When you stand in your ‘normal’ posture, do your feet rotate in, out, one in, one out or are they parallel? Another way to ask the question is, are you duck toed or pigeon toed? Stand, look, and answer. Go ahead, I’ll wait…so… which is it? In either case the issue of rotation is not in your feet or your ankle. You need to head uptown. Rotation in the lower leg originates at the hip joint.
A student of mine started classes about 6 months ago and told me had knee issues. Meniscus issues in one knee and also pain and mobility issues from lower thigh to just below the knee on the inside of both legs – but there had never been a trauma. I should mention here that he also had massive external rotation and foot supination when standing. We started with simply trying to find a new ‘normal’ in Tadasana. As his body awareness increased, his foot position changed drastically, and so did his posture.
After a month or so he was having less knee pain generally but still felt unstable at the medial knee. He then mentioned he rode a recumbent bicycle for exercise. Woah! Brakes on! What? New information! I asked him about his foot position when he clipped or strapped in. Did he put his feet in a parallel position or did he just strap in? He answered he just strapped his feet in, no correction. There it was. He was externally rotating his femurs at the hip while riding the recumbent. As a result, instead of using the muscles of flexion and extension (quads, hamstrings, glutes and gastrocnemius/soleus)he was recruiting his external rotators and abductors while stretching(weakening) his adductors. One of those external rotators is the sartorius (also a strong abductor) which originates at the iliac spine and inserts at the tibia, just below the inside of the knee. The exact spot of his pain. I asked him to make his feet parallel on the recumbent machine and focus on flexion and extension of the hip and knee, no side to side movement.
Three weeks later the knee pain was totally gone and we got to strengthening those weakened abductors and adductors. One of my favorite Yoga Tune Up® moves for this is Prasarita Lunges. You fire the outer thigh muscles to push you, the inner thighs to pull yourself from side to side or use the muscle groups equally. One great dynamic movement, two muscle groups, three ways to create balance in the hip. Talk about bang for the buck. Check it out!
Learn about our Quickfix Rx: KneeHab DVD.
Read the Scenic Route of Knee Pain.