If you've been with Pilates in Common for a while, you know we champion the view that the body is an interconnected, interdependent system. This isn't a new idea, but it often gets overlooked in conventional, medicalized approaches to the body. Consider this: when you have back pain, you typically visit an orthopedist who specializes in the spine. That’s a great start, but from our perspective, it might also be wise to consult a podiatrist.
Viewing the body through this lens, let's consider the knee. The knee shares bones with the foot, ankle, and hip. This means the health of your knee is directly influenced by the condition of the joints above and below it. To illustrate this concept, check out the graphic below.
This graphic can be interpreted from both a bottom-up and top-down perspective in the kinetic chain.
Starting from the foot: It illustrates how overpronation leads to internal rotation of the shin bones, which in turn causes the knees to knock inward. This misalignment influences the hip joints, causing them to rotate inward and ultimately results in an anterior pelvic tilt.
Conversely, beginning at the pelvis: An anterior tilt of the pelvis can induce internal rotation at the hips and shin bones. This alignment shift forces the knees inward and prompts the feet to overpronate.
This presents a classic "chicken and egg" dilemma. It's often challenging to pinpoint whether dysfunctional alignment begins at the hip or the foot. Given that the hip is a larger joint, there's a strong argument that dysfunctions originating there might have broader impacts throughout the kinetic chain. Nonetheless, it’s evident that the knees often bear the brunt of these issues. The pain felt may not stem directly from the knee but rather from problems in the connected regions above or below it. Focusing treatment solely on the knee can result in slow progress and recurring pain, as our experience consistently shows.
Regardless of the starting point, at Pilates in Common, we focus less on the origin of dysfunction and more on addressing all potential issues. This holistic approach helps us enhance overall body movement rather than merely alleviating symptoms at a single joint. We find that this approach leads to sustained reduction of symptoms.
So, the next time you find yourself with knee pain that seems to “come out of nowhere,” consider lengthening and strengthening the tissue around your hips and feet. What do we mean by that?
At Pilates in Common, our favorite hip lengthening trick is using a soft roller or a massage gun—since it seems like everyone’s got one these days. Just remember to keep it gentle. If you’re working with just a hard roller and no massage gun, your hands will do the job perfectly. Make sure to cover the whole hip area: the back (yes, target your booty!), sides, front, and inside.
For strengthening the hips, single-leg circles are our top pick. You can do this classic Pilates exercise lying on your back or on your side. We encourage you to do both! The two positions let gravity interact with your hips differently and activates various muscles. Feel free to keep your leg bent in this exercise.
For foot lengthening, the MELT Method Foot Treatment is our go-to, though it requires some special props. If you haven't gotten into MELT yet, try stretching the soles of your feet by tucking your toes under in a child’s pose. Or better yet, get a soothing foot massage from a helpful partner at home.
For strengthening the feet, we teach Pilates standing footwork. Start with your heels together in a Pilates-V, making sure your arches feel lifted. Then, bend your knees and ankles, keeping your upper body upright. Lift your heels off the floor, keep them together, and stand up straight. Lower the heels down without flattening your arches. You can also reverse it: lift your heels, bend your knees keeping the heels up, then lower the heels while keeping the knees bent, and finally straighten up, pressing into the soles of your feet.
Written by: Destinie Slavich
Photo credit: Flamingo
