An old friend stopped in for a brief visit over the summer. He was planning an extended trip overseas and was very concerned. His left knee caused him severe pain, especially when walking or kneeling, and he wanted desperately to be able to enjoy walking while on his trip. He asked me, “Could you please look at his knee? The doctors have all said that I need a knee replacement.” Father Peter is a 82-year-old retired Episcopal priest, still active as an assistant rector in his church in Maryland. He had spent the past several years caring for his ill wife who had just recently passed. He had lifted her, wheeled her around, and sat for days by her bedside. Now, after the death of his wife, he had trouble walking. What he found most troubling, however, was the fact that he couldn’t kneel properly in church. Peter's posture was good - erect and balanced. So where was the problem?
I explained to him that certain muscles involved in sitting, walking and moving his legs were probably tighter than they should be. When muscles are involuntarily tight due to having been overused they don't function well. We needed to restore his muscles to a healthy functioning.
Tight thigh muscles and an immobile kneecap will cause pain.
Due to the brevity of our impromptu “session,” I had Peter sit as I palpated his quadriceps muscles. His right leg was softer, the muscles more pliant. His left leg was hard as a rock. I gently moved his right patella up and down, side to side. There was only slight resistance. His left patella, however, wouldn't move. It refused to budge no matter the direction I moved it.
I explained to Peter how the patellar tendon, which is an extension of the quadriceps tendon, passes over the kneecap and attaches into the tibia. If the quadriceps are too tight (or suffer from Sensory Motor Amnesia), the tendons put pressure on the kneecap, and make it impossible to move. This can cause pain when sitting, kneeling, or walking upstairs – all the activities that bothered him.
Tight muscles require pandiculation to relax and release.
In Hanna Somatic Education our clients learn to pandiculate tight muscles. This resets the muscles length at the level of the central nervous system. Keeping this in mind, I taught Peter to pandiculate the right quadriceps muscles: he extended his leg fully to voluntarily tighten his quadriceps muscles. I told him to watch how the thigh muscle "drew the kneecap up," as if it were sliding on a track. He then slowly relaxed his thigh muscles and watched the kneecap slide back into place. Then he completely relaxed his thigh.
When we did this same movement for the left leg/knee, it was more difficult. At first he simply couldn't move the thigh muscles. He contracted every muscle he could think of except his quadriceps! His brain had simply lost sensation and voluntary control of those muscles, which caused them to "freeze up" and stay tight. After several slow, patient attempts in which he really had to concentrate and focus his attention on the feelings in his muscles, he was finally able to firmly and voluntarily contract the thigh muscles. He watched in amazement as his kneecap slid upward, and then downward, as he slowly and voluntarily relaxed the muscles. We repeated this movement several times (with his foot turned inward, then outward) until the kneecap wiggled easily.
Father Peter stood up, walked around the room, and to his utter amazement pronounced himself pain free. I gave him some gentle, easy Somatic Movements and concepts to do at home that would help him reinforce his progress. Just yesterday - a month later - I received this email from him:
Prior to our Somatics session I was hobbling and limping to ease the pain. Now I go for my evening walks marching like a soldier !!!To learn the methods and movements of Hanna Somatics for rapid relief of muscle pain purchase my instructional DVD here.