Knees and what they do.


What are knees anyway? How do they function? When do they get upset? What can you do to keep them Happy?

First the anatomy:
The knee is the largest joint in your body. The entire joint is about the size of your hand fully extended. It is made up of your femur and tibia. If you make 2 fists and put them together your knee kind of looks like that. The main motions are flexion (heel to butt) and extension. There is also some internal and external rotation at the knee joint.

The hamstrings are the main knee movers and groovers, and are located on the back side of your thigh. The muscles on the front side of your thigh are called the quads. The Hamstrings and Quads have a pretty cool paradoxical relationship: when you transition from sitting to standing their length stays the same, even though they are antagonistic muscles (opposing actions). See, the hamstrings extend your hip and flex your knee, while the quads flex your hip and extend your knee.

In the body there is a dynamic relationship between Mobility and Stability to produce optimum function and efficient movement. Ideally, the ankle joint is mobile, knee joint stable, and hip joint mobile. This alternating relationship of mobility and stability extends all the way up the body. So, if your ankle is locked (from previous injury, scar tissue, overly tight muscles, or shoe choice), then your knees will make up for lost motion and become relatively unstable, and your hips will become more stable (i.e., tight). Classic example and my beef with the ladies is high heels. High heels lock the ankle into a position, which upsets the mobility/stability model all the way up the body.

The hips are the driving force that translates and distributes energy from your feet up your spine, and back down. Since we live in a mostly 90 degree culture where sitting is how we do the majority of our travel and work, the glute muscles atrophy, meaning they are on extended vacation. The glutes, including all the deep hip rotators, help move the femur (thigh bone), which connects directly to the knee. The strength and endurance of your glutes is essential for proper knee placement and function.

Can you see how the health of your knees is in a direct relationship to your ankles and hips? What I tell my patients is that if you are experiencing knee pain with no specific injury to the knee, check the ankle and the hip.

Here are some exercises:
Practice standing on 1 foot and on uneven surfaces to bring strength and mobility to your ankles.

Strengthen your glutes by standing on 1 leg, while lifting your other leg up to 90 degrees hip and knee flexion. Make sure that your iliac crest (generally where your belt is) stays level. Hold that position and see if you can feel some engagement on your standing leg. For a little more awareness let your flexed hip drop down a little bit to the side, as if you are pouring out some tea from your greater trochanter (knobby bone on the side of your femur), and then re-level your hips. You can repeat that 5-10 times. Now there are many, many more exercises to engage your hips and we can go over those in class at a later date.