How does to much time sitting in chairs damages our ocean’s reefs? 

By Renee’ Fulkerson

You might be thinking what does sitting in a chair haft to do with an ocean’s reefs? I would be thinking the same thing if I had not made the connection personally on my last adventure out snorkeling.

A little back story:

Last year in the middle of April 2018 Kauai received 50 inches of rain in 24 hours that devastated the island. The north shore communities of Wainiha and Haena were cut off from the rest of the island due to countless mudslides that covered the only two lane road in or out of these communities. It took over a year to repair the road to a safety standard that would allow all non Wainiha and Haena residents to re-enter the area.

YogAlign Inner Breath Yoga Kauai (18)

During this one year period the only folks allowed in and out of the above mentioned communities while massive road repair was taking place were the full time residents. As a full time resident living in Haena I saw with my own eyes the land transform.

Myself and many of the locals had an opportunity of a lifetime to spend time on the secluded and empty beaches. We began to see the fish returning, turtles nesting that had not been there since folks could remember and the reefs were coming alive again.

DCIM100GOPRO  DCIM100GOPRO

This is when I began my regular snorkeling adventures!

During this time I continued teaching and practicing YogAlign – pain-free yoga from your inner core. I began realizing much of my movements in the water reflected my movements in YogAlign. Not to mention breathing through the snorkel replicated the SIP breath in my practice. Like snorkeling a full body activity we too in YogAlign engage the entire body in practice and view the body as a whole.

The primary muscle groups engaged while snorkeling include:

Hip flexors, ham strings, upper and lower abdominal’s, quads and gluteul muscles

A fair amount of flexibility in the ankle region as well as the ability to point the toes like a dancer is necessary (if you prefer to avoid leg and foot cramps).

A  strong core (abdominal, Oblique and back muscles) help to create a stable platform for legs to kick as well as a balance in your front and back leg strength.

Here is were the sitting in a chair comes in as none of the above mentioned muscle groups are engaged during sitting – it is quite the opposite. (the average American spends 7.7 hours a day sitting)

Having said that you take an average person who sits 7.7 hours a day in a chair and he or she decides one day to go snorkeling chances are the ocean reefs (fragile underwater ecosystem) and themselves are going to suffer.

How because he or she would be expecting their bodies to preform in a way it is incapable of preforming. The primary muscle groups that need to be engaged while snorkeling have amnesia from sitting. Flexibility in the ankles and pointing of the toes  would be limited – due to the shortening and tightening of the front line while sitting. Their core would be void creating an unstable platform for their legs to kick not to mention the unbalance between the back and front leg muscles.

How does all of this effect the oceans reefs?

On my last snorkeling adventure I realized I had gained greater endurance, strength and stamina (all supported by my regular YogAlign practice). However when I looked all around me as far as my eye could see people were STANDING ON THE REEFS! Why? Because they were tired and or had leg/ foot cramps and difficulty breathing (and yes I asked).

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I swam up and said do you realize you are standing on a fragile underwater ecosystem that has had a years gift to repair itself from the endless years of damage it has received? Usually the response was I was so tired I could not get back to shore or I was having trouble breathing and got a leg cramp. lol

I encourage everyone to get out and get moving including snorkeling however, not at the sake of our ocean reefs (fragile underwater ecosystems) or their safety. #getupstandupforyourlife

See you on the mat!

Top 10 benefits of Snorkeling 

Stilettos…A Pain In The ???

BY ERIKDALTON.COM

The biomechanical effect of heels in everything from running shoes to stilettos has puzzled researchers and fired controversy for almost a century. In a highly functioning body, the neuro-myo-skeletal system ‘hangs’ in dynamic equilibrium, each part balancing the other. But when a woman wears high heels, a new dynamic equilibrium occurs (Fig. 1) If one body part becomes ‘fixed,’ the whole system must compensate with altered movement patterns resulting in kinetic chain ‘kinks.’ Here’s an interesting experiment that’ll help you get a feel for biomechanical adjustments high-heel wearers deal with every day: • Stand barefoot with the back against a wall. Observe how your ‘upright’ body column forms a perpendicular line (ninety degree angle) with the floor (Fig. 2A).

* Slide a two inch wedge of some kind (phone book, etc.) under both heels and notice that by keeping your body column rigid, you’re forced to tilt forward from ninety to about seventy degrees (Fig. 2B).

* Now replace with a three inch heel wedge and straighten up so you’re touching the wall again and feel the dramatic myo-skeletal adaptations that take place. Can you feel your ankles shift from dorsi to plantar-flexion? In this standing posture, the knees are buckled, hips flexed, low back swayed, and the shoulder girdle retracted (Fig. 2C).

The brain, guided by foot, ankle and visual proprioceptors, must instantaneously make a whole series of myofascial and joint adjustments (ankle, knee, hip, spine, and head) to regain and retain erect stance and equilibrium (Fig 3). But high-heeled posturo-functional faults are not confined to the external milieu; they may also inflict compressional damage on the internal viscera…particularly pelvic bowl contents. According to research conducted by Diane Lee, excessive lumbar lordosis causes the pelvic bowl to dip anteriorly which raises the body’s center of gravity leading to reduced proprioceptive stability.1

Not only are we more unstable on our feet, but the increased anterior pelvic tilt squashes our poor organs. For example, when standing barefoot, the anterior angle (pelvic tilt) of the female pelvis is twenty-five degrees; on low, one-inch heels it increases to thirty degrees; on two-inch heels to forty-five degrees and on three-inch heels to sixty degrees. You don’t have to be a physicist to envision how increased heel height causes gravity to compress and distort abdominal organs (Fig. 4). Hopefully one day we’ll see a well-designed study testing the relationship of long-term high-heel wearing and ‘gut’ problems such as prolapsed colons, distended bladders, hemorrhoids, etc.

Many women love to wear high heels, and I might add many men like women in high heels. However, it’s true that some women suffer for their vanities. In young women, this is accommodated fairly well by ankle and hip mobility and low back stability. But, many high-heel wearing women find that as they age and the hip joints stiffen, shock waves shoot through the lumbar spine causing disc compression, ligamentous laxity and facet joint spurring. Women should be cautious about wearing heels constantly, or over long periods of time.

Clearly, the human foot was not designed to walk in stilettos… or cowboy boots for that matter. The foot is specifically constructed to land in a heel to toe ‘rolling’ motion whereby the arch, ankle, and knee absorb shock (stored energy) and release the ground reaction force up the kinetic chain to counter-rotate the torso and pelvis. The heeled shoe steals this propulsive power from tendons, ligaments and leg muscles. Not only do heels place the foot and leg under greater stress to achieve the demands of propulsion, but the borrowed power must be ‘leeched” from higher structures in the kinetic chain, i.e., knees, thigh muscles, hips, and trunk. As a small army of anatomical reinforcements are recruited to rescue the handicapped fascial tissues, the body continues to lose energy to the ground. Shoe heels of any height set in motion a series of gait-negative consequences, making natural gait — meaning the barefoot form — impossible. Don’t let your clients be a slave to fashion; fix their feet and give them back the natural spring in their step.

Here’s How Many Minutes of Yoga Can Save Your Bones

By CLEVELAND CLINIC 

Your doctor has told you that you have bone loss or thinning. Is this a reason to stop exercising? Not at all.

Weight-bearing exercise has been proven to help avoid these conditions, which are called osteoporosis and osteopenia. Weight-bearing exercise forces you to work against gravity. Some examples include weight training, walking, hiking, jogging, climbing stairs, tennis, and dancing.

A recent study suggests that yoga may be a good addition to the list of weight-bearing exercise that keep osteoporosis and osteopenia at bay.

Increased bone density
Yoga has established benefits — including better balance and coordination—that protect against falling, a major cause of osteoporosis-linked fractures, the study’s researchers said. But the researchers wanted to see whether a set of certain yoga poses also might increase bone density by imposing force on the spine and hips.

The researchers recruited 741 people who joined the study between 2005 and 2015. The participants submitted bone density scans of their hips and spines and other lab tests at the beginning of the study. They also received instructions for the 12 yoga poses, which included tree, triangle, warrior II, locust and bridge, and were asked to log their yoga activity online.

The 227 participants, 202 of whom were women, practiced the routine at least every other day for two years. The average age of the participants when joining was 68, and 83 percent had lower-than-normal bone density.

At the end of the study, the participants submitted new bone density scans — and the test showed significant increases in bone density in the spine.

Hip bone density increased, too, but not significantly. None of the participants reported bone fractures or other injuries caused by doing yoga.

Building bone
Incorporating yoga into a regular exercise routine that also includes strength training can be beneficial for those who want to maintain and build bone, says Judi Bar, E-RYT 500, Cleveland Clinic yoga program manager. Many yoga poses done on a mat can be considered weight-bearing, Ms. Bar says.

“Every pose has a benefit toward bone health if the pose is activating muscles and/or has any part of the body touching the ground,” Ms. Bar says.

Practicing yoga also improves balance and coordination, which can help protect you from falling and incurring a bone fracture.

“We’re practicing good posture, mind-body connection and balance all together. Practicing to develop better balance is a really important part of a protocol now for patients with osteoporosis. If we are able to develop better balance to be able to catch ourselves, we’re less likely to fall and possibly fracture our bones,” Ms. Bar says.

Ms. Bar noted that the study participants did 12 poses within 12 minutes, which might be a challenge for some yoga practitioners. Others may want to hold poses longer to build strength or work on alignment.

Both approaches are fine, she says, as long as they are appropriate for your personal fitness level and your medical conditions or physical limitations. Yoga is not a competition sport and should never cause pain, she says.

“What’s important to getting the desired results is the quality of how we practice the pose,” Ms. Bar says.

Yoga for every body
If you’re new to yoga and think you might have difficulty lowering yourself to the ground, use caution and take your time, Ms. Bar says.

When you first attempt balancing poses, try steadying yourself with one arm by leaning on a wall or using a chair until you build up strength and experience, she says. Practice yoga with the attitude that you are learning and not competing with anyone.

For people with chronic conditions or painful joints, Ms. Bar recommends finding a yoga instructor who is experienced in modifying poses for people with medical issues.

“Not all the poses in this study are accessible to everyone, but they can be adapted or modified to build a yoga practice that is right for you,” she says.

If you have very low bone density, be sure to avoid forward-bending exercises and spine-twisting movements, which may put too much pressure on your back, Ms. Bar says.

10 Tips for Starting Yoga at 50+

by Amber Burke & Bill Reif

Medical practitioners and health-focused websites are increasingly recommending yoga to those of middle age and up, perhaps because yoga can help make you more flexible and mobile, improve your balance, reduce age-related changes in gait, increase your energy, reduce chronic pain and addictive behavior, decrease the risk of heart attacks and strokes, alleviate depression and anxiety, improve sleep quality, and even slow the effects of aging on a cellular level.

Older adults seem to be listening. According to one large survey, those 50 and up constitute 38 percent of all practicing yogis, making them the second largest group of practitioners (after those 30-49). If you are considering joining this number, it’s important to consider how best to approach a new yoga practice at and after middle age.

Although no single type of practice will ever be appropriate for everyone in any demographic, a yoga practice for those 50 and up is one that understands and works with the differences between younger bodies and older bodies, rather than one that pretends those differences do not exist.

In particular, a safety-focused approach to yoga may be especially valuable for older practitioners, who seem to run a higher risk of in-class injury than their younger counterparts. Yoga, like all forms of exercise, can both cause and exacerbate injuries, and while the rate of yoga injuries for all demographics rose between 2001 and 2014, injuries were most frequent among those 65 and up (57.9 injuries/100,000 practitioners), followed by those 45 and up (17.7/100,000). This may result from the way normal, age-related changes and preexisting wear and tear on our bodies interact with a yoga practice.

Although all bodies are different, in general, our bodies become less resilient as we age. To varying degrees, we experience decreases in muscle strength, connective tissue elasticity, and bone density, the combination of which may make us more vulnerable to injury than our younger counterparts. Older adults may also find that their injuries don’t heal as quickly as they did a decade or two ago.

By the time we reach middle age, it’s also likely that we bring to yoga conditions or injuries—diagnosed or undiagnosed—that affect our practice and can make injury more likely. Kyphosis, frozen shoulder, osteoporosis, and back pain (discussed further here) are among the common conditions experienced by older adults that may necessitate changes in our yoga practice.

Fortunately, by making careful decisions about what type of yoga to practice, and how to practice it, we can decrease the odds of injury. While much of the advice below applies to yoga practitioners of all ages and levels, it is especially crucial for those starting yoga at or after age 50, when safety must take center stage.

1. Seek out the type of yoga class that’s right for you.

There are many types of yoga. A high-intensity practice like ashtanga, vinyasa, or power yoga (in which students often “flow” quickly through poses) usually requires the hands to bear weight. These practices may work for some beginning practitioners, especially those who are athletic and free from competitive urges, and who can easily make adaptations within a group class when needed.

But if you are newer to exercise and/or working with injuries or pre- existing conditions (especially of the shoulders, elbows, or wrists), the fast pace of a vinyasa or power yoga class and the emphasis on weight-bearing with the hands may not suit you. Instead, you might consider choosing a class that moves slowly and focuses on alignment. Hatha classes, Iyengar classes, classes geared specifically toward older adults or billed as “alignment-focused,” and introductory, basic, or foundational classes could all be appropriate. Kundalini classes, which often emphasize seated poses, chanting, and working with the breath, may also be beneficial. Yin yoga and restorative yoga (both floor-based practices emphasizing long holds), and chair yoga, in which many poses are practiced with the help of a chair, are of value to many practitioners, but may be especially valuable for older students who are newer to exercise, find balancing to be a challenge, or have difficulty coming down to and up from the floor.

Teachers of all of these different styles are often happy to teach you privately. A private yoga session is considerably more expensive than a group class, but often far less expensive than an appointment with a physical therapist or doctor.

During one-on-one sessions, a teacher can check your form and help you make adjustments to poses that haven’t been feeling quite right, or about which you may be uncertain.

Yoga International and other yoga sites will give you many of the tools you need to be your own teacher and embark on a home practice. There, you’ll find online yoga videos that offer classes for a variety of different levels that you can practice at your convenience. However, even those who prefer practicing at home often find participating in group classes helpful—both for the instruction from a “live” teacher, and the encouragement from a community of other students.

2. Find the right teacher for you.

Even within each type of yoga mentioned above, classes often vary tremendously depending on the instructor. Some say there are as many styles of yoga as there are yoga teachers. For instance, some vinyasa teachers may move slowly, while some hatha teachers pick up the pace. Shop around. Try different teachers. It is not necessarily important that your teacher be the same age as you, but it is important that younger teachers know how to work with students older than themselves.

Go to class early enough to talk to the instructor, or visit with the studio manager to inquire about various teachers’ styles. Ask about their philosophy and goals. Consider steering clear of teachers who think all poses are uniformly attainable and beneficial for all bodies. Instead, seek out a teacher who seems to care about any needs and pre-existing injuries or conditions you might have, and is interested in making your practice productive for you.
Find someone who gives careful instruction, teaches poses that seem valuable and possible, and who offers directions you can easily interpret. Above all, look for a teacher whose emphasis is not on the “what” but the “how”—a teacher who is more interested in teaching students how to move safely and with awareness, than in achieving a particular pose.

3. Be clear about your goals.

If, instead of accomplishment—like achieving handstand or lotus pose, you see the goal of your yoga practice as improved physical and mental well-being, the poses themselves become less important, a means rather than an end. You will then be less inclined to do anything in the short term that puts you at risk for injury, which would interfere with your long-term goal.

Yoga’s benefits for your well-being do not hinge on the attainment of particularly adventurous or dramatic poses, keeping pace with the person next to you, or practicing a pose just the way your teacher does. Rather, the benefits derive from a consistent and mindful practice of poses that challenge your range of motion and strength to a sustainable degree.

4. If you have any injuries or pre-existing conditions, tell your teacher about them, and share any advice you’ve received from your doctor.

A discussion with your teachers regarding any injuries and conditions you may have is essential, so that they avoid encouraging you to make movements that are risky for you. Sometimes, your teachers can help you modify potentially problematic poses or suggest alternatives. Even if you aren’t seeking advice (because you know exactly which changes you’ll make to your practice to keep yourself safe), it’s also important to communicate with your teachers to avoid hands-on adjustments that could place pressure on a place of injury or vulnerability.

Past injuries and surgeries matter, too, since the area of a previous injury is often the area that’s most likely to be injured again.

Any information your doctor has given you about which movements to do and which not to do can be invaluable to your yoga teacher. Though many experienced teachers will know how to work with practitioners who have certain common injuries and conditions, it’s simply not possible for them to know the particulars of every diagnosis. So if, for example, your doctor has given you instructions not to twist or forward-fold, pass that information on.

5. Take charge of your own well-being throughout your practice.
It can be tempting to assume that whatever poses the teacher suggests will be a good idea for you, especially if you’ve communicated with them about any injuries or conditions you have.

But it’s important not to surrender responsibility for either your own safety or your own good judgment. Sometimes classes are so large that teachers don’t feel they can attend to the particular needs of any one individual. Sometimes your teachers may not know how best to accommodate your needs.

But perhaps most critically, there will be times when only you will know what your needs are. For instance, only you can know when you are on the verge of losing your balance in a standing balance pose. But since, according to one study, falls from standing height are the most common cause of injuries in older athletes, it’s critical that you don’t wait for the teacher’s invitation: Exit the pose before your shaking destabilizes you.

Continually register what you are doing and how it feels. Stay attuned to warning signs like tingling, numbness, lightheadedness, and, of course, pain. These are cues telling you that it’s time to come out of a pose.

6. Move Slowly.

Moving slowly from pose to pose gives you time to both get your footing and to notice sensations in your body. And if you’re not in a rush during transitions, it may be easier to stay mindful of your alignment, as well as of any advice your yoga teacher or your doctor may have given you.

Slow movement can also help build strength. Slow doesn’t mean easy—quite the opposite. Try taking a few steps as slowly as possible. You’ll likely feel that moving slower requires more control and effort, rather than less. Moving slowly can also require mental strength to stick with the challenges it presents, as well as to keep a slow pace even when others are moving faster.

7. Give yourself permission to skip and alter poses as necessary.

Respect your feelings of hesitation. If you look at a pose and think, That looks like a bad idea, don’t do it.

Err on the side of caution. Take all directions as suggestions rather than mandates, and do only the poses you can do without strain and while breathing deep, comfortable breaths. Whenever you wish, take a break in child’s pose or any seated pose that is comfortable for you.

Often, there may be another way of approaching a pose to make it more accessible. Ask for help from the teacher in creating another version of the pose, perhaps using props. Having a wall to touch or lean against can help you with balance, and blocks or straps can arrest the depth to which you go in a pose, lessening strain and lowering the probability of injury.

8. Pay attention to how you feel, both after practice and the next day.

It’s important to take into account how you feel, not only during but also after your practice. Do you feel nothing at all? Do you feel you exerted yourself in a productive way? Maybe you’re sore in a “good way”?

Do you have a lightness in your step and a buoyancy in your mood? Or do you feel exhausted? Or maybe you even feel new pain somewhere?

If you feel nothing at all after the class you took, you might consider upping the intensity of your practice. If you feel absolutely exhausted or in pain, you may conclude that you did a little too much, and tone things down next time.

9. Give up comparisons.

You may or may not have something in common with the person practicing vigorously next to you. Do not expect your poses to look exactly the same way that other students’ poses look. Besides, impressive as some of those demonstrations may be, you don’t know what is going on inside any of those other bodies. For all you know, those yogis have rotator cuff tears, repetitive motion injuries, or pain they are ignoring (and perhaps exacerbating by practicing that seemingly advanced pose). Who knows, some of them may have managed to get into their pose only by compromising their alignment or stability in some way. They may even be holding their breath!

Trust that the more advanced student is one who recognizes their own limitations, and practices the version of a pose that is appropriate for their body while maintaining their personal optimal alignment and breathing deeply. Be that student.

It may also be tempting to compare yourself with the person you were twenty years ago, who could have done the suggested adventurous pose with abandon. You can no longer do anything to help or hinder the person you used to be, but your actions today will have a direct impact on the person you will be tomorrow. Do your future self a service by respecting your limits as they are today.

10. Men: Patience and persistence will pay off.

Researchers have long-noted that women tend to be more flexible than men, a gender gap that is slight in preadolescence but increases toward seniority (when older women maintain greater range of motion in many joints than older men do). This difference may be due to a combination of muscle size, tendon elasticity, hormones, and the kinds of activities that men or women are more likely to engage in.

The fact that aging-related declines in flexibility appear to be joint-specific, with, for instance, the shoulder and trunk experiencing greater losses in range of motion than the elbows and knees, indicates that habitual joint usage patterns play a role in these losses.
Statistically, men tend to participate in more vigorous physical activities than women, do more strength-training activities, and play sports twice as much (or more) than women do. But muscle bulk, the wear-and-tear of repetitive movements, and the scar tissue that results from injuries may contribute to losses in flexibility.

Men’s comparative inflexibility is not a reason for them not to do yoga; rather, it makes yoga even more important. And the good news is that, when embarking on a program of stretching, men seem to make gains in range of motion at a similar rate to that of their female counterparts.

However, it’s important that they take things more slowly than they might be inclined to, and that they don’t expect themselves to be able to do everything their female neighbors in class are doing—at least not right away.

Reflections

What all these tips encourage is viveka: a Sanskrit term for the prized quality of discernment and discrimination. Although certain physical aspects of yoga may be more challenging as we age, discernment may also be easier to come by.

At middle age and beyond, we may have an easier time discerning our goals, the kind of practices and teachers that are right for us, and the speed at which we may safely proceed. We may be able to better discriminate between the poses and movements that are of benefit to us and those we would be better off skipping, between what is right for another and what is right for us, and even between what was right for us 20 years ago and what is right for us now.

If we apply this earned wisdom to our yoga practices, it will not only help to keep us safe, but it will also serve as a signal to others.

Every time we stay in a less extreme version of a pose, or take a break when we need it, we model to younger, more ambitious practitioners a kinder way of practicing. We tell another story about what yoga can be. Through the self-awareness and self-care that infuses our actions—and at times our inaction—we become arrows that point inward instead of outward.

Three rules of thumb: The Body is a Machine

by Jonathan FitzGordon

1- THE BODY IS A MACHINE
Just like a car the body is a machine designed to work in a specific fashion. Nothing in the body works in isolation—every part has an explicit function meant to work in harmony with other parts. Our skeleton is like the chassis of a car and the quality of our posture determines whether all of the moveable parts can work effectively. Many of the body’s muscles though far away from each other are meant to work in synch and require proper posture to do so. Our body follows a mechanical model—it is a series of arches, hinges and pulleys, and learning about and understanding your body’s mechanics will allow you to effectively utilize the genius behind the body’s design.
2- OPERATING INSTRUCTIONS
You have to learn how the body works in order to use it correctly. A question I am often asked is—Don’t we just know how to walk? There are so many things we teach babies and young children— how to eat with a fork and spoon, how to tie your shoes and zip a jacket, but when it comes to walking, we all take our first step somewhere between ten and eighteen months old, get a big clap and a cheer from our parents and are then left to our own devices.
The fact is we are designed to walk in a specific way. Bones hold us up; muscles move us; nerves tell the muscles to move the bones. The foot is meant to fall very near to parallel with a distance of two or so inches between each foot. Our arms are meant to move in opposition to the legs with each step—when the left leg moves forward the right arm should move the same distance at the same pace. Our head is meant to be level so that the eyes can best communicate with the spine.
3-BATTERIES NOT INCLUDED
Some people are born strong. Look at your ancestry. Where did you come from? If your forefathers were strong like mine, you likely have a reserve of strength stored away in your DNA. Our level of childhood activity goes a long way to determining the strength you carry into adulthood as well. An active child who played a lot of sports or just ran around a great deal will have a lot more core strength and body awareness than someone who spent more time indoors and avoided the playing field. There are many mitigating factors to movement as well, including illnesses, accidents, and traumas both physical and emotional.
Core Power is a very popular cultural buzz phrase. My approach to the core is about creating strength to support the muscles and bones of walking. Without the proper tone in the muscles of the pelvis and trunk, the body is a machine that is not free to move effectively.
Our society’s aesthetic focus is on the surface and the extremities. When most people go to the gym they work the muscles that people can see—they build strength in the arms legs and the surface of the belly. While tone in these muscle might look good, if it is pursued at the expense of the muscles responsible for holding us up and moving us we will run into trouble in the long run. The muscles of the inner thigh, the pelvic floor and deep low belly are the key core muscles for the FitzGordon Method. These three groups of muscles tend to be weak dues to imbalances with their opposite more external counterparts. Pay attention to your mechanics and learn which muscles need building for a more finely tuned tuned and balanced body. The body is a machine that likes to function efficiently but you have to show it the way how.

Why Do So Many Runners Have Knee Pain?

BY NICOLE RADZISZEWSKI

My Knees Hurt!

Knee pain is one of the most common runner complaints. However, the knee itself—a simple hinge joint designed to bend in one direction—is rarely the root of the issue.

Often dubbed the “middle child,” the knee has the misfortune of being stuck between two problematic siblings: the feet and hips. But the poor knee’s worries don’t stop there. Even an old shoulder or back injury can add to the knee’s stress, particularly when running is involved, says Rebecca Johnson, a physical therapist in the Chicago area.

For this reason, it’s really important to look at how your entire body is moving. “If you have an overuse injury, you didn’t ‘hurt’ your knee—your knee is just a symptom that something is wrong,” she says. “Now we need to figure out how to unload the knee.”

Determining how to reduce the knee’s workload is a bit of a detective game. Typically, increased forces are due to an inefficient gait pattern, says Johnson.

Potential Causes Of Knee Pain:

  • Too much vertical movement/bouncy gait
  • Too much lateral movement
  • Left/right asymmetries, such as when hip extension is limited on one side
  • Alignment issues, such as knee valgus (when the knees cave inward) or overpronation at the foot (when the foot rolls inward and the arch flattens)
  • Inefficient or loss of reciprocal arm/leg swing

You can observe a runner’s gait and notice any of these issues. The challenge lies in determining the “why.” For instance, a bouncy gait indicates a lack of efficient hip extension—which likely results in overuse of the quads, and underuse of glutes and hamstrings, Johnson says.

She seeks the answers to several questions during an assessment: Are a runner’s glutes and hamstrings weak, or is a joint limiting their function? Could dysfunction at her core be to blame for tight hip flexors and quads? Is an old ankle injury inhibiting her toe-off and thus preventing her from getting good hip extension? Is there a range-of-motion issue—related to restrictions in the nervous, skeletal, myofascial or visceral (organ) systems? Or does the runner just need some cues to help her change her gait? Johnson says all of these potential scenarios need to be considered when knee pain is a nagging complaint.

Johnson adds that rest is rarely an adequate solution for nagging knees. “If your car alignment is off, you don’t just park in the driveway, hoping that with a little rest it will run better the next day—you take it to your mechanic. The same goes for your own body. Treatment by a skilled physical therapist will keep you up and running, not stalled on the couch.”