In Wednesday’s blog, we reviewed the anatomical elements of the hip to knee Q-angle. Today, by working with each of the components within an unfavorable valgus knee/ Q-angle pattern, we can begin to tame the ‘chicken-egg’ assault on lower body tissues. Use of Yoga Tune Up® Therapy Balls helps to release muscle fiber micro-spams (trigger points) that cause inhibition of optimal strength production in affected muscles. These trigger points contribute to uneven, unbalanced forces around the joints; in this case particularly hip and knee. By combining Therapy Ball rolling with Yoga Tune Up® corrective exercise techniques, healthy tissues can be mobilized and retrained to enjoy proper anatomical directions of movement. This science-based approach to ‘pre-habilitation’ aims to not only relieve current discomfort, but especially, to avoid excessive wear of affected areas or future injury.
Start with Therapy Ball massage techniques to relax taut tissues. Targeted areas include: quadriceps tendon above the kneecap (patella), inner thigh muscles (adductors); and on the lateral side of hip and thigh, the tensor fascia latae (TFL) and iliotibial (IT) bands. Give mindful attention to the inferior, anterior edge of the IT band (above and outside of knee) from where it infamously adheres to the vastus lateralis muscle. Since excessive medial (internal) hip rotation results in overuse of the adductor muscles and often weak hip abductors, the Leg Stretch series, dynamic Prasarita Lunges and Half Happy Baby Minivini are all effective techniques to bring equilibrium and strength to the lower body alignment. The kinetic chain reaches all the way to/from the feet, so faulty lower leg mechanics do, indeed, contribute to Valgus knee and Q-angle issues. Dysfunctional lower leg mechanics are also related to excessive foot pronation and often a measure of arch collapse, so Yoga Tune Up® self-massage and stretches for feet and lower legs are essential to address this pattern.
Yoga Tune Up® DVDs offer many targeted exercises to address these areas, especially Quick Fix Rx KneeHab or the customized At Home Series. Below is a sample of Yoga Tune Up® Therapy Ball work for the lower leg peroneal muscles:
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Prior to finding Yoga Tuneup- I spent time foam rolling IT band and vastus medialis to release the muscles, allowing for the knee cap to move better. I know when I need to focus on inner thigh muscles (adductors) when I feel the pull of my knee cap during poses such as baddhakonasana. Will be trying some of these stretches in the future.
I might just read this to my athlete students:
“By combining Therapy Ball rolling with Yoga Tune Up® corrective exercise techniques, healthy tissues can be mobilized and retrained to enjoy proper anatomical directions of movement. This science-based approach to ‘pre-habilitation’ aims to not only relieve current discomfort, but especially, to avoid excessive wear of affected areas or future injury.”
I love the idea of a muscle ‘enjoying’ its proper functionality. It’s playful, joyful and could be a terrific way to approach an area that we may have judged as negative or less than in some way. Thank you!
This is one of those areas that initially made me think something wasn’t right about the tissue (my thought process at the time) in my body. If my guy would give me a foot massage and rub up my perineal muscle (at that time I thought the muscle by my shin) it felt like immense pain with soft pressure. Just immense. I thought to myself that this can’t be right, did I always hurt like this with pressure on my body? No.. not just “normal”. I still get stuck sometimes on how to roll these areas.. I kind of forget… Read more »
Diane suggests appropriate “pre-habilitation” rolling and YTU exercises to prevent pain and injury caused by imbalances in hips, thighs and lower legs. Her video focuses on the peroneal muscle of the foreleg, an area I have been working on to release scar tissue from a twisted oblique fracture of the fibula several years ago. This 2 part series and suggested exercises gives me a more comprehensive sequence for dealing with valgus knees and peroneal scar tissue.
I am about 20 weeks post-op from knee surgery, and since exploring my lower legs with the YTU balls I have noticed that my right leg (non surgery, compensating leg) is much tighter on the outer leg, where you are rolling in the video; while the inside of my left lower leg (surgery leg) is where I am finding the trigger points… feeling the cross pattern there is really helpful on deciding where to work next. great post! thank you.
This is super interesting, I can’t wait to try this on my boyfriend for his knee pain, and on myself for constant ankle issues.
Agh! I felt the peroneals on my right leg today like I never have before during a YTU Restorative Hip Master Class. Wow. This is a body blind spot for me for sure! Your article and video were great Diane. And very helpful. I was analyzing my ‘blind spot’ and knew it must be related to my super-flexy ankles (sprained and rolled multiple times since I was young). Your article was exactly what I was looking for- thank you! I’m going to roll my peroneals now!
I’ve had pain and stiffness in my calf ever since I broke my ankle a couple years ago. This routine helps to ease the muscles that have become overworked, to compensate for the injury. Thanks for sharing it!
Yes! You really should secure your foot with a heel strap also to allow the big toe to do its job without trying to grip onto the shoe (which typically happens without a heel strap). Thanks for the compliment! Yes – I developed this routine because there was not a video of this bodypart… and it is a trouble spot for me so I was motivated. Katy Bowman has written a great book about foot pain and her blog has included many discussions about shoes including names of some manufacturers that offer some nice options!!
It’s finally summer and I thought wearing toe-separating sandals was sufficient and an improvement over flip-flops. In reading your article on the peroneal muscles I now understand the importance of a strap across the top of the foot to protect the foot laterally. I probably need to secure the back of the heel as well. I agree with John. The ball routine is awesome. Is this a Yoga Tune-Up ball therapy routine or one you developed? Thanks, again.
Hi Diane. I have been dealing with the chicken-egg issue for most of my life for feet-knees-ankles and without the understanding for the potential to heal the problems earlier in my life, I am now dealing with the results. This means finding ways to correct what I can while trying to minimize further degradation, reduce or eliminate the pain and uncover a healthier way to live in my body. I have arthritic knees so I tend to shy away from working closely with them and so most of my work stops at the hips, TFL, IT etc, although I do… Read more »
I so rarely remember to roll out the muscles below my knee. My quads and hamstrings are usually so tight that they get all of the attention. After reading the article and comments its so obvious to me how tightness in those muscles would evert the foot, pull the knees in toward each other and when compounded with Q-angle give you what I call “X-legs”.
Nice! The kinetic chain reaches all the way to/from the feet, so faulty lower leg mechanics do, indeed, contribute to Valgus knee and Q-angle issues. Dysfunctional lower leg mechanics are also related to excessive foot pronation and often a measure of arch collapse, so Yoga Tune Up® self-massage and stretches for feet and lower legs are essential to address this pattern. I love this because I have been actively working on this with Trina in my private practice. Both of my arches fall, and when I roll out my Fibula and tibia my arch will suddenly respond. It’s one of… Read more »
Hi Diane. Thank you for sharing your expertise with issues in the lower leg and how to ease them with the YT balls. I’m just beginning to use the balls, but as a frequent hiker/walker with some increasing inflammation in my first MTP joint I am always interested in the health of the lower leg and foot. I’ll add this to my daily “to do” list.
Hi Helen, sorry for my delay…. From my research on this topic, and personal experience from tricky leftover sciatica problems affecting this area; it seems that near the head of the fibula /insertion region of the peroneous longus ia where you might be most likely to aggravate the branches of peroneal nerves. While there is a “superficial” peroneal nerve that runs down the lateral superior side of calf, it seems that they are most exposed and/or most abused/aggravated right there –often impinged by tight peroneal muscles at this location. Also can be already aggravated by the upstream aggravation of the… Read more »
Diane…terrific! I have had sciatica pain in the past I know the nerve runs down that lateral side of the calf and crosses over the top of the foot. I’m thinking that one would have to be careful of too much pressure there so as to not aggravate the nerve. Any insight from you …you are awesome with this and carry it into my next lower body roll. XXOO
Hi John- as a general rule, I have read that cross-fiber action is more effective than stripping along the fibers when resolving trigger points, but frankly I feel a different experience with each move and would not choose to leave either out. Since the IT band as connective tissue does not technically form trigger points- I still find both moves offer a different sensation so I do both. There are so many sticky spots along the IT band where it gets tacked down both anterior (vastus lateralis!!!) and posterior edge. But – for sure –hit the smaller TFL each time… Read more »
Fantastic ball routine, thanks Diane!
Is it more effective to roll the IT Band lengthwise or cross-grain?