More Exercises for Pronated or Flat Feet

I contend that barefooting is the best and most natural way to have strong, mobile, and healthy feet. But it takes time to transition to an unshod or minimally shod lifestyle and not everyone wants that. So, I make a point to keep up with and share biomechanics- and physical therapy-informed clinical research on foot health. In the past, I’ve suggested you add the short foot exercise for arch strengthening to your foot health protocol. I use it regularly with my clients and in my FootLove Workshops.

Here is another foot exercise to consider for pronated and flat feet and hallux valgus – the condition that leads to bunions. The Toe Spreading Exercise is easy to do. I suggest you do it standing, but you could also do it seated with your hips and knees flexed to 90 degrees. I use a yoga mat under my feet for comfort.

  1. Stand with your feet pelvis width distance apart and facing forward.
  2. Spread the toes on your right foot as far apart as you can. If you are unable to spread your toes on your own, reach down with your hand and help to spread them.
  3. Raise your heel
  4. Over a slow count to 5, lower your heel to the ground.
  5. Hold in that position for 5 seconds
  6. Relax the foot
  7. Some protocols have you repeating this up to 100 times! But you might just want to start with 5 or 10 reps. Repeat with your left foot.

A recent study suggests that along with the toe spreading exercises,  you also strengthen your gluteus maximus, commonly referred to as your butt. Your big butt muscle is responsible for externally rotating your hip joint, and a strong one is thought to alter alignment of the lower extremity, thus reducing foot pronation. The authors found that the exercise most effective for a strong butt is performed in a prone position (lying face down) by slightly lifting the knee while maintaining the hip joint in external rotation and the knee joint at 90° flexion.

I bring this exercise into the yoga world as a unique modification of salabhasana aka locust pose. Or, you could think of it as a hybrid between locust and bow poses. The study protocol called for 3 sets of 20 repetitions of single leg lifts. I think you could explore fewer reps of double legs and longer holds.

Namaste, Michele

The Inconvenience of Movement

preventionMag

The July issue of Prevention Magazine featured a 12-page spread on Katy Bowman’s Nutritious Movement. I spent two years studying with Katy and in October 2015, I began working for her organization. While Nutritious Movement has had an influence on how I practice and teach yogasana, it’s greatest impact has been on my own personal life-driven movement practices.

I first heard Katy talk about the relationship between convenience and movement in the context of stacking her life. The idea is that convenience always equals less movement. Think about it. Taking an elevator instead of stairs is convenient but requires less movement. Tossing your clothes into the dryer instead of hanging them is convenient, but requires less movement. Parking close to your destination is convenient, but requires less movement. Driving one mile for a quick errand instead of walking is convenient, but requires less movement. Katy came to the realization many years ago that convenience was not convenient to her health and was in fact debilitating her.

Influenced by Nutritious Movement, I began to notice the big and small ways that choosing convenience robbed me of movement. One of the striking things I discovered was how often I am tempted to ask my partner to hand or bring me something instead of getting if for myself. I had no idea how precious I had become! So I began to intentionally choose movement over convenience. Every day, I am faced with countless decisions to either take a shortcut and “save steps” or to seek opportunities to increase my movement. For instance, at Costco, where I park at the farthest away space, instead of asking for a box, I have my purchased goods placed directly into my cart, which requires me to unload them one at a time into my car; and then several trips into my house. When I return my cart, it is not to the closest stall, but all the way back to the store. These are simple steps that don’t take much time and add up. 

In the Prevention Magazine article, Katy shares numerous ways she chooses movement. For instance, she places her everyday dishes in the lowest cabinets (under the counter) so that she has to squat each time she wants to get a glass, dish, or bowl.

I’ve compiled my own growing list of “inconveniences” that have added movement to my life that in aggregate over days, weeks, months, and years will provide incalculable benefits.

  1. I no longer own a couch or cozy living room furniture. When I wish to sit, I have to get down onto the floor, which is not convenient and requires me to mobilize ankles, knees, hips, and spine. It demands a combination of concentric and eccentric muscle actions to lower me down to the ground and bring me up to standing; and is a realistic test of strength to weight. The benefits of sitting on the floor go far beyond lowering down to and rising up from.
  2. I sleep on a three 3 inch pad on the floor. Again, because it requires me to get down onto the floor and back up again, I’ve added more movement and loads to my parts.
  3. I do quite a bit of computer work, so I had a standing work station built. Prior to making my living as a movement practitioner, I was a research librarian and spent 10+ hours a day sitting at my computer. Now, when I have to be at the computer for long stretches, I either stand or sit on the floor at a sit/squat desk. If you are standing for work, here are my top 25 movements at my standing work-station.
  4. One of the best changes I’ve made to my domicile is adding a squatting toilet. I use Nature’s Platform, which sits directly over my toilet. It provides more realistic squatting loads than that gimmicky foot stool called the Squatty Potty. Nature’s Platform differs from a true squat toilet in that you have to climb up onto it rather than lower to a squat from standing – the way you would do if you were toileting over a hole in the ground/floor, but once you are in a squat on the platform, the experience and benefits are much richer than using a foot stool to hike up your legs.
  5. Over a year ago, we downsized to one car and I walk as many of our errands now as I can. It does take some planning and there are far too many times that I don’t plan well and end up driving to errands that are walkable to save myself time. But I do try to think about where I need to go each week and how I can prioritize walking to get there.
  6. I grew up in Tennessee, where we had no shoes. Just kidding. We had shoes, but I chose not to wear them whenever I could get away with it – all the way up through college. Katy reawakened my love of barefoot living, causing my great neurotic shoe purge that while traumatic has been amazing for how, how much, and how much of my feet move.
  7. And I use my arms more. On my barefoot or minimally shod walks, I carry things in my hands and arms – like my day pack. Instead of using a cart at the grocery store, I carry two hand baskets (when they are available). Instead of using a motorized lawn mower, I use a non-motorized push mower and basic hand tools like clippers, loppers, and hand saws to trim what needs trimming around the garden and yard. Katy is a big advocate for hanging (like from monkey bars and tree branches), but I got bored with hanging, so I started rock climbing again.
datal

Michele, Datil, NM

If you are inspired to add more movement to your life, but you’ve been sedentary and would like to ease in slowly, I am certified by Nutritious Movement to teach the corrective exercises that Katy features in the Prevention Magazine article. These exercises will prepare your body for the loads required for squatting and getting on & off the floor with grace; adding more steps to get you to and beyond the recommended 10,000; and using your arms for lifting, carrying, pushing, pulling, dragging, climbing, digging, chopping pounding, swinging, reaching mantling, scraping, ripping, hoisting, throwing, hauling, heaving and all those other wonderfully nutritious movements your upper body has been missing.

Namaste, Michele

 

A modified raise, point, & curl for your toes

The American Orthopaedic Foot & Ankle Society recommends an exercise called Toe raise, toe point, toe curl, where you hold each position for 5 seconds, for 10 repetitions each foot. It looks like this: toeraisepointflex

It is promoted as an exercise to “strengthen toes and prevent foot discomfort.” While I think it has merit as a foot mobilizer, I’m not convinced that adaptive changes to strength occur because it is a passive exercise, relying on an external force – the floor – rather than an internal force – your muscles – to perform.

So, in addition to performing this exercise against the floor, I think you could move through these same positions, but dangling your foot just above the floor so that you are stretching and generating force in both your intrinsic and extrinsic musculature. In yoga, since we don’t use weights to provide resistance necessary to make strength adaptations to our tissues, we rely on something called maximum voluntary contraction (MVC), which is your maximum ability to contract muscle.

Position 1, when done with your foot on the floor, is actually more like the heel off phase of gait, but in this floor-bound exercise, it passively loads your your toes, which is not enough to strengthen them. Alternately, when you dangle your foot, you can maximally contract your toe extensor muscles, making it more of a toe raise as the name implies.

Position 2, when performed against the external force of the floor,  is almost all concentric calf contractions without much happening in the toes, because the floor is doing the work of keeping them pointing. However, if you dangle your foot, not only are you still working your calf muscles, but now you must engage your plantar flexors (muscles that engage the sole of your foot) to hold the position and can calibrate the force to ~80% of your MVC, which is the ideal amount of contraction for tissue adaptation.

 

As you can now see, position 3 will also be stronger if you are not flexing your toes against the floor. While it would be possible to grind the top of your foot into the floor as a method of resistance, it would be terribly uncomfortable and that sensation would likely detract you from reaching 80% MVC.

I’ve come up with two variations of the more active exercise  – standing on the floor with the knee of my working foot bent; and standing on a yoga block with the knee of my working foot straight. My preference is the latter because it encourages me to pelvic list on the standing leg in order for the working foot to clear the floor. But I think either method would be fine.

Here is a video of the passive and active variations of this exercise.

Learn more exercises for your feet from my teacher renowned biomechanist Katy Bowman with these brilliant 30 minute exercise videos that you can stream or download to view as often as you like for just $5 each!

Toes-and-Calves-Screenshot-300x300

Schoolhouse Series: Toes & Calves

UnDuck-Your-Feet-Screenshot-300x300

Schoolhouse Series: Unduck Your Feet

 

Namaste, Michele

How High is Your Wall?

In an earlier post on boobs, I mentioned upper body movements that are missing in the lives of many – pushing, digging, lifting, carrying, prying, hoisting, pulling, throwing, reaching, hanging, climbing, pounding, peeling, swinging, ripping, and dragging.  Because we have not regularly done most of these things for most of our lives, we have relatively weak upper bodies that fatigue easily and are prone to stress injuries. Baseline strength to weight ratio is bleak in many of us. Visualize the following scenario to see how your upper body would fare. Then go out and find some walls. Or better yet, rock faces, boulders, and trees.

Imagine that you are approaching a series of smooth concrete walls that you have to go over because there is no way to go under or around them.

The first wall is is only as high as your mid shin. Easy, you step on or over it and you’ll be on your way.

The next wall is higher, but only about knee high. Pretty easy. You step on or over it. However, you may have to turn sideways and take some of the load into your hip to step down because that damn knee.

The next wall is mid-thigh height. Can  you step up onto it and jump down on the other side? Or maybe you have to straddle it or sit on it and swing your legs around. Or maybe a combination of sitting and straddling.

The next wall gets interesting. It’s hip height. Can you still step up on? Can you do it with either leg leading? Do you sit and swing your legs? Straddle and schmear your junk?

The next wall is waist high. Can you hoist yourself up onto the wall?  Do you use momentum or slow muscle control? Do you have to jump down to the other side or can you lower yourself down face forward, controlling your descent with the strength of your  back and triceps?

The next wall is chest high. Have you ever mantled? Mantling is an intermediate level move used in rock climbing, where you press or push the mass of your pelvis high enough to be able to get a foot onto the same ledge so that you can stand up. Its not dissimilar to how your might press or push yourself up and out of a swimming pool. Can you get that foot up or do you make that classic beginning-climber move of mantling only until you can get one or both knees up, literally crawling onto the ledge, in the poorest of form. Can you mantle this wall? How do you get down? Can you envision lowering yourself down, backwards, by only eccentric action of your arms?

The next wall is as tall as you. If you were unable to mantle on the previous wall, the outlook is grim, because now you will have to pull yourself up high enough to change the orientation of your hands so that you can mantle. If you are a climber, now is a good time to throw a heel hook. Are you strong enough in your hands, wrists, forearms, shoulder girdle, and core to pull up the weight you are carrying? What would you do if you turned around and a mountain lion was there ready to pounce? While still unlikely, it is ever more conceivable that a concrete retaining wall and a mountain lion would be in such proximity.

The final wall is as tall as your fully reaching hands.

How high is the wall that shows you your boundaries? How high is the wall that stops you?

How high is your wall?

Namaste, Michele

datal

 

 

 

 

Busting other yoga myths with biomechanics

Unlike some of the improbable myths that the gals over at Smarterbodies take on in their new ebook Exposing Yoga Myths, yoga teachers could be forgiven for their misconceptions about demands placed on joints and muscles in common balancing asanas. In fact, nobody was more surprised at what is actually happening than Dr. George Salem, lead researcher for the Yoga Empowers Senior Study (YESS). Dr. Salem is Director of the Musculoskeletal Biomechanics Research Laboratory, Director of the Human Anatomy Program, directs the Exercise and Aging Biomechanics research program; and is Associate Professor in the Division of Biokinesiology & Physical Therapy at the University of Southern California.

In the study that is the subject of this post, Dr. Salem and his team used standard biomechanical analysis (joint moments of force and EMG measurements of muscle activation patterns) to examine physical demands placed on older persons, average 70 years old, performing three common variations each of Vrksasana (Tree) and Uthitta Hasta padangustasana (single leg balance).  Here’s what they discovered.

Vrksasana (tree pose)

Because it can become confusing, use this key for translating beginner, intermediate, and advanced vrksasana. You can see a visual here.

  • beginner = toes of non-stance leg touching the floor; hands on wall
  • intermediate = only stance foot touches ground; hands on wall
  • advanced = only stance foot touches ground; no wall support

They hypothesized that the beginner variation, which was done with toes on the floor and heel against the inside of the shank (lower leg) of the stance leg and using a hand on the wall for support, would be the least physically demanding . The intermediate variation, which had the entirety of the foot on the stance shank, but still holding the wall, would be more physically demanding. The advanced variation, which was classic vrksasana, with foot on shank and no wall support would be the most physically demanding. They hypothesized that the increase in physical demands would be linear. They were wrong.

Progressing

What they found was that there was a large increase in demand going from tree with the toes on the ground and wall support (beginner tree) to tree with the foot off the ground and wall support (intermediate tree). And there was not much change at all between having or not having wall support, when only the stance foot was grounded. Providing wall support doesn’t lessen demand nearly as much as lifting the toes from the mat.  This suggests that more time may be needed practicing the beginner variation before transitioning to the intermediate variation. Because older persons have diminished strength and balance, reduced joint range of motion, and a greater prevalence of osteoarthritis, some variations of what are seemingly appropriate asanas may place them at risk for musculoskeletal and neurological pain and injury. And while increased muscle loading may improve strength and endurance, excessively high joint moments of force may lead to damaging loads to joint structures and exacerbate osteoarthritis and other pathological joint issues.

Recommendation: In working with older persons in vrksasana, when they are ready to progress from the beginning variation, have them keep their toes on the floor and move away from the wall, rather than having them lift their toes while staying at the wall.

Hip Strength

Another finding was that advanced tree and intermediate tree (both with non-stance foot off the ground) were nearly identical in the physical demands of the lateral hip musculature aka abductors aka gluteus medius. Thus, there appeared to be no adaptive benefit to stepping away from the wall, when you are already balancing on one leg (toes of non-stance leg not on the ground). Thus, for students who feel safer holding onto a wall, they are gaining as much improvement in strength and endurance as those not holding the wall. Strong abductors are associated with better balance and reduced fall risk.

Recommendation: Let your students know that holding onto the wall does not undermine hip strength and will  effectively assist them in achieving better balance, decrease fear of falling and performance anxiety in class, and build confidence. 

Knee Safety

A really important finding has implications for students with knee issues. Intermediate and advanced tree pose increases loading of joint structures. Unfortunately, such loading characteristics are associated with knee osteoarthritis and joint pain, thus could exacerbate preexisting conditions. Importantly, and in contrast to commonly held conceptions, the use of a wall for support during these variations of Vrksasana does not offer protection for the knee joint.

Recommendation: For senior students with existing knee problems, suggest they stick with the beginner version of Vrksasana.

Uthitta Hasta Padangustasana (single leg balance)

Follow this key, when visualizing the beginner, intermediate, and advanced variations of padangustasana. Here is a visual.

  • beginner = extended leg supported on blocks
  • intermediate = extended leg supported on chair
  • advanced = extended leg unsupported aka supported by the strength of the student

Progressing with Props…maybe not

Again, researchers were surprised, when their hypotheses were not supported. It turns out that extending your leg onto a chair is not much of a progression over stepping onto a stack of blocks, although it appears quite a bit more demanding. (I interject that there is likely more balance anxiety for some older students to place their leg on the higher chair.) The real progression comes with the advanced variation, which uses active mobility – you holding your own leg up. What is striking to me is that while the leg may be higher on the chair, the effort is larger in the advanced variation – even though the leg is barely off the ground (see link to visual) because the student is generating internal force (muscle force) rather than relying on external force (chair) to assume the posture. It matters how you get there. It matters how you stay there.

Hamstrings

In the advanced variation, co-contraction of the hamstrings and quadriceps occurs, stiffening the joint and increasing stability, however, this increased loading may exacerbate existing knee osteoarthritis symptoms.

Recommendation: For senior students with existing knee problems, suggest they stick with the beginner or intermediate variations of Vrksasana.

Ankles

This study found Padangustasana to be an excellent posture for improving plantar flexor (think rising up onto the ball of your feet) strength and performance, which is associated with balance and postural control, gait, and fall risk in older persons. However, it’s not until students are confidently performing this one legged balance that they appreciatively load the plantar flexor muscles.  This asana is also excellent for ankle inverter strength (think sole of the foot facing in towards the midline of your body), which, like strong plantar flexor muscles, is critical for balance but also in agility and walking proficiency.

Recommendation: encourage your appropriate older students to work towards the advanced variation o Uthitta Hasta Padangustasana for improving ankle strength and agility.

Conclusions

This study’s biomechanical insights provide evidence that can be used by yoga instructors, when selecting modifications for their older students.

Here are three points to remember:

  1. Posture variations that have long been considered introductory may actually induce higher demands at some joints and planes of motion, than pose variations considered advanced.
  2. Pose variations can produce forces that are in the opposite direction of those generated during the classical variation.
  3. Use of props, such as a wall, to reduce contraindicated joint loading may have little or no effect.

As a yoga and movement teacher, my biggest take away is that there are few well-designed studies in the area of biomechanical forces and yogasana. In fact, the authors’ state that this is the first study to quantify the physical demands of yoga pose variations, using biomechanical methodologies. I will continue to seek more research like this so that I can replace time-honored ideas about what I think or what I’ve been told might be happening in yoga with what is actually happening in yoga.

The Physical Demands of the Tree (Vriksasana) and One-Leg Balance (Utthita Hasta Padangusthasana) Poses Performed by Seniors: A Biomechanical Examination. Sean S.-Y. Yu,  Man-Ying Wang,  Sachithra Samarawickrame,  Rami Hashish,  Leslie Kazadi,  Gail A. Greendale, and George J. Salem. Evidence-Based Complementary and Alternative Medicine. 2012.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437689/

Namaste, Michele

Welcome to your shoulder girdle – shoulder extension

Q. When I extend my arms, called shoulder extension in yoga, with a strap looped around my hands (or just hands clasped), I have significantly more range of motion than when I do the same action but holding a block. What is the difference?

These are the kinds of questions that I ponder at 3:30 am, when I should be sleeping. I don’t have enough tacit knowledge (yet) to answer such questions, so I get out my anatomy books and play, trying to puzzle it out. It is in this way that I’ve layered functional, contextual understanding on top of fuzzy recollections and ineffectual memorization. As always, what is happening is way more complex than my summation, but you’ll get the drift.

What are the similarities?

Let’s first look at the similarities. In both examples of shoulder extension, the primary movers or agonists – being the posterior deltoids and triceps – are contracting with help from latissimus dorsi aka lats, while the anterior deltoids, pectoralis major aka pecs and biceps are stretching.

And now the differences.

shoulder_extension_strap

In the strap example, because my hands have to push outward against the strap to keep it taut, my arms are therefore attempting to abduct or move away from my body, which means my lateral deltoids are also contracting. Were the strap removed, continuing to abduct my arms would eventually bring them into the arm position of Virabhadrasana 2. The loads are different, but the result would look about the same if I were clasping my hands instead of using a strap.

shoulder_extension_block2

In the block example, because my hands have to push into the block to keep if from falling to the floor, my arms are thus adducting or moving towards my body, meaning my lats and pecs are also contracting. By contracting my chest muscles, I effectively put the break on further extension of my arms behind me because I am now co-contracting muscles that both cause and keep me from extending. And that is why I cannot lift my arms as high with the block. 

Which method is better?

Is one method – strap or block – better than the other? It depends…

If you want to increase strength and integrity of your tendons, which is my goal in yoga, the bock technique is better for two reasons:

Co-contracting provides greater resistance for the primary movers – posterior deltoids and triceps. I don’t need to tell you this as you can experience it yourself, when you attempt to extend further.

  • the technique I use is to place a block behind me with elbows extended (straight), press firmly into the block (~75% of maximum effort) and try to lift it higher – just like in the picture above.

Adding  an isometric contraction at end range of motion signals collagen production in your tendons thus increasing their stiffness and their capacity to withstand greater loads. Relax already, stiffness as a biomechanical concept is not the same as that feeling of “tight” or “stiff” often exclaimed in yoga; tendon stiffness is a desirable thing. This kind of muscular work in yoga will make your tendons and ligaments more resilient against injury and ultimately may improve your flexibility.

  • One technique I use is to place a block behind me with elbows extended, and barely holding the block, lift my arms until I hit my end range and then press my hands firmly (~75% of maximum effort) into the block, holding for 10 seconds. This technique differs from what I described previously in that I lift my arms first  and press the block second; whereas previously, I pressed first and lifted second. It makes a difference how you get there. 
  • Another technique would be to press the block down onto a counter/table which is essentially trying to move into shoulder flexion and will fire the stretching anterior deltoid. At the same time, press your hands into the block (adduct) to isometrically contract your pectoralis major. It’s a lot of work!

shoulder_extension_blocktable

  • And yet another technique would be to clasp your hands and push them into a block positioned against your sacrum – here you get concentric work in the posterior deltoids, triceps, and lats as well as isometric contraction in your anterior deltoids while they are stretching at what may or may not be your end range. It doesn’t matter – you want to be be able to generate force at all ranges of motion.

shoulder_extension_block3

Think of this work in shoulder extension as prep work for puvottonasana aka reverse table top/plank. Ray Long, whom I introduce in an earlier post, is a master at knowing what muscles are working in just about any yoga pose you can think of. Once you know which muscles are contracting and which are stretching in a pose, you can manipulate variables to increase active mobility. He cues to isometrically attempt to scrub or drag the hands towards the hips, but without actually moving them. This simulates shoulder flexion,  and just like in the examples above using the table or the block against the sacrum, it causes an isometric contraction in the muscles that are stretching, and that makes them strong, more resilient at that range of motion. You can read more here in his book Yoga Mat Companion 3: Anatomy for Backbends and Twists.
Try it.

purvottonasana_RL

Purvottonasana by Ray Long

Or, you could just go back to passively flopping your arms overhead, which may increase your flexibility, but won’t increase strength and resiliency of your tissues. I like to think of passive, yummy poses as junk food yoga, a nod to Katy Bowman’s junk food walking. It’s really yummy and pleasurable, but should only be consumed in small amounts, not that often, and never in place of nutritious, connective tissue loving active mobility.

shoulder_extension_yummy

Namaste, Michele

Oh My Knee (OMK!) and lateral hip strength

I’ve been studying knee biomechanics for an epic upcoming series of posts on knees and yoga. I’ve had over 25 years of knee pain and will be blogging about my dumb knees, what finally nearly fixed them, what set me back from this fix, and how to apply yoga and Restorative Exercise™. Thomas Michaud, who wrote THE book on human locomotion – Human Locomotion: The Conservative Management of Gait Related Disorders, provides in another of his books, Injury-Free Running: How to Build Strength, Improve Form, and Treat/Prevent Injuries, an eye opening test for lateral hip strength, which is the domain of the abductors – gluteals and tensor fascia lata. The test is called the Forward Step-down Test.

I photographed and videotaped (see my FB page) myself doing this test. In the images, I used an 8″ stool instead of a 4″ box to step down from, because that is what I had at the moment and I am impatient. **Later, I stacked yoga blocks on a book to make a 4″ box, which is the customary height for the test. The results were about the same, albeit less dramatic on the 4″ box. Otherwise, I tried to replicate his assessment.

Ideally, when I step off the box, my non-stepping hip should not displace laterally (to the side). The more it displaces, the weaker are my abductors.  My abductors should be firing (eccentrically contracting) to stabilize my hip joint, keeping movement in the sagittal plane since I am moving sagittally or forward. Notice the difference in displacement of my right hip (second image) as compared to my left. What is interesting is that I can and do make a point of firing my lateral hip muscles in yoga, especially in single leg balancing postures, and I regularly do the “pelvic list,” an exercise I learned from my teacher Katy Bowman (warning if you don’t like toddlers, don’t watch this video).  All of this work balancing while intentionally firing my lateral hip muscles in yoga and active mobility training via the pelvic list has made me strong and good at balancing in yoga and pelvic listing. But, it has not translated into coordinated, timely recruitment of my lateral hip muscles during this particular movement – stepping down.

ForwardstepdownLforwardstepdown1R

Who cares? Well, besides my hips, my knees care. Not only do my hips take a beating each time I go down stairs or downhill, hip weakness is the most likely cause for patellofemoral pain syndrome. It turns out that this pain may not be due to an unstable patella that is not tracking correctly, thus moving  sideways, as has been thought for years by sports scientists and clinicians, but it is likely due to the outer aspect of the femur moving into a stable patella because of weak abductors. Whoa!

Here is the lesson. “The inability of strengthening exercises to alter movement emphasizes an important point…you can’t just make a muscle stronger, you have to retrain the muscle to interact in synchrony with other muscles.” Dr. Thomas Michaud

I want to protect my hip and knee joints by functionally improving my lateral hip strength. I’ll continue conditioning these muscles through active yogasana balancing and pelvic listing, but I’ll also be devising a plan to train my hips for the hugely important and frequently occuring movement pattern for which they are currently offline – stepping down. By varying frequency, rate, direction, location, and any other force characteristics of stepping down that I can manipulate, I will train my hips not just for stepping down from a 4″ box but for stepping down in a multitude of situations. Like life. I’m going for variation in my stepping down –  from varying heights, from unstable objects,  from varying surfaces, by controlling different joint angles, etc. If you get in my way, I will step down from you. Or maybe onto you.

Namaste, Michele