Fixing the Split Jerk: A Case Study of Femoral Retroversion
Monday, August 18, 2014 at 11:03AM
Aaron in assessment, corrective exercise, corrective exercise, mobility, split jerk, technique, trochanteric prominence angle test, weightlifting, weightlifting

Image courtesy of Danny Schlag, 6 for 6 Productions © All rights reserved.

Read time: 13 min

Today's post is an interesting case study of a recent assessment and the implications of a key finding on fixing the split jerk.

This post will detail everything from the assessment process and clinical implications to, perhaps most importantly, the practical application of that information in the gym to develop, strengthen, and program the split jerk.

The clinical component details important information on hip function, and the practical application discusses useful strategies for all athletes who perform the split jerk.

Meet the Athlete

Andrew is a former football player, having played fullback for three years at Ole Miss, and he's currently focusing his competitive drive on qualifying for his first national competition in the sport of weightlifting.

Given that Andrew played Division I football, it's safe to say he's got a great background of strength and power to help him achieve his current goal. But Andrew wanted an assessment to make sure there weren't any issues from years of playing football that might hinder his progress.

Andrew's assessment revealed a few common imbalances affecting his shoulder, core, and hip stability, which we'll work to address over the coming months.

However, the most notable finding from his assessment came when examining hip internal (IR) and external (ER) rotation, which we'll detail next.

Assessing Hip Rotation

Andrew demonstrated a pattern of limited hip IR and excessive hip ER on his left side. This pattern was present in both the supine (on back) and prone (on stomach) hip ER/IR tests (Figure 1).

Figure 1. Hip rotation range of motion tests A) supine external rotation B) supine internal rotation C) prone external rotation D) prone internal rotation. Note the excessive external rotation and limited internal rotation ranges of motion.

When someone presents with this pattern, or the inverse pattern of excessive hip IR and limited hip ER, it's an indication to the examiner to perform the Craig test as a follow-up to determine if each hip rotation pattern is the result of femoral retroversion or anteversion, respectively.

Femoral anteversion/retroversion is a result of the angle between the neck of the femur (the part of the thigh bone that connects it to the hip socket) and the knee—the femoral neck anteversion (FNA) angle in clinical speak (Figure 2).

Figure 2. Illustration of normal, increased, and decreased femoral neck anterversion (FNA) angle (Cibulka, 2004, p. 552).

With a normal FNA angle (≈ 15-20° [1]), a neutral hip joint will correspond to the knee cap pointing straight ahead, more or less. However, in the case of femoral anteversion, the hip joint will actually be in a position of external rotation when the thigh is neutral, as indicated by the knee cap pointing forward.

With femoral retroversion, as in Andrew's case, the hip joint is in a relative position of internal rotation when the knee cap is pointing forward.

The Craig test indicates the presence, or absence, of femoral retroversion/anteversion by finding the "neutral" position of the hip joint and noting the amount of hip rotation (Video 1).

Video 1. Demonstration of the Craig test. The FNA angle is equivalent to the hip rotation angle when the greater trochanter is at its most laterally prominent position [1].

Remember with Andrew's case of femoral retroversion, the hip joint is in a position of internal rotation when the thigh is neutral. Thus, in order to achieve normal alignment at the hip joint, the thigh must be externally rotated as demonstrated by the Craig test in Video 1.

This article is not intended to be a how-to on performing the Craig test; readers are referred to Cibulka (2004) [1] for more information on the FNA angle and the Craig test.

The important point here is that specific diagnostic tests are useful for revealing the nature of specific issues or limitations that each require specific approaches, which will be discussed next.

Clinical and Functional Significance

As discussed above, the FNA angle affects the proportion of, and total available, hip ER/IR range of motion. Let's focus on Andrew's case of femoral retroversion to maintain clarity.

Remember that femoral retroversion results in limited hip IR and excessive hip ER ranges of motion.

The most significant clinical implication of femoral retroversion is that it is not soft tissue-related. It is a structural adaptation that alters the shape of the thigh bone—a point past sports medicine staff and physical therapists have failed to apply in Andrew's case.

No amount of corrective exercise, stretching, or other modality will improve the hip IR of a person with femoral retroversion. The only way to increase the available hip IR for a person with femoral retroversion would be to surgically alter the shape of the femur—an unrealistic option except in extreme cases.

Altered hip ER/IR range of motion can be problematic because current joint position and relative joint position within its range of motion are important components of proprioceptive feedback.

A gross simplification is to say that if a person has too little, or too much, range of motion at a joint, then the brain may not be able to accurately sense that the joint is approaching "dangerous" positions, affecting stability and muscle activation.

Due to the physiology and function of the hip, femoral anteversion is more problematic than femoral retroversion in this regard. The excessive hip internal rotation range of motion associated with femoral anteversion may contribute to femoroacetabular impingement (FAI) and labral pathologies [2] and non-contact knee injuries [3].

Femoral retroversion can restrict movements that require appreciable hip IR, such as deep squats, patterns of full hip extension with the leg extended (e.g. late stance phase of gait, rear leg of split jerk), and during some phases of the baseball pitch (e.g. the stance leg during the wind-up phase, the stride leg from arm acceleration through to the end of the follow-through phases).

Trying to force oneself beyond the available range of motion in these types of movements may contribute to osteo- or labral pathologies. Femoral retroversion can also result in a toed-out position when standing or during gait.

Now that we've discussed some of the functional implications and injury risks of femoral retroversion, we can present how we are addressing Andrew's case of femoral retroversion in training.

Practical Application

As stated at the beginning of the article, Andrew's current athletic goals include qualifying to compete in a national competition in the sport of weightlifting.

Adequate hip rotation is important for many of Andrew's training lifts (e.g. back squat, front squat, snatch, clean, split jerk), not to mention performing the snatch and the clean and jerk at maximal loads in competition.

Andrew does not experience any pain or impingement when squatting or performing split jerks, which doesn't necessarily mean that no pathology is present or developing. These are risks Andrew has made an informed and conscious decision to accept in order to achieve his goals.

Our task is to minimize Andrew's chance of developing or progressing existing hip pathology while helping him advance toward his goal.

Squatting is a necessary component of Andrew's training, so he accommodates his femoral retroversion by setting up with a slightly toed-out foot position. It's also important for Andrew to place additional focus on improved hip and pelvic stability through exercises that target the core, especially the obliques.

The biggest impact on Andrew's weightlifting activities is to his split jerk. Andrew previously performed the split jerk with his left leg as the back leg, but, as described above, the split jerk requires adequate hip IR of the rear leg, which Andrew lacks on his left side.

Andrew would compensate for his lack of left hip IR in the split jerk position by turning his left leg and foot out, with the leg straight and the foot flat or nearly flat (Figure 3A)—a highly unstable and unsafe position, particularly for his left knee.

Figure 3. Comparison of A) incorrect and B) correct split jerk receiving positions. Panel A represents Andrew's previous technique, whereas panel B demonstrates the new technique and position we are working to establish.

With proper split jerk technique (Figure 3B), the rear leg is aligned and oriented closer to the sagittal plane with a slight bend at the knee and the weight placed on the ball of the back foot with the heel up.

Since Andrew only has femoral retroversion, and the accompanying hip IR deficit, in his left leg, the fix for his split jerk is to switch legs—the right leg will now be the rear leg and the left leg will be the front leg.

This change places Andrew's left hip in a more favorable position of abduction and external rotation, and he can take advantage of his sufficient right hip mobility to achieve the proper position of the rear leg.

In order for this change to be effective, Andrew must first develop this new pattern of movement, then practice the actual skill (i.e. perform the split jerk in training), and develop the specific strength needed to split jerk maximum weight.

Developing the Movement

The biggest struggle for Andrew will be learning this new pattern of movement, especially since he's already been performing the split jerk the other way for years now. As with any movement, it's important to develop the pattern first before focusing on any other component of the skill (e.g. speed, load).

Andrew began practicing isolated split jerk footwork (Video 2) to work on the technical aspects of foot timing, rhythm, and placement, body position and movement, and balance. He has progressively increased the speed of the movement only after gaining accuracy and consistency at slower speeds.

Video 2. Split jerk footwork.

In the proper split jerk receiving position, the front shin is vertical, the torso is upright, the hips are square and level, the back knee is bent, and the weight is distributed evenly between the front foot and on the ball of the back foot.

He has eventually worked up to performing the split jerk footwork at full speed and is gaining more accuracy and consistency with every repetition.

Unloaded split jerk footwork is valuable during initial learning stages for beginner and intermediate athletes. This exercise can also be useful during the warm-up prior to performing split jerks and for athletes to periodically hone specific components of the movement (e.g. rhythm, timing, balance, foot placement).

3-5 sets of 5-10 repetitions are sufficient for warm-up purposes. As a teaching drill, 5-10 sets of 10 repetitions is more suitable.

To perform this simple exercise, stand with the feet hip-width apart and then rise onto the balls of the feet and pause. Once you maintain your balance, quickly move into the receiving position of the split jerk.

If your receiving position is off, such as your balance biased too far forward, back leg being too straight, or stance being too narrow or short, correct your position. Maintain the correct split jerk receiving position for a 3-count before returning to the start position by first stepping back with the front leg then forward with the rear leg.

Athletes may progress from the unloaded split jerk footwork exercise to performing it with a PVC pipe or unloaded barbell. In this variation, the set-up is the same with the exception that the athlete now holds a barbell at eye level in the set position.

The barbell variation allows the athlete to practice pushing the body under the barbell with the arms, as should occur with all jerk variations. The same principles from earlier apply—focus on accuracy and consistency of proper split jerk technique.

Programming for Long-term Gains

Andrew previously performed the split jerk with his right foot forward and left foot back for years, so the change to Andrew's split jerk technique challenges his body in subtly different ways than his past technique.

In other words, Andrew's body is currently unprepared to handle the weight with his new technique that he could split jerk with his old technique. He not only needs practice performing the actual split jerk but must also develop the specific strength to serve his new technique.

As a result, he must initially use lighter weight than he used with his old technique so he can focus on developing proper technique. This initial reduction in weight is also important to avoid overloading an unprepared system.

Andrew is maintaining the relative intensity of his split jerks between approximately 60-80% of his previous bests. As his accuracy and consistency at lighter weights improve, along with his specific strength, he can progressively increase the weight he uses.

Andrew needs more time to develop the requisite strength and ability to truly push his max. His short-term goal is to qualify for his first national weightlifting competition, but his long-term goal is to lift as much weight as possible on the national stage.

Later phases of his current training cycle may increase the split jerk to around 80-90% of previous bests. It's possible that Andrew might not test his true max on the split jerk this cycle—even at the target competition of this training cycle.

This long-term approach forgoes short-term, immediate "success" (i.e. an increase in maximum weight) to help Andrew realize greater potential and ability over the course of his weightlifting career. (Here's a great article on the psychology of motivation that applies to long-term goals.)

Additional Approaches

The split jerk recovery (Video 3) is a great accessory exercise Andrew is using to develop the specific strength, in addition to the balance and positioning, for the split jerk.

Video 3. Split jerk recovery.

To perform this exercise, place the barbell across the safety bars of a power rack adjusted to match the height of the barbell in your split jerk receiving position.

Grip the barbell with your jerk grip and position yourself in your jerk receiving position. Once set, push up to support the barbell and lift it from the safety bars. Once you are stable, recover your feet as described earlier and then return the barbell to the safety bars.

Jerk recoveries can be performed from the split or power jerk positions. The split jerk recovery is highly specific for weightlifting and can be useful during specific preparatory and competition phases for the weightlifter who performs the split jerk during competition.

The power jerk recovery would be appropriate for weightlifters who employ the power jerk as their jerk style during competition and may also be appropriate for athletes of other sports trying to build maximal isometric strength of the shoulders and upper body.

Athletes should perform up to 5 sets of 1 repetition of the jerk recovery near or at maximum weight. A 3-5 second hold will help further develop isometric strength.

Athletes should be able to perform the split or power jerk recovery with supramaximal loads of their split or power jerk, respectively. The ability to overload the jerk receiving position in this manner will help to build the confidence of the athlete to support maximum weight overhead in the jerk.

Conclusion

This unique case provides some valuable lessons that are applicable to all athletes. Without a proper assessment, you may be missing key pieces of information that are necessary to produce improvements and minimize injury risk.

If you coach weightlifters or other athletes that use the split jerk in training, make sure you heed the advice in this article to develop proper split jerk technique and build the strength to lift more weight safely and effectively.

References

[1] Cibulka, M. T. (2004). Determination and significance of femoral neck anteversion. Physical Therapy, 84(6), 550-558.

[2] Ejnisman, L., Philippon, M. J., Lertwanich, P., Pennock, A. T., Herzog, M. M., Briggs, K. K., & Ho, C. P. (2013). Relationship between femoral anteversion and findings in hips with femoroacetabular impingement. Orthopedics, 36(3), 293-300.

[3] Kaneko, M. & Sakuraba, K. (2013). Association between femoral anteversion and lower extremity posture upon single-leg landing: Implications for anterior cruciate ligament injury. Journal of Physical Therapy Science, 25(10), 1213-1217.

Article originally appeared on Five Rings Athletics - Excellence through Sport (http://www.fiveringsathletics.com/).
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