Healthy Hips and Knees|
Posted Jul 16, 2008 - 09:25 AM
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HEALTHY HIPS AND KNEES
By Luna Jordan, ERYT-500, LMT
What causes joint dysfunction?
Imbalanced use of muscles is the major cause of joint dysfunction. The dysfunction may manifest as pain or limitations in movement, or both. If these symptoms are ignored, the dysfunction can result in deterioration of the cartilage in that joint. Joint dysfunction can be further exacerbated in the hips and knees due to the consistent weight-bearing on the legs while standing or walking. Without intervention, the cartilage will eventually become so worn away that the result will be “bone-on-bone” where there is virtually no cartilage left in the joint. At this point, joint movement is usually severely restricted. What movement is left becomes quite painful and joint replacement surgery may become necessary.
The good news is that there are many years between when the joint first becomes dysfunctional and the need for joint replacement. In that time, yoga therapy can be a useful practice in restoring healthy movement and balance to the muscles around the joint preventing a progression of deterioration. Luna Jordan, RYT-500 is a registered yoga therapist and offers individualized instruction to address your specific needs. Click here to contact her today and set-up your appointment.
What is healthy movement?
Healthy movement in the hip is six-fold. There is internal rotation, external rotation, extension (the leg moves behind the torso), flexion (the leg moves forward of the torso), adduction (drawing the leg toward the opposite leg) and abduction (drawing the leg away from the opposite leg). If any of these actions is restricted, it can cause uneven wearing of the cartilage in the hip joint.
Healthy movement in the knee primarily involves flexion, or bending the knee, and extension, or straightening the knee. The knee has minimal ability to rotate internally (10 degrees) and can rotate a bit further externally (30-40 degrees). This helps explain why most often knee injuries happen during internal rotation.
What is balanced use of muscles?
Around the joint, there are muscles whose actions compliment each other. Put simply, one muscle engages while its antagonist stretches and vice versa. If the ability of one muscle to stretch is restricted by tightness, that will restrict the ability of its complimentary muscle to contract and strengthen. The tight muscle will also restrict its own ability to contract and is usually weak, as a result. The agonist and antagonist muscles around the joint lose tone and are unable to provide the necessary support to the joint.
Similarly, if the joint is hyper-mobile, movement comes easily but the surrounding muscles are not encouraged to develop the tone needed to support the joint. Without that support, this extra mobility leaves the joint vulnerable to injury.
Stretching and toning the muscles around a joint will bring more balance in the use of the joint. This balance will help to stabilize and support that joint.
What is the relationship between hip and knee?
In leg movement, the hip and knee must work together for normal activities such as walking and standing. Restriction of movement in one of these joints will invariably cause problems for the other joint.
Restriction in the movement of the hip may cause pain in the knee. The hip’s normal range of internal and external rotation is 35-50 degrees internally and 50 degrees externally in a healthy hip. Remember, the knee can only perform this internal and external rotation minimally. When rotating the entire leg, most of the motion should be coming from the hip so as not to place too much torsion on the knee joint. If the hips are tight and range of motion is restricted, excess movement may be required of the knee and could account for pain felt in the knee joint.
Likewise, restriction of movement in the knee can result in pain in the hip. The knee’s normal range of motion during flexion is 150 degrees and 180 degrees during extension. Although the hip can flex up to 135 degrees, it can only extend 30 degrees in a normal hip. So, compromised movement in the knee can require the hip to extend beyond its normal range of motion and reveal itself as hip pain.
Balanced movement in the hip and knee as well as BETWEEN the hip and knee is the best prevention against deterioration and pain in these joints. Furthermore, mild to moderate deterioration may also be helped by restoring range of motion and balancing the actions of the muscles around the joint.
Yoga and Balance
Yoga is often translated as “union.” Uniting the actions of body, mind and spirit is the foundation of the yoga practice. This union brings balance to our human experience. Most yoga practitioners in the West begin their yoga practice in the physical body—with good reason. Properly applied asana (yoga poses) provide the opportunity to bring balance and restore health to the physical body. So let’s look at how certain yoga poses might be used to restore balance in the hips and knees.
Strengthening the legs is imperative to stabilizing the hip and knee joints. Standing poses are the key to this stabilization:
Samasthiti (Even-Standing Pose), as known as Tadasana (Mountain Pose) is useful for the reasons its name implies—it can teach how to stand evenly on both feet and the actions of the muscles of the leg that this requires.
Lunging Poses such as Virabhadrasana II (Warrior II) and Parsvakonasana (Side Angle Pose) are excellent for increasing range of motion in the hips while also stabilizing the knee. Remember to keep the front leg at a 90 degree angle with the knee directly over the ankle. Placing the knee forward of the ankle can increase stress in the knee joint.
Straight-leg standing poses and Balancing poses can also be beneficial if proper understanding of how to engage the leg muscles to support the hip and knee is present. It is recommended that you work with a knowledgeable yoga therapist when trying to incorporate these poses into your practice if you have hip or knee dysfunction.
Encouraging healthy range of motion will allow for proper movement in the hip and knee to reduce stress on these joints while also allowing the stabilizing muscles to function optimally. Poses which stretch the muscles around the hip and knee can increase mobility and reduce torsion in the opposite joint:
Supta Padangusthasana (Reclined Leg Raises) and its variations will stretch the muscles of the back of the leg and the inner and outer hip.
Anjeyasana (Kneeling Lunge) will provide a deeper stretch of the hip flexor muscles on the kneeling leg and open the external hip rotators on the front leg.
These are just some examples of yoga poses that can bring greater balance to the hips and knees. There are many others which could be beneficial. Contact me to schedule an appointment today.
There is no substitute for working with a knowledgeable yoga therapist. Prevent injury and receive maximum benefit.