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WHERE ARE YOUR HAMSTRINGS?

6/15/2015

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Aegean Sea Picture
Ferry on the Aegean
I’m sitting on a ferry and then bus ride, still in a state of
bliss on my way back from the island of Kea to Athens . . . now fooling around with my phone flipping through photos, and I come across - oh yeah! There's my old Find My Hamstrings Project that I hoped to share with like-minded people.  
                                      Maybe you are them!  
                                        ~~~~~~~~~~~~~~~
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Bus selfy
hamstrings from Netter's Picture
Netter's Atlas of Human Anatomy, p 461
Onward to Hamstring Self-Discovery:
Here on the left is a beautiful illustration of the hamstring muscles, from Netter's Atlas of Human Anatomy. The lateral and medial hamstring groups both attach on the pelvis at the ischial tuberosities (so much more elegant than "sit bones"). They travel down over the back of the thigh and attenuate into tendons that frame the back of the knee (popliteal space!) and attach on the medial and lateral lower leg.  See?  Their centerline is on the posterior thigh.  

See the back of the knee where the tendons of the hamstring muscles cross over to attach on either side of the lower leg?  That's the "knee pit." To position our femurs in a neutral position, we line up the knee pits until they face directly backward, so when the hamstrings contract, the knee  joint bends in the sagittal plane.  Problem is, if our feet are lined up in neutral most of us discover that our knee pits face outward, revealing that our femurs (thigh bones) are inwardly  rotated in relation to the lower legs. 
We develop these misalignments because our cultural habitat of flat surfaces, shoes, chairs etc. leads to immobility and weakness in our feet and hips.
Please, if this is all new to you check out Katy Bowman's video, "All About the Knees," or read Crystal Young's "Shocking News about the Knees." If you are with me on this, please continue on and view my embarrassing but I think interesting photo-self-exploration.
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One day, preoccupied with the puzzle of my own knee pit alignment, I indulged myself with searching out and delineating where my hamstrings actually are with my knee pits in their normal misalignment, in comparison to where they land when I line up my knee pits to neutral. 
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1) My knee pits face outward when my feet are lined up  (with the outside edges parallel), revealing that I have internally rotated femurs. Notice that my right one is more extreme than the left?
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2) Now I externally rotate my femurs, until I can see that my knee pits are facing straight back, which shows that my femurs are now aligned in neutral position. 
(IMPORTANT NOTE: DO ALLOW the inner edges of your feet to come up in response to external femur rotation! If you don’t you will put too much pressure on feet and knees.)

In the slide show below, I explore with my fingers, tracing the perimeter of both lateral and medial groups of muscle. 
  • In the first 4 images my femurs are relaxed into internal rotation. 
  • The next 11 photos (the ones with the inner edge of feet lifted) show me attempting to keep my femurs externally rotated to a neutral position.  Watch the hamstrings shift position. Neat, huh? 
You can see that when the knee pit faces outward, the hamstrings are twisted out of their natural line of pull, and because this is the state they're in all day and all night, during all our movements and non-movements, the muscles themselves are constantly under stress -- not to mention the effect on how our joints articulate, and gradually degenerate.  

So, are your hamstrings on the back of your leg, or are they facing out?

Before I performed this little self-obsessed experiment, I already was completely convinced that I need to practice the position and exercise of External Femur Rotation*, but I wanted to get a better sense of just what is happening with the position of the muscles directly involved. It helps me when I get a wider focus**.  

Try it out in the mirror, and you can get a very red face, too! 
(Or get a friend to help, instead.)
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* See Katy Bowman's video, "Finding Your Deep Hip Rotators" for a great exercise to help with this.

** (Speaking of wider focus and overall picture, you may have noticed how my Achilles tendons look really weird when my knee pits are lined up.  Yes, it's troubling, isn't it? That's a whole 'nother piece to work on.  Hint: "Shank Rotation." The fun never ends!) 
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stiff behind the knee? Try this out.

2/21/2015

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Do you sometimes have stiffness behind the knee after you get up from sitting? Or maybe there's no pattern that you can figure out, yet, but you just get attacked at random moments by stiffness and  discomfort in the back your knee, you feel kind of outraged because you are doing all kinds of things to figure out why you have imbalances and trying to unwind and understand them … 

Okay, that is ME.  It happens to me.  I haven't figured out the key to why and when this happens, except that sometimes a flexed-knee position (like sitting in a chair, or even squatting) will set it up.  I don't even know exactly "which muscle" is involved. I don't imagine it is just one muscle, and probably the reaction is set off by a pattern not even localized at the knee joint, but from a miscalculation in the hip and/or ankle and foot.  I understand more every day (in fits and starts), but I do not have it all figured out.
However: I have found a trick that helps me! I'm calling it a trick, because one stretch by itself will not solve the whole-body problem, and isn't in itself a key answer that will unravel whole dysfunctional patterns, but - aren't tricks great when they have an immediate result! This is what's been working for me: one of Katy Bowman's 50 basic exercises from Restorative Exercise™, the "Prone Inner Thigh Stretch."  I hope it's helpful for you, too.
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Here are instructions from Katy's blog: "Lie down with your belly flat on the floor. Reach one leg out to the side without bending the knees!  Relax your head and neck on your hands. Try to bring your leg up until it is at 90°.  . . If you have a hip replacement, only stretch the leg that has not been replaced." 
(It's a great post about knee pain, osteoarthritis, and more: "Knee Bone Connected To The PF Bone".)

So simple: Lie prone ("on your stomach") on the floor with your pelvis flat on the floor and both legs straight, and reach one straight leg out to the side.

                                DETAILS AND MODIFICATIONS:
NOT quite so simple of course, because: 1) To not hurt your back, you need to keep your ribs from thrusting forward and your pelvis from anteriorly tilting.  2) Rushed into without caution, this position could set off a painful reaction for vulnerable hips or knees. 3) It's important to be working on not letting your knee turn down toward the floor, while you 4) work toward getting your pelvis flat on the floor (i.e. both ASIS's and pubic bone on the ground).

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Is there a face in your knee?

1/25/2015

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Yesterday I ran across this photo in the San Francisco Chronicle, and I thought, "Oh, that's lovely!" . . . 



. . . "But HOW could there be no mention of the amazing face peering out of Ms. Frances Chung's knee?"
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And so I find myself pulled back into my old fascination with the faces in our knees! Years ago in art school, I got my first exposure to this thrilling topic on page 134 of the "Atlas of Human Anatomy for the Artist" (Stephen Rogers Peck). I thought it was a charming idea and it stuck in my mind, but it wasn't until many years later as a Pilates teacher that I saw my first real live knee-face. 

"Whoa!" I said to my client practicing on the Pilates Reformer in shorts, "You've got faces in your knees!"

He said: "What?" (Nervous laughter.)
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I had to take a picture so he'd believe me.  
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So then I went home and dug out the old book, hoping to find forgotten details explaining what these faces are made of, but alas, the only explaining Mr. Peck had done about this tantalizing topic was "kneecap has a 'beard' of fat," and "Cupid's face in female knee." Humpfh. (And I had just found out that he was wrong if he was implying that only female knees can have faces.) 

What can we deduce from looking at these sketches?  I think the brow, the eyes, and the bridge of the nose are formed by the patella. 

That's about as far as I've gotten, but I want to know which structures in the knee, during what phase of action or tension or other factors, actually make the human face appear.
Don't you?
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heal your shoulders by walking

10/8/2014

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(North Coast, California)
The day after I got back home from Greece, I was out on a long walk on a dirt road in Northern California (poor me, haha), and got preoccupied with how much my shoulder blades were moving as my arms swung, and how I couldn't really be sure what my own bones were doing unless I was monitoring the area with my own hand.  (You do need to cultivate a certain amount of self-absorption for this kind of learning!) *
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Is my scapula moving around back there, even though I'm trying not to?
Because of tight and short tissues in the front of our shoulders (pectoralis muscles, internal rotators, etc.), we tend to hunch up, thrust our ribs forward, twist around, and squeeze our shoulder blades back when reaching or swinging an arm back.** Would you like to check and see if you can align your shoulders better as you bring your arm back (aka shoulder extension)? Real shoulder extension is glenohumeral joint extension, and it means that the head of the humerus pivots in the glenoid fossa, and the scapula has to stay still while the arm moves back. 
So I was trying to swing my humeri while stabilizing the scapulae, because I was chasing that delicious feeling you get when long-dormant muscle fibers wake up, look around and grin with delight. "Look! I'm finally aligned and breathing! Yay!" say the long-neglected muscle fibers. You know that feeling, right? (I'm not kidding here: I do own the url ALIGNMENTBLISS.COM, though I haven't utilized it. Yet.) 
Small digression before I tell you about the little shoulder thrill move:

When we are walking, our legs should be pushing back to propel us forward (see Jillian Nicol's very funny blog post). So should our arms (on the opposite side). Our forward propulsion power should come from hip extension (leg going back), and our reciprocal arm swing effort should come from shoulder extension, with hip and shoulder flexion (the forward swing) coming mostly from momentum.  What most of us chair-sitters tend to do is to lift the forward leg or arm (effort on the flexion), and then just kind of let the hind limb trail back until it's time to lift it forward again. Lots more on that later, or in the meantime you could browse hip extension gait alignment bowman… 
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Here's what I entertained myself with on my walk, but for the photos and for practice 
it's best to just stand (weight in heels, neutral pelvis and ribs) and try this:

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Too-Tight-Toe-Extensors #1

9/23/2014

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My tight toe extensors were so noticeable in that last photo I put up, it reminded me that I've been neglecting my foot stretching. And calf stretching. (You name it.) 

But it's so easy to do Top of the Foot Stretch!    -- Here, I'll show you: 

It's simple to do -- just bend one knee and place the top of that foot on the ground behind you. (But darn it, I had the wrong pants leg rolled up, and the stretching foot doesn't even show!) 

If this is the first time you're trying this, perhaps you should hold on to something for balance (a wall, a chair), though that is not what I'm doing here. I was typing on the computer at the kitchen-counter-standing-work-station, demonstrating how we can do some things that are helpful for our bodies while we work, rather than just ignoring and wrecking our selves. It is so simple, BUT we need to get into a few necessary lower body alignment points.
 (For even more fun, read Katy Bowman's STANCE blog). 


ALIGNMENT from the side: LATERAL ANKLEBONE, KNEE and MID-PELVIS LINED UP 

See how my standing leg (the straight one) is lined up so the middle of my pelvis is not forward of my knee and ankle? You might quibble that my pelvis is actually back a little behind the anklebone (aka malleolus), but that is okay in this case. It's good that my weight is in the heel of my standing leg, not the forefoot, so my toes are free, not scrunching up to keep me from pitching forward. 
That way we give our quadriceps muscles (front of the thigh) some slack, and they need that. (They need it because we use chairs, they need it for the sake of our knees. And hips. And backs.) 

Is your stretching foot cramping? Don't worry, you are not damaging yourself, just shake it out and try again. It will get better (and more ALIVE) with practice. DO PUT SOME PADDING under those toes. I used a folded-up sheet, you can use anything.

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Here is a closeup of the stretching foot: 

At first you may only be able to get your toenails on the ground and trying to do more may be painful. DON'T BE PAINFUL. I mean, seriously, if you aren't being nice to yourself you are not doing it right!  Keep doing a little bit, but often (like, up to a minute 1 to 10 times a day) and it will get easier, and it will start to feel great.  Think of "letting go" in your foot, and do both feet.

Notice how my front foot looks like it's levitating? That's just because I'm externally rotating my femur.   "What, huh?" you might say?  I will explain another time.

Alignment from the front: OUTSIDE EDGES OF FEET STRAIGHT, FEET HIP WIDTH APART

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Give us some slack

9/17/2014

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I'm in Greece! Looking out off the balcony over ceramic tile and clothes-hung roof tops toward the soft rippling and breathing of the Mediterranean Sea, basking  in the caressing air and glowing light, the cicadas saying dzi dzi dzi (and dzi dzi dzi some more), and gentle Greek voices echoing up from the street. 

Have I been doing all the industrious Restorative Exercise explorations and practices and every-single-day long walks I intended to do since I got here 2 weeks ago? Umm … well, a little bit, but not so much!  I am LAZY. 

Or: Hey, shall I give myself some slack, some of the same nonjudgmental understanding I have for my clients and students who would be feeling so much better with a dedicated practice of Restorative Exercise and no chair-sitting so muscle imbalances can unwind, and walking walking walking for better and better well-being; but it is hard to get these things incorporated into our days that keep marching on in the way we live, and then we do some but backslide for one reason or another, but Hey again, just because some of us haven't been doing much of it lately DOESN'T MEAN WE WON'T, does it!

I am working on being more like the person I'd like to be. All community-oriented and bustling around, that's what I envision. With A Blog. I think this person I'd like to be should write a blog about some of the endlessly useful-to-humans concepts and information I am privileged to keep learning more about.  (BLOG is such an ugly word btw, but I haven't found a better one so far.) (And did you know that "blog" is short for "web log?" I looked it up.)

Things to write about: why it matters how we walk, for instance, or why we shouldn't sit in chairs, or why we should care if our feet are stiff -- and how I came to think this way. I'll talk (for instance) about how to begin walking better, being able to sit on the floor, mobilizing the feet. I'll add links to other people's thoughts. Then what I hope for is community -- questions and arguments and discussion, leading to more learning and understanding. 

And PS: I am sitting in a CHAIR on this balcony, because otherwise this would be my view:

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Hmm, I guess that's not so bad, after all!

PPS: FEET photos will be prominent in this person's blog, since foot function is so important to how the rest of our bodies work. (And my feet are not yet fully functional. See how those extensor tendons down to my toes are standing out? That means those muscles are too tight (give 'em some slack!). Also, our toes should be wider spaced even at rest.)
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POSTURE ANALYSIS

3/7/2014

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Have you ever had your posture analyzed? I have, several times over the years. Two or three of those times I was taking a class, learning how to do it for others. It never did much for me though. 


Okay, there should be a straight line running from the ear to the shoulder to the middle of the pelvis, to the side of the knee and anklebone. Seems reasonable. So here's this group of eager-to-learn, able-bodied movement teachers standing around looking at each other, noting and measuring each other's deviations, nodding wisely. Oh yes, her left hip is higher than her right, and her left shoulder is higher than her right. Mm hmm. 


I learned that my knees were forward of my ankle bones and so were my hips. I learned that the front of my thighs were tense, and so were my buttocks. Mm hmm.


SO WHAT??

No one ever satisfactorily explained why that actually mattered. Or if it matters what am I supposed to do about it? And if I discern issues like these in the people I am teaching Pilates to, what am I supposed to do with this information besides tell them what's wrong with them and make them feel bad?

I just kept hoping that someday I would accumulate enough experience that it would all come together and be meaningful for me; but everywhere I looked for more information about what alignment is and what it means to how our bodies function,  all I found was unsatisfyingly vague - and even hilariously contradictory!

Enter Katy Bowman and Whole Body Alignment: she explains why "Alignment Matters" with a grand sweeping beautiful overview, and describes a tremendously detailed protocol of what we can do to make it better,  along why we would want to.

NOT VAGUE: there are 25 bony markers we all have on our bodies (assuming we have the standard human body), and all we have to do is see if we're able to stand comfortably and line up all these bony markers simultaneously, without straining.

HA HA HA HA HA.

If you can do it, please write to me!

Both feet pointing straight ahead with the outside edges lined up. Check. (But wait a minute - I'm all pigeon toed and my knees are facing each other!)

From the side: outside ankle bones lined up with the middle of the knee and the middle of the pelvis, weight in the heels. Check. . . (Ack! I'm falling over backwards!)

Pubic bone lined up with the front hip bones aka the ASIS's. (Ok, um, am I really supposed to be sticking my butt out like that? ... Oh no, now it's making my low back hurt, are you crazy?)

Rib cage dropped down and back so that the bottom rib in front lines up with the ASIS and the pubic bone. (Ohh, now my back feels much better. But wait a minute, my chest is all sunk in and my shoulders are all forward, I look like a hunchback!)

Shoulder blades W-I-I-IDE, back of the neck L-O-O-ONG, ear over shoulder and chin dropped! There, now you're perfect!

What? You can only do one of these things or two of these things or none of these things? How'd you get that way? What are all these anomalies and weird contortions about? What? Does? It? Matter?

MORE LATER...



Oh sweetie, you just lived in this world, the way we have it set up.
They put casts on our feet since we were babies, diapers that made our legs splay out as our hips were forming, stuck us in chairs and made us sit still. They didn't know any better, and we didn't know any better. 

But we are learning amazing new things, now. 
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    Author

    Sarah Kotzamani

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 "I was in a lot of pain from driving and playing tennis.  I thought I might have to give up both. However, Sarah helped me identify the source of the problem in my neck, generated through my shoulder and into my arm.  She gave me helpful exercises.  She performed body work that helped me feel the adjustments I should make in my posture, and she helped me stretch muscles that eased the pain.  Thank you, Sarah, for helping me return to tennis and allow me to have hope of a pain free arm."  - Richard D

“... I have been meaning to write a long thank you for such a long time! ... My prolapse symptoms are mostly gone, and I am able to walk comfortably for long times too. ... My plantar fasciitis is pretty much gone too, and I am able to walk around barefoot now .... I've been walking lots (averaging 5 miles a day, and do up to 10 miles on some days without any plantar fasciitis pain) ... I really really really just want to say a huge THANK YOU for your help. I feel so fortunate to have found you.” M.H.

" ... I've been working at the exercises you gave me. The rib thrusting change was a little miracle. My early morning back pain has been almost entirely gone since our session." Cathy D

" ... I went to a kayak rolling class yesterday with great success! By the end of the series of progressive exercises I was rolling my kayak unassisted, and I did 7 unassisted rolls! I know I have you to thank for the increased strength, kinetic awareness and flexibility that enabled me to finally achieve this skill. I of course need to practice a lot from now on but I just wanted to thank you and give credit where it is due!" – Denise B