Here’s what to do when ...

... when your sweetie doggy, jumping around excited about going out for a walk, knocks a cast iron frying pan off the hook on the wall and you try to catch it and your first two fingers end up between the floor and the cast-iron frying pan as it lands.

Fingers immediately go completely numb and turn purple, and you were just about to head out with Alice for the  two and a half mile walk to your Berkeley studio for a day of manual therapy clients.

            Is this The End?  Have you Lost Your Fingertips?  Will you Ever Work Again?

Ah!
You suddenly remember that Greek “old wives tale” and in desperation:
You pull a clump of butter out of the fridge and pat it on to your fingertips, mold it around and around and hold it on there with your thumb.

You grab your dog’s leash with the other hand and head out the door, working that pad of butter around and around as you walk, with your hand held up to help move the blood through your fingertips but also because Alice is SO interested in this remedy.

"I will stay right with you,“ she says with shining eyes, “I. am. not. interested. in sniffing. anything by the roadside today!”

Amazingly, right away it begins to feel better, and continues to improve for the whole 45-minute journey. Eventually you are feeling good enough to share the messy remedy little by little with Alice, and by the time you reach the studio the purple (and the butter) is GONE.

Full feeling (you'd never know the world ended 45 minutes ago) in those thoroughly-licked fingertips. Wash your hands, continue on to work all day with those fingertips, and give thanks!

Butter as a healing ointment! It’s a folk remedy I learned from Greeks, and in my experience it works better than Arnica. Apparently everyone uses it there for their kids’ bumps and bruises.

Keep it in mind, try it sometime and let us know how it goes!

If you can get this combination of skills down, you have an exercise that helps with most knee issues, often with immediate relief. I came up with this putting together various tips from various people during my Knee Saga days, but really the understanding that makes it possible comes from my studies with Katy Bowman.

THE KNEE DETORQUER:  This exercise addresses the common misalignment that accompanies knee pain, namely the lower leg (shank) being turned out, in relation to an internal rotation of the thigh bone (femur). 

(Directions are for Single Leg, but you can do both simultaneously.)
 
Skills to help you: Kneecap Release, External Femur Rotation, Internal Shank Rotation, Forefoot Eversion

Stand on a wide block (or a bench, step, or curb).

1. Place your foot so that the outer edge of the foot (the pinky side) is parallel to the edge of the block, and hanging half off the edge of the block. Keep your “behind, behind you” (weight in your heels) and quadriceps relaxed.
2. Externally rotate your thigh bone (so your “knee pit” faces straight back but kneecap will be turned out), allowing the entire inner edge of your foot to lift up off the block. 
3. Strive to press the ball of the big toe down onto the block as you keep your neutral femur still.  This will lift the outer edge of the foot up, toward leveling out your foot.
4. The goal is: Neutral femurs (knee pits straight back), Relaxed quads, feet straight forward and level. 

                Hold this position for a minute, or as long as you can without pain.

                 IF IT HURTS, STOP.

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.

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. 

(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.)

* 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!) 

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.

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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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.

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

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:

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.)

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.