As I’m often asked about joint-related problems and how Pilates can help to remedy these aches and pains, I wanted to dedicate the first article to the knees so you can get a little insight into the possible causes of knee pain. I also wanted to demonstrate how everything is connected in the human body so if you have knee pain you could quite possibly end up with tightness or pain in your hips or ankles or vica-versa as a result of misalignment or muscular imbalance. I try to explain everything as clearly as possible so don’t get hung up on the anatomical terms, just do yourself a favour and read on you might just pick up a few useful nuggets of information.
The human body is an amazing machine that is capable of healing itself and constantly wants to work and function as a whole and balanced unit. However, the business of every day life and other external factors can often throw the body off-balance making our muscles less functional. Unfortunately the knees are one of those body parts that can be badly affected by imbalances in the body. The good news is,however, that with conscious care and body awareness we can recreate balance and guide the body back on the right track of healing itself and functioning at its optimum.
One of the most common knee pain is the Patello femoral syndrome which is a term used to describe pain in and around the knee. Pain can be the result of a number of different things and in this case it’s the abnormal position and movement of the patella when flexing the knee. This misalignment of the knee can damage the surrounding tissue as it grinds away at the cartilage and destabilizes the knee. Abnormal position of the knees can be the result of a variety of factors. One of the factors could be genetic structural alignment of the legs ( ie; hypermobility of the joints where the ligaments are not taut enough allows the patella to be pulled laterally and out of its natural alignment). The position of the feet is also important , if the feet roll in or are flat they can make the whole leg rotate medially. Another important factor is muscular imbalance and the main culprit is usually the quadriceps (the quads), more precisely the medial quads ( Vastus Medialis Obliques – see diagram below) and the lateral quads (Vastus Lateralis – also below). The VMO pulls the patella medially (in towards the body) the vastus lateralis pulls it laterally (outwards) so in the case of an imbalance between these muscles the patella will get pulled out of alignment leaving the knee joint vulnerable to injury and pain. Now that we are talking about muscular imbalance let’s focus on the Gluteus Medius (the ‘glutes’) too as it plays a very important part in stabilizing the pelvis and the knees. If this muscle is lazy or under developed the knee will roll medially causing strain on the joint, while in order to stabilize the pelvis the Gluteus Maximus becomes too tight. Finally, strengthening the core is a must if we want to keep the torso, the pelvis and knees stable.
Now after this long list of possible causes of pain and problems, keep reading because here’s the good news :). The solution can be as simple as doing Pilates. Pilates is a wonderful way of strengthening, stretching and stabilizing the body from top to toe without being taxing on the joints and muscles. We aim to target even those hard to reach muscles so no muscle group is left over or under trained creating that balance our body craves and needs. Some of the best moves you can do to stabilize and strengthen the knees include anterior leg raises in a seated position with the feet flexed so your VMO gets activated and fire up. Side-lying glute exercises (such as clams, leg circles or leg lifts) as well as moves in shoulder bridge ( ie. shoulder bridge with small ball) would focus on strengthening the outside of the thighs, hamstrings and glutes too. Last but not least, for specific abdominal exercises any of the supine (whilst on your back) core strengthening moves would get you covered.
Here’s a word of caution though, make sure you always stabilize your body before initiating any movement as you cannot move safely from a point of instability. Get your alignment right and keep the center engaged to support your torso and stabilize your joints. Combining proper Pilates breathing with movement can help you execute moves with more power, control and efficiency allowing the body to work as a whole. Although Pilates is extremely beneficial to your joint health do not be alarmed if you experience pain or discomfort. As we lengthen and tone the muscles in Pilates we also increase flexibility, joint mobility and correct body alignment. The body is trained to maintain this neutral position and create positive postural habits. Therefore, if you happen to have any misalignment in your body specifically in your spine,pelvis or hips you could easily experience pain in the knees. While doing Pilates regularly could relieve pain in time, it usually takes a while to regain correct alignment. Do not get discouraged, keep moving mindfully and stay body aware. You know your body more than anybody else so if something does not feel right or gets worse make sure you consult your doctor or physiotherapist. I’ll leave you with one of my favourite quotes from Mr. Pilates himself “ Change happens through movement, and movement heals“