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Our Knees are a Link in a Chain

When I asked for requests for my the latest block of embodied anatomy classes three people ask for a series dedicated to our knees. So we covered hip flexors, spiral motion of the pelvis in gait, movement at the hip and knee and then had three classes on the ankle and foot. The class on the knee itself was very short. Why? Because, pain at the knee usually comes from the foot and pelvis. Someone with a stiff forefoot and a mobile rear foot often has a valgus (pulled inwards) knee. Someone who does not move fully into hip extension in gait adds extra load to the knees. When the hip does not fully extend and if the glutes don’t support your weight then your calf muscles must work over-time to push the foot off the ground. You can spot people who do this by their bouncy gait, or toed out walking. If the psoas won’t extend the hip then the body will create extension in the lower back to push the body’s centre of mass forward. Someone with a left rotated pelvis often feels strain through the right knee. Though rotation of the pelvis may come from one foot that pronates more than the other. It is all linked in weird and wondrous ways. Our body is very clever and adaptive and if there is restriction at the foot or pelvis other structures will adapt to enable us to walk. The only problem is that at some point down the line this adaptation may start showing up as pain and more often than not, the pain is felt at the knee.

Knowing that our knees are part of a chain how do we strengthen and mobilise the whole system? Each foot has 33 joints and 26 bones that are designed to move so let them do this. Challenge your awareness of your foot, walk barefoot, feel the ground and a variety of textures and terrains under them. Challenge the stability of the foot ankle and knee, walk in barefoot shoes up, across and down hills. When you walk let your glutes do their job, could you pause mid stride and not fall over? How good at balancing on one leg are you? Can you balance on one leg while moving the other? Can you balance with your eyes closed? Squat and rise onto tiptoes, lunge, circle your hips, salsa dance - let your pelvis move in a variety of ways every day. Be aware of your dominant leg. This is the leg that you choose to support you while the other leg swings or steps. Be aware of your favourite turning direction. Change it up. Start walking with the “wrong” leg and turn in the less familiar direction. Your pelvis, knees ankles and feet will thank you.

Below are my handouts for the block of classes on pelvis and lower limb, I hope they help you understand where your knee troubles might be coming from.

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