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.

Heidi Broecking

I've been a yoga practitioner for 13 years and took my 200-hour certification in 2010. I received my Level 1 YTU certification with Jill Miller in March of 2011 at the Kripalu Center. When I'm not with my husband and son, I love to geek out on anatomy and ride a road bike, really fast. Providing a science based system of total body fitness, Yoga Tune Up® has provided me a seamless bridge between enhancing my performance and recovery as an athlete. Yoga Tune Up® has also given me greater understanding of mobility and biomechanics as it relates to the practice of Yogasana. YTU inspires curiosity for me as both a teacher and student of Yoga.

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Sigrún Haraldsdóttir

Just love when you have one movement that can so easily shift the dominant muscle creating the movement. Get the client or class member to feel the difference of movement using opposing muscles. They can hopefully feel their imbalance and where their weakness and strength lie.
Wonderful strengthener for the midline. Thank you!

Angela

Thanks for sharing. I recently had a student who tore her meniscus. She didn’t believe me or the PT the standing posture would so dramatically affect the knee. After 3 weeks of making a conscious effort to stop the external hip rotation and spread weight spread evening over both feet she noticed a big difference in the amount of pain she was feeling. Thanks for the validation!

Bonnie Bloom

Thanks for describing the difference between adductors/push and abductors/pull as the innitiators of the movemnt side to side.
I don’t splay my feet but I do have weak adductors and externally rotate hips. i think it might be causing my knee issues (like his). no matter how much you become aware of the body there is always more.
its a universe

Katrina Sukola

After studying ballet for several years, I am definitely duck toed. I have on and off again knee pain, but it is most excruciating when I hike. I will experiment the next time I hike with parallel feet, and see if my knees enjoys it better. Thanks!

Marie-Michelle Darveau

Thanks for this share. I started to realise more and more that by activate certain muscle you can control more you allignement and posture in my dance class or yoga but I also havo to take a look at my everyday habits to understand the bigger problem. It took more time and patient to change bones than to changes muscles.

Connie

Another great article on what is behind the scene of the epidemic of duck feet!

Pascale hazledine

Great article and example,this also happens to people using elliptical the foot pads are so wide and allow you to externally rotate.i love the prasarita lunges because as a runner I do not move in a lateral plane enough.

Jonathan McKinna

Standing with parallel feet is also the raddest way to wait for and ride the subway! #asyourfootgoessogoesyourhip

Betty Homer

Really appreciate this article. Both timely and appropriate, as I am a fitness instructor (cycling no less), yoga teacher and long-distance runner. Thank you for the real life illustration; this could happen to any of the students in having incorrect foot placement. I will share the contents of your article with my students. Thank you.

Carol morgan

After tearing the meniscus ( lateral tear, almost through) I have battled knee issues for a long time, and had to stop running which was something i loved to do. MRI showed the bad news. One of the things that really helped me was to constantly check out my stance and stop the external hip rotation!! Feet parallel, toes pointing forward, weight spread evening over both feet really helped. But I have to check myself all the time, very easy to slip into the “spinless slouch” where we get the hip depression, and lean over, feet all akimbo. Notice how… Read more »

Elise

Really interesting! I have an external rotation of my right foot for a long time, but I do not have a knee problem. I practice running and I had a pain in the groin radiating down front of the thigh and interior knee within the last few months. I also have pain in the tensor fascia lata and piriformis, many links are forming in my head ! Practice this exercise yesterday during YTU level 1 training was a revelation for me and made me feel good and I would have benefit to integrate to my regular practice ! Thank you… Read more »

Nicole

This has been a favorite of mine for recovering from knee surgery! I definitely have more external rotation on my surgery side right now…

Chloe Whitfield

My adductors and abductors are weak so I’ve incorporated parasite lunges to my knee rehab routine after rolling out my quadriceps and hamstrings. I’m on the road to recovery thanks to the Level 1 training and all the blog posts on the website!

Aude

I love the way your story shows the link between knee issues and the position of the foot that is ultimately related to the strength of the hip region! Prasarita Lunge is a great exercise to strengthened the entire hip region ( the hip flexors, the adductors and abductors as well as the glutes), reinforcing this region is essential to gain greater stability in the pelvic region which then allows you to walk better.

Mei Wong

I am loving this pose. But I have an issue with keeping my hips leveled. Jill suggested a weight lifting disc but I tried with a large heavy text book. It worked to use a prop to ensure the integrity of my hips. Thank u.