACL occurs when foot is planted then rotates (hence need for ankle mobility) 70% of runners will become injured according to the AAPMR Runner's World poll 40% of running injuries are knee injuries
  4. Knee Anatomy: FACT: Knee is the biggest joint in your body FACT: Knee is filled with synovial fluid, no blood supply to the area, therefore will take a long time to heal. FACT: Movement is key to providing nutrition to the area. FACT: Knee needs stability Synovial fluid - lubrication, shock absorption and chondrocytes (nutrition such as oxygen and clean out such as carbon dioxide) NO muscles cross the knee joint, movement is made via attachment of muscles to the tendons 50/50 stability bone and ligaments, 90% of stability is ACL ACL prevents tibia from moving forward and limits rotation 4 bones, 4 ligaments Quads (extend), Hams (flexion), Calves SUM UP: Knee needs movement and stability DO NOT forget the importance of the: Hip joint, ankle joint, shoulder joint important for better movement HOW THE BODY WORKS IF YOU LOCK UP JOINT THAT NEEDS TO BE MOBILE, IT WILL LOOK ELSEWHERE TO GET ITS RANGE OF MOTION Just like other organs: heart for oxygenation, kidney blood pressure and filter urine, liver filter waste products – the structure of the body is the same Joint by Joint approach – look at the body as a stack of joints/lego blocks, each block has a specific function and specific training needs. For example, ankle mobility, knee stability, hip mobility, lumbar stability etc..
  5. Nutritional Support Unglue and Floss – Mobility and Trigger Point Stability and Strengthening exercises
  6. Glucosamine POTASSIUM Sulfate is better than HCL - sulfate assists in the production of cartilage - will take at least 8-12 wks to assist in pain reduction vs 2 wks for tylenol, nsaids - research says effective between ages of 18-35 yo - protective - for people older, it helps protect joint and alleviates pain symptoms - required? nope..just recommended - 1500 mg daily Fish Oil - REQUIRED - DHA for brain development and connections - EPA for nerve protection and regeneration - Decrease inflammation, “oil” the joint - 500 mg DHA + EPA to avoid deficiency - 1000 mg DHA + EPA to for proactive support - 2000 - 4000 mg DHA + EPA for high intensity support - when it comes to this spend a little extra money
  7. 1oz/kg, pinch of salt, due to diet and filtered water not much electrolytes nowadays 100 lbs divided by 2 is = 50 oz = 6 cups dehydration leads to dehydrated tissues - remember synovial fluid
  8. Our response to injury is like hearing the smoke detector go off and running to pull out the battery. The pain, like the sound, is a warning of some other problem. Icing a sore knee without examining the ankle or hip is like pulling the battery out of the smoke detector. The relief is short-lived. Find areas that are causing your knee pain to occur. JOINT BY JOINT APPROACH – ankle mobility, knee stability, hip mobility Measure ankle mobility, look for hip mobility
  9. REASON: prevents injuries, hits all 3 planes of motion - frontal, transverse and sagittal plan http://www.t-nation.com/training/defranco-agile-8 1. Foam roll your IT band. Start just below your hip and roll up and down to your outer mid-thigh ten to fifteen times, focusing on any tight spots. Then perform ten to fifteen rolls starting at your outer mid-thigh and rolling all the way down to the outside of your knee 2. Foam roll your adductors. Start just below the crease of your hip and roll up and down your inner mid-thigh ten to fifteen times, focusing on any tight spots. Then perform ten to fifteen rolls starting at your inner mid-thigh and rolling down to the inside of your knee. Again, focus on the tight areas 3. Glute/piriformis myofascial release with a tennis ball. Take the tennis ball and sit on one your left butt cheek with a slight tilt. Cross your left leg. Roll for 30 seconds or so. Switch cheeks and repeat. Feel free to cry 4. Rollovers into "V" sits: Perform ten reps. 5. Fire hydrant circles: Perform ten forward circles and ten backward circles with each leg. 6. Mountain climbers: 20 total reps. 7. Groiners: Perform ten reps. Hold the last rep for ten seconds. Make sure to push your knees out with your upper arms while dropping your butt down. 8. Static hip flexor stretch: Perform 3 sets of 10 seconds on each leg. Complete all three sets on one side before moving to the other.
  10. Pose method is running on the balls of your feet. Involves: pose, fall, and pull Wall drill - back against wall, use balls of feet, 10 times appx 20m then do it 4-5 times Bunny Hop - ball of foot hop like you are on a jump rope - or single unders for crossfitters, lean forward, knees bent slightly, gravity is going to move you forward - LET GRAVITY DO ITS WORK - 3-4 times
  11. SEEK and DESTROY
  12. Explain striation and pattern on this one.
  13. Band for hip/knee/ankle joint Use ball or foam roller for ankle/achilles/soleus OR use band for ankle Assess ankle mobility 4 inches from wall
  14. ASK: which one of these needed a resource and which one needed the doctor (trick question: both require a doctor, the difference is that one didnt require too many treatments) 1. saw MD and PT, xrays were clean, hip motion decreased, ankle motion decreased, tx: trigger point w/lacrosse ball, nutrition, hip mobility and ankle mobility exercise 2. saw DC, MD, and PT, Massage therapist, had prescription meds given, had low back manipulated, did rehab with physio for low back, recent knee pain was a result of shifted pelvis and anterior head syndrome from xrays- structural correction, upper back mobility, hip mobility addressed, corrected anterior head syndrome, addressed ankle mobility