The Needs of Knees: New Perspective on Knee Pain
I’ll never forget one day back in 2007 when, in the middle of a dance class I felt a tiny explosion in my right knee that sent waves of pain running through me. It came seemingly out of nowhere, in the depth of a plié (a deep squat). The extreme pain receded but the ache stayed for years.
That moment began a multiple-year healing process which would take me into the Wild Wild West of our knees’ anatomy, learning from a variety of somatic experts in physical therapy, Alexander Technique, Body Mind Centering™, pilates, and others to understand how the knee affects and is affected by the rest of the leg, the lower back, even the core.
It was a journey that required me to release enough patterning by tapping into my core sense of movement. Staying rooted in that, I unraveled a string of reactions that led me out of chronic tendonitis and limited movement into full range with little to no pain on a daily basis.
It’s important for me to begin this knee conversation by registering what we’re actually doing when we use our knees and lower legs. Let’s look at the world from their perspective.
The knees allow movement and collaboration between the hip and the foot, which makes them very important when it comes to changing levels, walking about, shifting weight, and any movement possible for the lower body. They are the middlemen – transferring the force of motion from the pelvis and thigh to the lower leg and foot. Equally true, the knee communicates the force of the foot to the hips, pelvis and spine above.
Source: healthyknee.blogspot.com
The knee joint, itself, is the space between the thigh bone above and the shin below, with the patella floating in front of the joint as a protection mechanism. A balanced joint space requires good alignment between these bones, like a well choreographed dance between the thigh, shin and patella.
Within the lower body, the knee wants to be like Switzerland – a neutral channel – through which force and movement can flow. When something isn’t quite right above or below, your knees can provide some flexibility to the system, allowing more range of motion, more stability.
But because of this flexibility, it’s our knees that usually take the brunt of imbalances found elsewhere along the chain of command. In fact, oftentimes, knee pain is a result of congestion in the hips or collapsed arches in the foot. What results is a holding pattern in the knee that stops the flow of force through the entire leg, resulting in a lot of tension and eventually structural degeneration.
Misleading Leadership
The misuse in our knees arises from the misinformed story of the knee as the primary mover – the director calling the shots and managing everything from leg length to rotation. But it’s not all the knees’ fault. Our tight hips and underused feet inspire the knees to take over directing the legs’ actions.
Muscular and ligament imbalances arise when the knees forget they are anchored above and below and meant to hold an open channel. As acting Director, they pull this way and that against the established structural integrity – that is, they move against and not with your bony alignment. This pulls the joint out of balance and creates chaos in that well-choreographed bone dance. Imbalanced movement begets more imbalances, eventually leading to strained or torn ligaments and and a host of imbalanced muscles from right to left and/or above and below.
If you’ve ever felt pain above, below, in front or off to either side of your kneecap, that’s your knees’ message to find better tracking in the joint and rebalance those muscles.
Source: www.Orthopedicsindia.com
Hyperextension is the story of your knee believing itself the Director while extending the leg. This takes the joint capsule beyond its range into unknown territory backward. This is not only excessive pressure beyond natural range. Overt time, that pressure overstretches the ligaments, taking the knee joint out of balance and blocking that channel both up and down. If you’ve ever felt pain in the back of your knee after standing for a long time, you can bet you’re hyperextending those knees.
I’ve worked with numerous movers who are born with very lax ligaments. That means the connective tissues that connect their bones have less awareness of themselves and stretch far beyond the range appropriate for their bony friends to hold. While this is common, it can cause a lot of pain, instability and muscular imbalance down the road. When the ligaments can’t do their job of connecting bones, the muscles take over and become overburdened.
In the image below, see how the knee on the right does not remain aligned and thus it cuts off the flow of force between the upper leg and the lower leg.
Source: www.elliehermanpilates.com
As both a dancer and everyday mover, I would use my knees like a slingshot. I’d push downward on them to bend deeply and then pull them back abruptly as if doing so would send me soaring high into the air. Instead of straightening my whole leg, I was kicking back into the flexibility of my joints.
When we hyperextend, the joint space - meant to be spacious - is compressed on the front surface and forced too far open on the back surface. This cuts us off from our lower leg. It takes the weight our bodies carry out of our feet which are designed for it and into our knees, which aren’t.
The Core Issue
I didn’t know any of this in 2007 when my knee exploded. I had pulled it so far out of alignment and then asked it to bear all of my weight in a compromised angle one too many times that it finally rebelled.
In my case, it wasn’t only the imbalances found at the knee joint. Knees are the messengers, and thus can sound an alarm when there is deep core weakness too.
With weak core postural muscles, the weight of the torso is unable to balance well on top of the pelvis. The pelvis has to accommodate extra weight, which filters into the hips and on down the line, where the knees are ever-ready to once again take the brunt of that weight.
Knee Solutions
When working with clients who have knee pain or injuries, I am looking to preserve the integrity of the knee joint, itself, as well as its relationship to the entire lower body and to the core. When the knee plays its natural role as an open channel, its easefulness affects movement up and down the chain, allowing more freedom in the hips and more stability in the feet.
Similarly, when attention is brought to strengthening core muscles, loosening and bringing balance to tight hips, and awakening the feet, the knees can stop doing everyone else’s job. They can stop being the Director and go back to being Switzerland.
When I came to understand the powerful role of my knees, I stopped collapsing into them. I stopped squeezing and forcing them. I let them be the part in the chain of command they were meant to be. Years later, the chronic pain in my knee is all but gone and what’s left is a deeper appreciation for how my knees have the ability to support my whole body.
Wondering how you can put your intentional knees into action? Try this tutorial on how to squat in ways that both support and are supported by your healthy knees.
Are you trying to strengthen your hyperextended knees with no luck?
My 1:1 consultations and signature programs are a great way to get clear about your knee’s alignment and proper function to get you out of pain and into healthy balanced movement for life.