Yoga_Journal_-_June_2016_

PHOTO: RICK CUMMINGS; ILLUSTRATION: MICHELE GRAHAM

ANATOMY

practice well

HIP

ABDUCTORS

CORE

QUADRICEPS

RECTUS

FEMORIS

VASTUS

MEDIALIS

OBLIQUE

(VMO)

VASTUS

LATERALIS

QUADRICEPS

TENDON

TIBIA

PATELLAR

TENDON

PATELLA

PATELLO-

FEMORAL

JOINT

FEMUR

Body of knowledge

Put an end to knee pain by

targeting some surprising muscles.

By Ray Long, MD

IN MOST YOGA CLASSES, you’ll

often (hopefully!) hear cues

meant to help protect your

knees. For example, Angle the

knee no more than 9o degrees,

or, If you feel pain in your knees,

back off. And perhaps one of

the most popular: Strengthen

your quadriceps to lift your knee-

caps. Cues like these are cru-

cial, as injuries and pain

originating in the patella, or

kneecap, can be quite com-

mon—and quite slow to heal.

However, what these cues

don’t address is the importance

of the core, hip abductors (outer

hips), and glute muscles when it

comes to knee health. That’s

because traditionally, treatment

for pain in the front of the knee

focused on strengthening the

innermost quadriceps muscle,

called the vastus medialis

oblique, or VMO. It was thought

that when the VMO was weak,

the patella was more likely to

drift out of alignment, ulti-

mately causing issues. Interest-

ingly, new fi ndings published in

the Archives of Physical Medicine

and Rehabilitation and the Jour-

nal of Athletic Training show that

strengthening the core, hip

abductors, and glutes—in addi-

tion to stretching the quads—is

actually much more effective at

easing knee pain than solely

strengthening the VMO.

To understand how these

muscles affect the knee joint, it’s

helpful to think of the knee in

the context of the entire leg and

pelvis. The patella is a mobile

bone structure between the foot

and the pelvis; any wobble that

travels up from the foot or down

from the pelvis affects the

patella. While instability in the

foot or ankle can contribute to

knee pain and dysfunction, it’s

a less likely culprit than insta-

bility in the pelvis—which is

where a strong core, hip abduc-

tors, and glutes come into play.

These three muscle groups

all surround the pelvic bowl,

which means the stronger

and stabler they are, the sta-

bler the pelvis will be. This is

important, because the orien-

tation of the femur (thigh-

bone) at the hip joint causes

a small degree of normal rota-

tion at the knee joint during

42

june 2016

yogajournal.com

continued on page 45

JOINT MATTERS

When you flex and

extend your knee, there’s

some rotation in both the

femur (thighbone) and

the tibia (shinbone); these

actions can wear and tear on

the patella over time. So, the

more you can stabilize the

knee joint, the healthier

the knee will remain.