"I've been going to physical therapy for a month and my knee still won't straighten."
This is what "Sam" said when he came to my Releasing Legs and Hip Joints Workshop this past weekend. He'd had back pain and chronic left knee pain for years, and his doctors told him that a full knee replacement was his only option. He's had several knee surgeries from playing squash and completed months of physical therapy - his therapists pushing down on his knee passively in a futile attempt to straighten his painful knee. But the knee remained slightly bent, and he continued to limp slightly on an unstable knee.
During the workshop Sam discovered that although his LEFT knee hurt and couldn't straighten, he could easily move his left hip and back. It was his RIGHT hip and waist muscles that were "frozen" and could barely move. This undoubtedly had something to do with his knee pain. Tightness on one side of the body is indicative of the Trauma Reflex, causes an imbalance in the large muscle groups in the center of the body, creating an imbalance in the pelvis and changing one's gait. This adversely affects the hips, knees and feet.
Sam's back felt great after the workshop, but his knee still wouldn't bend. I told him that when the hamstrings bend the knee (flexion), the quadriceps (thigh muscles) should relax and lengthen to allow the movement to occur (extension). When the quadriceps contract to straighten the leg and knee, the hamstrings must relax and lengthen to aid in the movement. This is how muscles work together in a synergistic manner.
If the hamstrings are habitually contracted, and won't relax, the knee can't move through its full range to straighten completely. Those tight muscles, which attach into the joint, create pressure and restriction in the joint, thus causing pain. The solution?
PANDICULATE the hamstrings to their full length for easier movement of the knee joint.
Pandiculation: A deliberate contraction of a muscle tighter than the muscle's present contraction rate "wakes up" the nervous system, gives maximum sensory feedback to the brain, and allows the brain to give new motor output, thus re-setting the muscle's length.
I had Sam lie face down on my table, and do the following:
- He bent his left knee to 90 degrees, and I put my hand at his heel. I asked him to pull his heel back to his buttocks, and into my hand. Interestingly, he couldn't seem to contract the hamstrings! This was a sign of Sensory Motor Amnesia, which means that his muscles weren't fully under his brain's control. They were "asleep," "amnesic," not moving. I gently tapped the muscles, and asked him to do it again. This time he was able to feel the muscles, and contract them more deliberately, thus overriding the contraction that his hamstrings were already stuck in.
- Sam then slowly lengthened, then completely relaxed his hamstrings. We repeated this series of movements several times. Then I had him contract his quadriceps muscles firmly, pushing down into my table so he could feel how the hamstrings relaxed when his thigh tightened. He was beginning to get the hamstrings and quadriceps to begin coordinating properly again.
This entire process took 10 minutes.
He stood up and was able to straighten his knee. He was ecstatic. I reminded him that now that he'd "woken up" his leg muscles, and begun the process of reversing his knee pain, now it the time to begin a daily practice of Somatic Exercises to continue his progress. If Sam continues doing the brief, easy Somatic movements he's learned, he should see most, if not all, functionality returning to his knee - without pain, in about two weeks - the average time it takes for the brain to fully integrate new habits into the muscles and joints.
Take a look at the video below. The first movement is what I did with Sam.