I was in a discussion with a few women a few weeks back, and as chance would have it, the ladies started to quiz me about certain exercises to develop their backsides, or “touchies” as one of them so eloquently put it. For those who appreciate the more technical jargon, we’re talking “glutes” here. Now, considering that I’ve written a post about the “Squat” being the King of legs exercises, I contemplated sighting this reference for their consideration. One of the ladies had already picked up on my “Let’s talk about the Squat-vibe” and said she doesn’t feel like the squat exercise activates her glutes nearly as much as the Lunge pattern does. Oh, sorry, I forgot to mention that this discussion was taking place at a friend’s party, and that these ladies and I, along with my wife, were all in a very socializing mode. Just a FYI. Ok, back to the narrative. Two of the other ladies chimed in by saying that the lunge movement tends to aggravate their knees, not necessarily during the movement itself, but moreso, afterwards.
As I was listening to the descriptions of their particular pain patterns after executing their lunge exercises, it became apparent to me all of these ladies were currently wearing high heels, (4 inches or better) and that everyone of them were supporting their weight on one leg or another, but not both legs evenly. One of the things I look for in people’s postures is how they currently live in their bodies, statically and dynamically. Statically, that is to say without much movement, these lady’s bodies were preferring to load on one side of their bodies only. This usually indicates some kind of imbalance in the pelvis, lower back and hips. An imbalance can mean everything from tight muscles, a tight joint capsule, arthritic changes in the joint (hip), or some kind of acute injury they sustained. Although this analysis was fairly covert, I asked one of the ladies if they also had pain in the side or near the hip when they experienced their knee pain? Two of them replied in the affirmative. So, I reminded these ladies that the knee joint is somewhat of a dumb joint, and is mainly subject to the imbalances in the joints above and below it, namely the pelvis, and foot. In other words, if you have a flat arch/foot you are likely to experience problems or pain syndromes in your knee, or if you have hip tightness or contractures, this will translate down from your glutes, into your I.T band which inserts into your knee. One of the ladies, named Alley, inquisitively stated “So, the knee bone is connected to the foot bone then huh”? To which I replied “More or less” ! I went onto explain further that our brains only knows our body as a “whole-entity” as opposed to containing separate parts and constantly trying to connect them. I could slowly start to see see light bulbs go off in the minds of my company. I also explained that once you started to lose one movement pattern such as the lunge, due to an injury or unresolved imbalance, other movement patterns were soon to follow.
Now, aside from the squat and lunge patterns, which are the corner stones of any good exercise program, there are five other movement patterns that our bodies should be able to perform relatively well. These patterns include, pushing, pulling, gait or locomotion (walking, jogging, running) rotation and bending over. Without these basic movement patterns we wouldn’t have been able to evolve as a species, much less get anything productive done.
Case in point. I was with one of my clients yesterday, who is super fit by the way, and she was unable to complete her reps for the lunging exercise in her superset due to the pain she was experiencing. It was her left knee, which was also the rear knee. Unfortunately, this is a fairly common occurrence for people with weak glute muscles ( glute medius) which is responsible for stabilizing the hip in the frontal plane (side to side plane). If you are weak in the gluteus medius, you will be unable to stabilize your pelvis in the lunge position, or, as was my client’s case. Put simply, your muscle simply “shuts off” which muscles can do, and leaves the remaining muscles to pick up the role of stability. These smaller muscles aren’t equipped to do the bigger muscle’s job, so you can imagine the kind of trouble they’re going to be in?
What can also occur is that the joint of your pelvis (sacro-iliac joint or S.I joint) has experienced a shift out of it’s optimal alignment and rendering that side of your lower extremity relatively unstable. This can be caused by a muscle spasm, or a phenomena called “reactive muscle resonance”. This occurs when the affected muscle’s “buddy or partner” becomes irritated or restricted in some way and abandons it’s role as the helper with its buddy muscle. In this case, it is the glute muscle on the side of your hip (gluteus medius) that has failed its duty to keep your pelvis level, and maintain a stable base. Without a stable base, the muscles that attach at the pelvis and help stabilize the knee will be overworked and underpaid real fast! This instability can result the knee to “buckle-in” (valgus collapse) (see image on right) on the front knee of the lunge or the rear knee’s stabilizers will detect instability and cause you to change your lunge pattern ever so slightly to compensate for this lack of stability. (see image on right)
The compensation is the problem. Joints have very specific and preferred alignment and pressure tolerances, and when they are nudged out of that optimal alignment, the inevitable result is pain and weakness.
Ok, enough of the sciency stuff. Luckily, I detected the pelvic shift in my client’s pelvis as I eyeballed her executing her lunge. In her case, I corrected her pelvis manually by correcting her S.I. joint, which then turned back on her glute medius, and presto, she lunged 5 repetitions without any pain whatsoever.
Based on her smile, I could tell she was happy with the result as well.
So, if you know your knee buckle’s in while you do lunges as in the photo, then you can either perform your lunges in front of a mirror where you will monitor the alignment of the center of your knee over your second toe. If your condition is minor, you may simply have to retrain your hip/pelvic stabilizers to do their job again. This time you are using visual feedback from the mirror to tell your brain to tell your knee and hip to make the necessary adjustments to alignment your knee properly. Better alignment means better biomechanics, and happier joints.
If you experience pain during your lunge, then your something’s wrong! Try and brace your abdominal muscles before you attempt your lunge. Bracing your abdominals is simply “pre-tightening” them before you move. The abdominal brace is really the key to providing stability to the pelvis and knee. Now, if these techniques don’t seem to work, and if you still experience pain or poor alignment during your lunge exercises, you will need an experienced therapist to make some corrections for you. If this is the case, and you live in the Hamilton, Ancaster area, send me an email so I can answer any questions you might have about your knee problem.
Email us at : firstname.lastname@example.org
Yours in health,