Wednesday, August 31, 2011

Knee Pain

**Warning: I've avoided talking about my knee pain, but I'm posting this now in case it helps anyone else.   Other people's health problems are by definition boring though, so feel free to skip this post.***

"The pain in your knee is caused by your alignment," the Physical Therapist explains as he points to the video he's just taken of me on the treadmill.  "The problem isn't your knees, it's the overpronation of your feet combined with your pelvic alignment.  You need to change your hiking form." 

I stare at him blankly.  This is not what I expected to hear.  I thought I had bad knees, would be prescribed knee exercises, or told I'd need surgery.  My biggest fear, and why I'd put off going to see a doctor since May, was that I though I'd be told to stop hiking.  Could it really just be my alignment?  Seriously?  But there it was on the screen, my knees bent inward at an awkward angle, which he explained caused the knee cap to wear away at the bone instead of riding nicely in the groove (this is called "runner's knee").

After a lesson in biomechanics and anatomy, I was sent home with a series of self-correction exercises and stretches for my hip joints to do several times a day, and instructions on how to change my posture and form while I hike and run.

Focusing on keeping my knees in alignment
Last weekend, I tried it out-- a few exercises on the picnic table at the trailhead before the hike, and then every step, trying to remember to keep my butt squeezed and chest up.  The result was no pain on my 18 mile hike!   Or at least no pain in my knees.  My butt was another story! Those muscles were sore from being worked in new ways.

In retrospect, I don't know why I was so surprised that form and alignment mattered for hiking.  Alignment is so central to other types of movement that I do-- in trapeze and aerial fabrics class, our teachers constantly stress proper form.  In fact, my trapeze instructor always urges us to keep our chests open when we are doing certain tricks.  "Show your necklace" she calls it.  This sounds very similar to the instruction from the PT, who says to lead with you chest instead of keeping your head down.  Anyway, I am excited to bring that same body awareness to my hiking now that I have gotten some direction about how to improve my form.  Concentration on form is something that is a wonderful mental exercise during trapeze, and it forges a mind-body connection that is especially calming.  When I direct my attention towards keeping my body moving in a precise way, really feeling the movement, it changes my relationship with my own body.  When I concentrate this way in trapeze on my form, it is just about the only time when I actually feel beautiful and happy with my body.  Rather than pounding out the hike and throwing myself down the trail, I want to try this new way to be more gentle with it, coax it into place, and see if I have a shift in mental alignment as well.

Showing the necklace

I'm still waiting to see what happens when I go backpacking this weekend, but I'm hopeful that changing my alignment will help stop the pain in my knee.   If any of you out there have pain in your knee, I really encourage you to stop ignoring pain and get it checked out!


  1. I would like to know the knee exercises you received from your PT and compare them to my exercises. I was also told I had poor alignment and tracking problems.

  2. Hope you found a good PT!

    I was told I had/have iliotibial band syndrome, and alignment problems and muscle imbalances.

    I start with self-correction technique shown here (muscle energy, hip sway, sacral rotation correction for SI joint dysfunction):

    Also, I do hip hikes and one-legged deadlifts, and then to strengthen hip abductors- side plank with hip abduction:

  3. Thanks a lot...I also do have IT band problems and knee alignment problems along with some arthritis. Some of the exercises are similar.