Here’s my client question: 43 year old former dancer (ballet) and gymnast Runner in her late 20’s until recently when she has been sidetracked by hip bursitis. She spoke with her Doctor and Physical Therapist before starting with me. They said that she can do any type of movement provided it doesn’t cause her pain.They would prefer we don’t do extreme hip rotation.
In my visual assessment, I caught right away that she is bow-legged with hyper-extended knees and her parallel stance is not strong as she prefers turn out. Today, was our first session and we spent a lot of time on the Tower with Roll Down, Push Thru Seated Front and Circle Saw as I wanted to see core strength, rotation ability/mobility and articulation. When I got to Footwork (Bend & Stretch) I found a pattern that surprised me. I expected her to pattern her movement like I used to since I began with bow legs and hyper extended knees. But, instead of her knees splaying out, they come in and almost knock when she corrects her feet to parallel. So, we moved to Reformer Footwork and it was the same, when she pushes the carriage away, if I apply gentle pressure to her heels to “swing” them parallel, her knees “knock” inward. I put the Franklin ball between her knees to keep them apart (when, in my case, I use the ball to keep my knees more together). We then moved to bridging where I discovered the lack of hamstring strength. I focused on the hamstring connection for a while, did some pulling straps/swan and finished with mermaid. Can you offer me any suggestions? Am I on the right path? I do feel that we need to get her hamstrings stronger but will this help with the knock knee/footwork issue? Should I use something bigger than a ball, like maybe a yoga block between her knees? Or between her ankles? H-E-L-P!! As always, thanks for you insight! Cheri
by Lesley Powell
How a client organizes in a static position can be different when moving . Watch how she organizes her body to stand on one leg. As she stands on one leg, look at the bone rhythms of the legs.
Does the foot remain stable, supinated or pronated?
Does the shins rotate inward or outward?
Does the femur rotate inward or outward?
What happens to the pelvis and spine?
She might have been doing some compensation patterns in standing to appear not knocked knee. Your working with her on creating balance in the legs is great. Be careful about pushing parallel if she can not maintain it on her own. She has been working on this pattern for awhile.
Sometimes with knocked knees, putting a block/ball between the femurs can be a poor cue. They should not be squeezing the block hard. It might be better to use a theraband tied around their thighs. The tightness of the theraband should be enough to get them to parallel not beyond.
Strengthening the abductors/rotators is important. Since her PT’s do not want her to do extreme range, keep the movements small.
Rotators - lie on the side with knees bent. Only lift knee a inch off the other leg. Or with theraband tied around thighs tightly lying on the back. Move one knee again in tiny range of motion.
Abductors - range of motion on side should not be higher than her hip
Standing - Can she stand on one leg without letting the knee knocking in?
Working on balance of all the leg muscles is important. Since she is not allowed to do range of motion, I would also teach some release techniques for lateral rotators, abductors and adductors, and feet as well.