What does alignment have to do with knee flexion and extension?

The knee joint is mostly a hinge joint. But being that it is not a pure hinge joint, things get complicated. The main action of the knees is flexion and extension. The normal active range of motion of the knee is 0° extension (fully bent knee) and 140° flexion (fully extended knee). Any loss in the range of motion can be detrimental to one’s ability to engage in sporting and recreational activities or even functional motions like walking up and down steps. In addition to flexion and extension, the knee also allows slight medial and lateral rotation. The weight-bearing function of the knee is considerable. For every pound on your body, your knee feels the pressure of 3 pounds when you take a step. It is crucial that the ankle, knee and hip are aligned properly to allow the pressure to pass through the centre of the knee joint. The slight allowance of rotation makes the knee joint susceptible to injuries that can drastically reduce the range of motion in knee flexion and extension. If you’ve experienced acute knee injuries that required surgery you’ve probably felt the drain of the long rehabilitation process to obtain the full range of motion in knee flexion and extension. It’s important to take preventative measures while our knees are healthy and mobile.

While we have healthy knees to go about our physical activities, it’s important to develop keen awareness around alignment to help the knees maintain the most mechanically efficient position for weight bearing. 

We’re predisposed to knee pain

Our natural physical form predisposes the knees to injuries because our hip joints are wider than the knees in a neutral standing position. This predisposition is even more prominent in women as women tend to have a larger hip to knee ratio than men.

The natural Y-shaped configuration to the leg bones promotes uneven contraction of the quadriceps. As a result, when we contract the quadriceps to straighten the leg, the unevenness of the contraction tends to pull the kneecap to the outside. The outermost quadriceps are responsible for this pull so it’s important to counteract it with the innermost quadriceps. Unfortunately, the innermost quadriceps are usually underused and weak, as a result. 

Another area to pay close attention to is the strength of the hip muscles, namely the gluteus medius. The gluteus medius abducts your hip and thigh, rotating your leg out to your side. When your gluteus medius becomes weak, your thighs tend to rotate and pull inwards abnormally. This is called a “collapsing kinetic chain.” This abnormal position of your thigh can put excessive stress and strain around your knee joint and kneecap. 

The first step to keeping healthy knees is to focus on strengthening the innermost quadriceps and the gluteus medius.  

Yoga-based exercises for improving knee alignment

Yoga can seem daunting when you have knee issues. But in actuality, yoga exercises can be used to directly combat knee issues by cultivating alignment awareness and building strength in the key muscle groups. 

Goddess Squats

  • Separate the feet about 3 ft apart
  • Turn the feet out 45 degrees facing the corners of the room
  • Tuck the pelvic bone slightly under and press the knees back
  • Keep that action and slowly bend the knees over the toes squatting down
  • Hold this position for five to 10 seconds and lower down
  • Move up and down 10 times 
MixPose instructor demonstrating a goddess squat

Bridge Pose Lifts

  • Grab a yoga block and place it between your inner thighs 
  • Lie on your back with your knees bent at a 90-degree angle and your legs held hip-distance apart
  • Engage your core muscles and hug the block 
  • Keep that action and lift your pelvic bone up
  • Hold this position for five to 10 seconds and lower down
  • Move up and down 10 times
MixPose instructor demonstrating bridge pose with a block

Clamshell Exercise

  • Lie on your side with your knees bent and your legs on top of one another
  • Bring your knees toward your chest so that your ankles and hips are in a straight line.
  • Slowly raise the top knee toward the ceiling keeping your feet together, resembling a clam opening
  • When you are unable to open your legs further without rocking backward, hold the position for a second or two before lowering back down again.
  • Complete 10 to 25 clamshells
  • Switch to the other side and repeat

For more on healthy knees, check out our schedule where you’ll find classes targeting specific body areas or try a personalized session with one of our instructors.

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