Click on NOTE CATEGORIES to browse by topic, read through the entire archives, or type a topic in the search box.Last week I was teaching a Squat in class when a physical therapist asked, "How do we protect the knees in such a deep squat?" I found it such a telling question, because the primary reason our country's knee health is so poor (yes, we've got the highest incidence of osteoarthritis) is because we don't squat. The most true answer to the "how to we protect the knees" is squat more often. The bigger issue is, once you have "bad knees" (I really dislike this term. What did your knees do, rob a bank?) it seems like you can no longer squat without pain, right? Well that, we can do something about.
One of the first things you should know is, OSTEOARTHRITIS IS NOT A DISEASE. I can't type this big enough (I need bigger font!). One of the largest disservices done by the medical community is not clearly explaining this fact. Osteoarthritis is not an autoimmune disorder like regular arthritis, which means a joint inflames for no reason. Osteoarthritis is the damage caused by user-induced friction of the joint. What does this mean? Let's make a little math formula:
Damage: Ripping, tearing, burning up, or acidic damage to joint tissues like cartilage, meniscus, bony surfaces, etc.
User-Induced: That's YOU, your gait pattern (quality of movement), and the amount you move (quantity of movement).
Friction: Put your palms together and, pressing hard, rub them together for one minute. The interaction of the the palm on palm surface is friction. The heat in your hands after rubbing them together for one minute is the result of friction.
User+Gait Pattern & Tight Muscles= Friction=Heat=Joint Damage
or more simply,
User+Gait Pattern & Tight Muscles=Joint Damage
If you vigorously rubbed your palms together every time you took a step, you would eventually tear into the flesh of your hands. This doesn't happen because you know how to pull your hands apart. What you don't know how to do is pull the joint surfaces in the knees apart, which is why it's so easy to think of OA as a disease. 'Cuz you can't do anything about the space in your joints...it's just genetic, right? Wrong! Joint space is determined by the tension in the muscles that cross over the knee joint. How tight are your calves and hamstrings? If they are really tight, that's awesome! It means that with just a little stretching you can increase space, decrease friction, and decrease heat. It means you can get better whenever you choose to.
When you have Osteoarthritis of the knee, what you really have is the constant rubbing of the bones in the knees. This is not a disease, but a mechanical situation that can be changed at any time. Elevated heels on shoes, extreme tension down the backs of the legs, and the habit of tucking the tailbone under have arranged muscle fibers into short, tight muscles that increase friction in the knees.
Did you notice the mention of the tailbone being tucked? Chances are, if you have pain in the knees you may also be having issues of the pelvic floor (as mentioned in other squatting and pelvic floor blogs on this site). One of the reasons pelvic floor exercises like the kegel have been invented is because we aren't walking with the correct "pushing off" (hip extension) motion. This pushing back motion tones the glutes (naturally), which (naturally) keeps the pelvic floor long and contracting eccentrically (instead of shortening during contraction), and minimizes the falling forward action most people do when they think they are walking (using the knee's cartilage for each crash landing is a good way to burn through the knees quickly). Can you see how it's all connected? The good news is, the very same movements that get the pelvic bones aligned and the PF strong are also the same stretches needed to increase joint space in the knee (and in the hips too).
If your muscles have been super-tight for a super-long time, begin to open your joint space with these exercises. They can be used for knee and pelvic floor issues and are a gentle way to prepare your body for a future squat.
Do you sit all day? Wear heels? Tuck your pelvis under because it is the "proper" way to stand? However your pelvis became tucked, the double calf stretch is a great way to see if your pelvis can even move! Place your hands on the seat of a kitchen or desk chair and step your feet up onto a thick, rolled towel. Line up the outside edges of your feet and straighten your knees all the way. Your weight should be back in your heels and all your toes lift-able. See if you can lift your tailbone up the the ceiling without bending your knees. No? Do this exercise a few times a day, holding up to a minute, until you can.
If you have always been a pelvis "tucker" the groin muscles can become very tight. Start with this groin stretch before moving onto the more advanced "Legs on the Wall" shown later. Lie down with your belly flat on the floor. Reach one leg out to the side without bending the knees! Relax your head and neck on your hands. Try to bring your leg up until it is at 90°.
