Do you remember that game where two people throw a ball to each other over the head of another player who is standing in between them? The ‘piggy in the middle’ has to run around like mad trying to intercept the pass, whilst the
Do you remember that game where two people throw a ball to each other over the head of another player who is standing in between them? The ‘piggy in the middle’ has to run around like mad trying to intercept the pass, whilst the others play all sorts of tricks like ducking or switching directions at the last moment. Yep, well, the piggy in the middle is a great metaphor for the knee.
When the ankle joint receives weight it is normally in contact with the ground. This restricts the movement possibilities within the ankle, providing a relatively stable base on which to stand (‘relatively’ being the operative word here). The hip joint is structurally stable being both deep inside the pelvis and reinforced by layers of strong tendons. In relative terms, the knee is in a much more precarious situation. In the downward spiral (my term, not a technical one), the knee has to accommodate the torsion created by deviations / restrictions above (in the hip) or below (in the foot) or both.
However, the knee is not designed to rotate! It’s a hinge joint. It is designed to allow us to flex in the lower limb. This decelerates the fall of the body, reducing the impact of the ground’s force when our weight is met by a hard surface. It should only move forwards (flex) or lengthen (extend – as opposed to hyper extend (that’s another story)). Restrictions around the ankle and hip force the knee into inward (knock knee) or outward (bow legs) rotation (- bow legs is not really a result of the Spiral Line collapsing, I’ll cover that on another post). Continuous torsion over time ultimately leads to injury. It’s the piggy in the middle, and all it can do is scream in pain.
It is very rare that a knee injury is directly the result of poor functioning in the knee itself! (Dislocation and hyper extension are obviously an exception.) And yet the tendency is just to treat the knee with medications, massage and exercises that directly relate to the knee alone, instead of addressing the underlying cause of the torsion which may be in the ankle, the hip or both. No, I’m not saying you shouldn’t strengthen the VMO and release the ITB (if you have dodgy knees you’ll have come across these terms already). Unfortunately, we often only know about the pattern when the kne