Anatomy

Are com­mon cues in stand­ing poses wreak­ing havoc on your knees, sacroil­iac joint, and lower back?

Yoga Journal - - CONTENTS - By Tom My­ers

Tom My­ers, founder of Anatomy Trains, helps you align your feet and knees in stand­ing poses for long-term hip and sacroil­iac-joint health.

YOGA TEACH­ERS AL­MOST UNI­VER­SALLY AD­VISE their stu­dents to place their an­kles and big toes to­gether or line up their feet un­der their hips with the out­side edges par­al­lel to the edges of the mat— in Tadasana (Moun­tain Pose) or Utkatasana (Chair Pose). The most anatom­i­cally in­clined teach­ers urge stu­dents to align their feet so the se­cond toes are point­ing straight for­ward, po­si­tion­ing the tib­ias (shin bones) rel­a­tive to the feet.

While align­ing your feet in these ways may seem like a good idea, es­pe­cially if you are splay-footed or pi­geon-toed, it could cause long-term dam­age to your knees, other joints, and lower back. Here’s why—and how you can avoid it.

Foot and leg anatomy

Your legs tech­ni­cally start from your 12th ribs, which sit be­side your lum­bar (lower) ver­te­brae. They in­clude the psoas and quadra­tus lum­bo­rum mus­cles as well as the rest of the pelvic mus­cles that move or sta­bi­lize the hip joints.

The feet and legs are con­structed as a se­ries of hinge joints, known as sin­gle-de­gree-of-free­dom joints, al­ter­nat­ing with ro­ta­tional (mul­ti­ple-de­greeof-free­dom) joints.

The balls of your feet are five joints that to­gether act as a hinge when you go on tip­toe. Above them is the ro­ta­tional joint un­der your an­kle: Rock your feet in and out from col­lapsed prona­tion (an ex­ag­ger­ated rolling in of the heel to­ward the mid­line) to locked-up supina­tion (heels roll out) to feel this joint.

The up­per an­kle joint is also a hinge. From a stand­ing po­si­tion, bend your knees and bring them

back to locked to feel your lower legs hing­ing over your feet from dor­si­flex­ion (a de­creased an­gle be­tween your foot and shin) to plan­tarflex­ion

(an in­creased an­gle).

Above that, in the lower legs, there is a small amount of ro­ta­tion be­tween the tibia and fibula, the bones be­tween the knee and an­kle. Flex one knee so that you are on the ball of your foot, and swing your heel in and out, like grind­ing out a cig­a­rette, to feel this ro­ta­tion.

Keep mov­ing up your leg: The knee it­self is con­structed as a hinge. The ball and socket of the hip can, of course, move in mul­ti­ple direc­tions. The next link in the joint chain is the sacroil­iac (SI) joint. To iden­tify this joint, feel the prom­i­nent bones at the dim­ples at the bot­tom of the lower back. The SI joint, also con­structed as a sim­ple, one-de­gree-of-free­dom hinge, starts about an inch in front of those. The sacrolum­bar joints, where the spine sits on the sacrum, al­low for some ro­ta­tion.

Ro­ta­tional joints are lim­ited by bone shape, re­strict­ing lig­a­ments, and overly tight mus­cles. But the range, in­ter­play, and adapt­abil­ity in ro­ta­tional joints are greater than in hinge joints—which are lim­ited to one di­men­sion.

What hap­pens when you fo­cus on the feet?

Think about hinges such as those on the screen door of a porch. Each hinge works fine on its own as long as the screws are tight. It opens and closes, flexes and ex­tends, and can con­tinue to do so for years with­out re­pair. But if two hinges are mis­aligned,

they are un­likely to last more than a few months be­fore the door is bent, the screws tear loose, and the frame gets chewed up.

Now ap­ply this to your legs: When you align your feet, the toe hinge and the an­kle hinge will work like those of a good screen door. But your knees and lower back may be pushed into mis­align­ment by align­ing your feet— and that might in turn cause trou­ble for your knee, SI joint, and lower back, es­pe­cially as you chal­lenge them with more dif­fi­cult asana.

To pre­vent this, most prac­ti­tion­ers will be bet­ter served by align­ing their knees un­der their hips and back and let­ting their feet fall where they may.

Hear me out: If you line up your feet but one or both knees are twisted on top of this (see the as­sess­ment be­low), you are mis­align­ing the hinges on the screen door and risk­ing long-term trou­ble. Think of walk­ing: If you aligned your feet as you walked, your knees and lower back would op­er­ate like those mis­aligned hinges and start wear­ing down faster than they should, with bones press­ing and grind­ing on car­ti­lage un­evenly. In­stead, align each knee so that the patella (kneecap) faces for­ward. This way the im­por­tant hinges above—in the hip, pelvis, and lower back—will also be in align­ment. Align your feet, and there is no such guar­an­tee.

Check your leg align­ment

Of course, if your feet, an­kles, knees, hips, and pelvis are all truly in a line, then there is no prob­lem to solve. Here’s how to find out if that ap­plies to you:

Stand in front of a mir­ror and line up your feet so that the se­cond toes are fac­ing for­ward, but you are

oth­er­wise in a re­laxed stand­ing pos­ture, not forc­ing it. Does your pelvis lie square to the mir­ror? Put your fin­ger­tips on the front of your hip bones, and look down to check. Re­mem­ber, no forc­ing.

Now look at your knees. Are your kneecaps also di­rectly aligned with the mir­ror, like head­lights? Or are they headed in or out com­pared with the joints above and be­low? As you bend each knee, does the cen­ter of the kneecap go di­rectly out over the se­cond toe, or does it head off some­where on its own? If the lat­ter, trou­ble could en­sue if you work from ar­ti­fi­cially aligned feet. In­stead, line up your knees and work from there.

If you are think­ing, Oh, I’ll just con­tinue to line up my feet and sim­ply turn my knee un­til it’s straight,

to train it into align­ment—don’t do it. Pulling your me­di­ally ro­tated knee into align­ment usu­ally strains the hip in lat­eral ro­ta­tion and locks the lower an­kle joint into supina­tion—not a good so­lu­tion, as it just sets you on a course for a dif­fer­ent set of prob­lems.

For teach­ers: To do a more pre­cise check for ro­ta­tion within the knee, get down and lightly pinch the in­side and out­side edges of your stu­dent’s kneecap with your thumb and fore­fin­ger. Put your other fore­fin­ger right on the tib­ial tuberos­ity (the bump on the top front of the shin bone). The dis­tance from here to the edges of the patella, where your fin­gers are, should be the same.

If they are not the same (and it is more com­mon for the in­side line to be longer and the out­side line to be shorter), the knee is mis­aligned. Have this stu­dent work with the kneecap straight for­ward un­til you (or a body­worker, phys­io­ther­a­pist, or os­teopath) can get this align­ment re­stored.

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