Use Your Toes to Protect Your Knees

Knee Replacement

My friend Jane had knee replacement surgery last winter. Now, a year later, she’s struggling with some compensation patterns. The knee feels fine, but she has persistent strain in her upper thigh and in the opposite side hip.

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One of the joys of having been a Rolfer for nearly 50 years is that I have skills to help my friends when they need it. Some strategic body bodywork chased Jane’s pains away and decompressed her crumpling spine, but I knew that unless we worked on her gait patterns her complaints would come right back.

I’ve learned that when there’s a problem in the knee, there are probably imbalances in the feet.  My friend had no complaints about her feet, but when I watched her move I could see that, especially on the side of her knee replacement, she wasn’t using the full  articulation of her foot.

Articulating the Foot

For Jane this showed up in two specific situations—when hiking uphill she would plant her foot and then pull herself forward using her thigh muscles to straighten her knees. She’s able to hike because her hip flexors and extensors work just fine. But by learning to feel the toe-off from each foot as it moved behind her body, she got extra leverage from her feet without overworking her quads and hamstrings. This same habit in walking—omitting toe-off—may have been responsible for the pain in her upper thigh. Putting it simply, she had been overusing the thigh to do the foot’s job.

Going Down Stairs

The second situation in which Jane was having difficulty was going down stairs. She stepped down onto each step with her whole foot, heel first, the way you walk when you’re on level ground. It took a little while for her to get the hang of stepping down onto her forefoot and then lowering the heel onto the step.

Gades Photos

Gades Photos

To feel what I’m talking about, step down on a step flat-footed.  Sense how jarring that is to your knees, hips and spine. Then step down using your toes and forefoot to soften the landing of your heel and whole body.

To sense the foot articulating in that way, it helps to practice some simple ballet relevés and pliés. But doing them slowly and with lots of awareness in the forefoot and ankle joints, not as a mindless calisthenic.  Those long ago ballet classes stand us in good stead when we become senior citizens.

Jane had gotten by just fine without full functionality of her feet until she had a problem with her knee. Working with my friend led me to reflect that many people may not be getting maximum mileage out of their feet. Watch the video to see how your toes can partner with your knees.

© 2019 Mary Bond