Member Login
The ATG Knee Checklist and WHY
PART 1: THE BACKSTORY
I grew up learning that we can train and adapt our muscles, but I was never taught that we can develop our joints.
Only after 10 YEARS of knee problems did I realize I could DO something about my joints. From age 9 to 19 I just assumed I had “bad knees” and that was the way it would always be. “Oh what I could have been… if only I had strong knees.” Basketball is not a forgiving sport if your knees are a mess of surgeries and you don’t have the genetics to dunk! (Or so I thought.)
In the 1970s, “No knees over toes” was the conclusion after a university study found this position puts more pressure on the knee. That led to widespread prevention of knees over toes exercises, including full range of motion squats since they require the knees to go over the toes to get into that position. As a result, the dozen or so trainers I went to between age 9 and 19 all lacked knees-over-toes know-how, and so just generally avoided the area and had me skip exercises I couldn’t do.
Forty years later, the Department of Human Movement Science and Athletic Training at Goethe University in Germany analyzed 164 research articles and found this “bad” position is actually how you DEVELOP a joint:
“Menisci and cartilage, ligaments and bones are susceptible to anabolic metabolic processes and functional structural adaptations in response to increased activity and mechanical influences. Concerns about degenerative changes of the tendofemoral complex and the apparent higher risk for chondromalacia, osteoarthritis, and osteochondritis in deep squats are unfounded.”
“Provided that technique is learned accurately under expert supervision and with progressive training loads, the deep squat presents an effective training exercise for protection against injuries and strengthening of the lower extremity. Contrary to commonly voiced concern, deep squats do not contribute increased risk of injury to passive tissues.”
In simple terms: The stuff inside our knees can GROW, and the effort to do this does NOT wear down our knees faster.
So the finding of “knees over toes = more pressure” is true.
But the conclusion to avoid that position led us AWAY from solutions.
I’d like to be fully honest, though:
I completely transformed my knees before I ever knew about the research cited above.
My guide? RESULTS.
Charles Poliquin gave me the initial “aha” moment when I realized that my knees were MEASURABLY weak compared to the HUNDREDS of Olympic medalists he produced. His results are among the best of any strength coach in Olympic history.
Then the dominos really started to fall when I noticed how one of my heroes, Olympic gold medalist high jumper Stefan Holm, used full range of motion squatting in his training! This was unusual and controversial in the field of sports training, and in the many jump programs I had purchased prior to seeing it, I was never advised to use a full range of motion.
But here’s the key point: Holm was the IRONMAN of high jump, meaning he had more durability to continue competing than any other high jumper in history. Now in his 40s, he’s not only not broken down… he can still fly!
By far the most unusual thing about Holm’s training - relative to other high jumpers - was his full range of motion squat.
Yet: Full range of motion knee training was never advised for me with in-person trainers and online programs, even though the best RESULTS (Stefan Holm) included a full range of motion.
Today, the world’s greatest dunk longevity case, Kadour Ziani, is yet another example of an “unusual” full knee trainer.
Here is Kadour demonstrating a perfect ATG Split Squat. At 49 years old and 5 feet 11 inches tall, he can dunk!
But the reality is none of the greatest jump longevity cases had to start their training journeys like I did - after major knee injuries. This is what led me further and further down the path of figuring out knee over toes training…
PART 2: WHY JOINTS ARE TRICKIER
There’s a basic inverse ratio between blood supply and the depth of the joint.
Farthest out, muscles get the most blood supply and can recover fastest.
Deeper in, tendons attach muscles to the bone, and tendons get less blood supply than muscles, taking longer to recover. Also of note: Tendons are STRONGER, pound for pound, than muscles.
Even deeper into the joint, ligaments attach bones to bones and get even less blood supply than tendons, taking even longer to recover. Ligaments, pound for pound, are even stronger than tendons.
All of the above can adapt and develop, but muscles have the most room for error, and the need for precision increases as we go deeper.
So while Stefan Holm was able to start working on a squat with full range of motion, it’s the full data below that took me from age 20 having never grabbed rim, to now dunking with ease in my 30s, with basketball feeling better for my knees than I thought possible (first listed, then explained):
The Basic ATG Knee Checklist
(“ATG” is short for “ass to grass” and the reason I called my gym “Athletic Truth Group.”)
Now explained…
Layer 1: Reverse Walking is the gentlest way to put pressure on knees over toes strength. Dragging a sled on smooth turf is the gentlest way to increase strength demand of that position. A treadmill - not turned on, and spinning the belt in reverse - can also provide smooth resistance. Turf varies in friction so the weight of and on the sled is not a universal metric. Treadmills vary in internal resistance so also is not a universal metric, and not all brands of treadmill allow you to spin the belt when the treadmill is off.
In between layers 1 and 2 is the KOT Calf Raise. This involves holding your knee over your toes at whatever degree you can do it pain-free, and then performing calf raises from this position. After my initial knee breakthroughs, I realized the muscles of the lower leg would have to be given adequate volume in order to keep the body balanced for ankle protection and athleticism. In working on this solution, I understood that merely HOLDING the knee in a position over the toes is a form of knees over toes strengthening which is even more controlled than reverse step ups.
Layer 2: Reverse Step Ups mimic the same motion of Reverse Sledding with the added difficulty of lowering yourself down. Lowering your body and/or weights is called the “eccentric” portion of a lift. Reverse Sledding has no eccentric portion. This allows more rapid recovery since there is less breakdown. HOWEVER: The “breakdown” caused by the eccentric portion of a lift is more capable of producing adaption to protect yourself. Also, Reverse Step Ups are precisely measurable in height, load, and form, and therefore become an excellent metric for long-term knee protection and athleticism. The Standards article goes over all current basic ATG metrics, and The Freak Checklist article goes over all current advanced ATG metrics.
This is where the subject of regression became a huge deal, and in my opinion my most important contribution to exercise science:
Working on knees over toes through PAIN can make training dangerous.
But avoiding knees over toes altogether can make LIFE dangerous.
Training knees over toes at a pain-free level from which you can recover is a solution.
Layer 3: Working on the knee’s ability to bend - but one side at a time - gives an imbalanced lower body an opportunity to eliminate great differences in strength or mobility between sides, which is a major risk factor for knee injuries.
There are additional benefits from this exercise which have yet to be explored the same way knees over toes and full squats have. I’ve likely done more training and coaching of this exercise than anyone ever has, and the results to peoples’ ATHLETICISM seems to have a different outcome than just squats alone.
The hip-flexors make long-term changes in LENGTH, and this perhaps enables more fluent use of the antagonist glute, hamstring, and lower back muscles, which are all powerful performance-enhancers.
Further, the inner thigh muscles get more load than in a double-leg squat. This may allow the knee strength increase to more fluidly express itself as speed, jump, and change of direction increases, compared to the knees increasing strength but the inner thighs and hips not also adequately increasing strength and flexibility.
And all that being said, perhaps it’s just that having balanced ability between sides is still badly underrated since so many elite squatters I’ve seen still struggle with one knee compared to the other. However, once able to express one’s full power pain-free, you’re able to better adapt FROM the sporting event itself, compared to holding yourself back.
All in all, I believe the ATG Split Squat allows an athlete to go out into their sport with greater intent and less breakdown compared to any other exercise I’ve extensively coached.
Layer 4: A full range of motion squat is perhaps the “king” of exercises, but in such a motion you use your knees and hips together, and people with a history of knee problems are likely to shy away from the knees. This is where a simple slantboard can become a life-changing knee tool. When squatting on a slantboard, there is no choice but to use the knees.
People who have avoided knees over toes for long periods are unlikely to be able to do a full squat without excessive back rounding, due to the ankles and hip mobility having been limited for so long. So in addition to a full slantboard, there is a category of smaller heel wedges which simulate more ankle mobility. Independent rubber heel wedges are particularly valuable when working on the ATG Split Squat, as well as for getting Reverse Step Ups to engage the quad muscles, since it’s much less stable to set up a full slantboard for single-leg training.
Further, chains should be understood for fullest squat results.
A full squat prevents you from using as much weight as you could in a half squat, but by hanging chains from the sides of the bar, you can make the weight appropriate for the full range.
If some believe the full squat is the king of exercises, and others believe the half squat is the king of exercises, I believe they’re both right to some degree, and by adding chains you have the KING of kings. And believe it or not, for people like me with nasty knee histories, using chains usually feels BETTER than no chains. I think this is because it creates a smoother flow from top to bottom, encouraging you to go deeper and have better form.
(Fernando Lopez, my original ATG training partner and coach, demonstrating an amazing full squat with chains.)
Conclusion:
Reverse Sled to Reverse Step Ups to ATG Split Squats to ATG Squats is the ATG Knee Checklist because it allows you to gradually increase demand in a knees over toes position.
I hope you can use it to get great results in yourself and others.
Yours in Solutions,
Ben
Special thanks to my little darling Sapphire for being such a good napper on me while we went on a long walk to write this article from my phone. Onyx is home sick from school so Alissa and I are man-to-man coverage on the kids today (zone coverage if you count Lucky, who’s pretty demanding himself!) and there’s no way I can type while watching a 2-year-old! Sapphire loves to sleep while I walk her, and today is my writing day - NO EXCUSES. Thankfully we got the job done. Now she’s awake, and it’s time to go home. Good job, girl!
