Here’s my client question: 43 year old former dancer (ballet) and gymnast Runner in her late 20’s until recently when she has been sidetracked by hip bursitis. She spoke with her Doctor and Physical Therapist before starting with me. They said that she can do any type of movement provided it doesn’t cause her pain.They would prefer we don’t do extreme hip rotation.

In my visual assessment, I caught right away that she is bow-legged with hyper-extended knees and her parallel stance is not strong as she prefers turn out. Today, was our first session and we spent a lot of time on the Tower with Roll Down, Push Thru Seated Front and Circle Saw as I wanted to see core strength, rotation ability/mobility and articulation. When I got to Footwork (Bend & Stretch) I found a pattern that surprised me. I expected her to pattern her movement like I used to since I began with bow legs and hyper extended knees. But, instead of her knees splaying out, they come in and almost knock when she corrects her feet to parallel. So, we moved to Reformer Footwork and it was the same, when she pushes the carriage away, if I apply gentle pressure to her heels to “swing” them parallel, her knees “knock” inward. I put the Franklin ball between her knees to keep them apart (when, in my case, I use the ball to keep my knees more together). We then moved to bridging where I discovered the lack of hamstring strength. I focused on the hamstring connection for a while, did some pulling straps/swan and finished with mermaid. Can you offer me any suggestions? Am I on the right path? I do feel that we need to get her hamstrings stronger but will this help with the knock knee/footwork issue? Should I use something bigger than a ball, like maybe a yoga block between her knees?
Or between her ankles? H-E-L-P!! As always, thanks for you insight! Cheri

by Lesley Powell

How a client organizes in a static position can be different when moving. Watch how she organizes her body to stand on one leg.  As she stands on one leg, look at the bone rhythms of the legs.

• Does the foot remain stable, supinated or pronated?
• Does the shins rotate inward or outward?
• Does the femur rotate inward or outward?
• What happens to the pelvis and spine?

She might have been doing some compensation patterns in standing to appear not knocked knee.  Your working with her on creating balance in the legs is great.  Be careful about pushing parallel if she can not maintain it on her own.  She has been working on this pattern for awhile.

Sometimes with knocked knees,  putting a block/ball between the femurs can be a poor cue.  They should not be squeezing the block hard.  It might be better to use a theraband tied around their thighs.  The tightness of the theraband should be enough to get them to parallel not beyond.

Strengthening the abductors/rotators is important.  Since her PT’s do not want her to do extreme range, keep the movements small.

• Rotators – lie on the side with knees bent.  Only lift knee a inch off the other leg.  Or with theraband tied around thighs tightly lying on the back.  Move one knee again in tiny range of motion.
• Abductors – range of motion on side should not be higher than her hip
• Standing – Can she stand on one leg without letting the knee knocking in?

Working on balance of all the leg muscles  is important.  Since she is not allowed to do range of motion, I would also teach some release techniques for lateral rotators, abductors and adductors, and feet as well.

Yes alignment and muscle balance can make a difference. Sometimes when there is an injury, you need to look above or below the problem. For instance, knocked-knees (valgus) usually puts the weight on the inside of the ankle. The ankle, knee and hips have to organize around this disfunction.

I have a Pilates client who has a pin in her ankle from a terrible fall. Because of the pin, she no longer has much range of motion in the ankle. I still train her feet, legs and work on alignment. Her gaining strength has made a big difference in her posture. When the foundation is weak, the entire body compensates.

A lot of bunion surgery is unsuccessful. What was not addressed is the movement patterns that caused the bunions. I highly recommend training like Pilates, yoga especially the standing poses to help build strength in the legs and torso to help with standing and walking. A good teacher can work with the limitations of an injury and help a client gain the necessary support for better function. Of course, certain injuries, such as my client with the ankle pin, will never return back to normal function. By improving overall tone, alignment and flexibility, my client has made incredible changes in function.

Some great reading about foot strengthening are:

The Wharton Stretch Book by Jim & Phil Wharton
See the section on the foot

“One of the dirty secrets of the fitness world is that for all the talk about the importance of stretching, many athletes and other fit people don’t bother with it. It’s hard to gauge the benefits, and it seems as if the time could be better spent running, lifting weights, or perfecting sports skills. This sentiment is expressed by Dr. Bob Arnot in the foreword to “The Whartons’ Stretch Book,” and he says that the Whartons changed his mind. He went to them with a stiffened hip that he thought needed surgery, but after a regimen using the active-isolated stretching technique, his flexibility in that hip had increased 40 percent.

Active-isolated stretching is very different from what your high-school gym teacher made you do. Rather than holding a stretch for a half-minute, you hold it for just two seconds. This prevents the muscle from activating an instinctual braking device to keep itself from overstretching. Traditional stretching forces that braking to occur, and the Whartons think that’s not only counterproductive, but dangerous. If you force too deep a stretch while the muscle is doing all it can to keep itself from being stretched, something’s got to give. And a torn muscle will repair itself with scar tissue, ultimately making that muscle less flexible.”

Conditioning for Dance by Eric Franklin

This book has a great section on the foot. Even though it is written for dancers, there is great information how the foot works and how to train it.

I have been teaching a class, PilatesDancing, for the past year. It has been amazing how many changes are happening in my students. I combined Pilates, Laban/Bartenieff and the Franklin Method to create this class.

The structure of the class consists:

1. Foot training includes releasing tension, strengthening the foot and the mechanics of the foot in movement. We bring the new foot connections back to standing. As the foot become better connected and grounded, alignment and core tone changes.
2. Pilates mat and floor barre includes strengthening the core three dimensionally in a dynamic movement routines on the floor. This includes challenges of balance and level changes which demand more core than doing exercises on your back.
3. A standing warm up, we use a block to challenge balance and understand the importance of the standing/working leg. I also bring into principles from my training from the Franklin method and Amy Matthews, a BodyMind Centering practioner, about rhythms of bones in the leg to enhance standing and function.



4. We end with an adagio. The purpose of the adagio is to practice the themes of the class that day.

This is a series that I learned when I was doing the Franklin Method training. Eric Franklin’s Books

Rolling on the balls is like giving yourself a massage. Tight muscles are poorly functioning muscles. Tight muscles hold the bones in positions that are not always the design of how the body works. Getting bones to move in their normal range is another way to release tight muscles.

Foot Release

Pelvic floor Exercises

Psoas Release

Pelvic Tilts

I AM WALKING YESSIREE…ABOUT YOU AND ME.

Your walk is a reflection of how well or poorly your fitness is. A great gait has gentle movement of your entire body in a balance and coordinated fashion. If one body part is tight/rigid, it will affect the entire body. Tightness is many times a reflection of weakness.

Dr. Eric Cobb, Director of Zhealth, www.zhealth.net, spoke that the transfer of weight on the step forward equals 500 lbs on a healthy walk. When the body is not moving correctly, the forces increase and exacerbate with speed.

A healthy gait is a reflection of trunk (core) control, coordination of your spine with your extremities especially your knee and ankle and good expenditure of energy so that you are not fatigued after just a half-mile walk. Faulty movement patterns in walking can lead to fatigue and injury. Improve your gait will enhance your balance, strength and injury prevention.

As a teacher, I observe my client’s gait to get an idea of how they move their bodies. Especially with injuries, my client’s walking can tell me a lot how they use their bodies. When a client has a knee injury, there are faculty patterns of movement in their walk. Their walking pattern can be making the knee injury worse. By teaching better movement patterns, the client can find better function, strength and mobility.

In June, I will be teaching a course on Gait for teachers 6/22-23. Laura Gates will be teaching Hanna workshops for all with the themes of improving your gait. Go to www.movementsafoot.com for more information.

Lesley Powell