What To Do With Sway Back Knees…?

Dear Lisa

I have quite sway back knees and one of my teachers likes me to stand with my heels as far apart as I can and press the backs of my knees together (I also have pretty good natural turnout). But sometimes if I really focus on this in class I get some pain in the back of my knee. Another one of my teachers says that this is bad for my knees and that I should keep them a little bent, but this just feels weird! I have beeen searching online and lots of people say that you shouldn’t work with them too straight. As you are always working with injured dancers, what do you think about this?

Thanks! From Caitlin

 

Dear Caitlin,

Thanks so much for a great question! Yes it can be dangerous to stand with your knees hyperextended, but you dont need to stand with the knees bent either!  While some people spend their live trying to achieve more extension through their knees to get a beautiful classical line, others struggle with too much mobility and knees that are hard to control. Learning how to stabilize the knee in a good alignment does take practice, but your dancing will benefit!

Anatomically, if you over extend the knee, you risk stretching out the back of the capsule of the knee joint and the internal ligaments. If you are already a little bit on the floppy side (Hypermobile) sitting into your extension will cause these ligaments to stretch out even more and make the knee unstable. It often increases over time as once a dancer ‘sits’ back into her knees, the ligaments get stretched out further. It is REALLY important to maintain softness in the knees in regular standing and walking when you have hypermobile knees as overstretching already mobile knees can put great strain on all of the other parts of the knee. 

Hyperextended Knees

You also have a little muscle called ‘Popliteus’ that sits across the back of the knee. This muscle is designed to unlock your knee from full extension, but if the knee is constantly overstretched it can get a little inflammed. (This is probably what is getting sore when you really stretch your knees in class).

Popliteus Muscle at the back of the knee

However, bending the knees also has its drawbacks… Working with the knees bent can result in excessive tension in the quadriceps (front of thigh) and a build up of muscle bulk (As can over straightening!).

The trick is to get an awareness of ‘pulling up’ not ‘pulling back’ when you straighten the leg. When you have hypermobile joints it is very important to learn how to not ontly control the joint in neutral, but to recover when it does go too far.

Good ways to practise this include:

1) Sit on the floor with your legs extended. (Lean back on your hands with neutral spine if your hamstrings are a little tight. Slowly extend your knee to full range so that you can see how far back it goes, then lower your heel until it is just 1cm off the floor. Focus on lengthening the leg from hip socket to heel and maintain this position for at least 10 seconds. Slowly lower and repeat.

2) Assume the same position as in the first exercise. Then practice little pulses. Lower the heel to the floor, lift back up to 1cm off, then extend just a tiny bit more. Lower back down to 1cm off and repeat at least 10 times. This helps you find the control either side of your neutral position.

3) Then repeat this in standing, either in first position, or when you have more control, on one leg. Stand in less turnout than you would in class and focus on controlling the knee into a tiny fondu/Plié, return to neutral. Then extend the knee slightly before returning to neutral, maintaining the pull up.

The biggest challenge is to actually do this in class. If you have hyperextended knees, it will feel very strange to stand in first with the heels together. This is not to say that you should stand with them 10 cm apart though! Try having a maximum of 2.5 cm (one inch) between your heels and focus on maintaining the control through the knee. This is especially important when you begin to take one the other foot off the floor.

While it takes some effort to control hyperextended knees, once you can do this, it can give you a lovely line for classical dance! Strength to control the position of your knee in any position gives you a lovely line without the risk of injury!

 

Hyperextended Knees can give a lovely line but must be well controlled to avoid injury.

Here are a couple of links to other articles about hyperextension in dancers. Feel free to add more links if you know of any good articles on the topic!

http://www.dance-teacher.com/content/hyperextension-and-bowleggedness

http://www.med.nyu.edu/hjd/harkness/patients/injuries/knee.html#hyperextension

http://teachingsmart.blogspot.com/2008/12/dancing-smart-newsletter-hyperextension.html

 

I hope this helps all you dancers and teachers out there trying to deal with Hyperextended knees!

Kindest Regards,

Lisa Howell

2 Responses to “What To Do With Sway Back Knees…?”

  1. judith fakes Says:

    Thankyou Thankyou Thankyou Lisa
    I have had hyperextension-and-bowlegs all the years
    that I have danced which is 59yrs from being 4yrs old. And way back then I had a good teacher who taught me exactly what you have said, and which I have tried to instill in my students who have or had the same/similar condition. But when the feet apart in first came in for the heperextension it was like I didnt know what I was talking about. So thankyou Lisa for vindicating my teacher Miss Peggy Wilson FMBBO
    ( England) in that she was correct in the way she taught for hyperextension. So to all students who are reading Lisa’s article please take note, you will have succsess
    Thankyou once again Lisa

  2. Beth Kurtz Says:

    Thank you Lisa for the wonderful suggestions. I must deal with this problem often — but I am not a PT, just a ballet teacher. I send all my students to you for your great ideas, and hope they will adopt them, but still must try to get them to work in class in a constructive way that will not make the problem worse. I had to learn it myself, 40 or so years ago, so feel confident that what I’ve learned can help others.

    I ask the hyperextended student to stand in first position, heels together. They will say right away that their knees feel bent. Looking in the mirror, their knees do look bent, because the kneecap is hanging down. I then ask them to pull up their kneecaps lightly. (LIGHTLY — beware of the Eager Beaver syndrome!). They will say their knees still feel bent. I ask them to look in the mirror — do the knees LOOK bent? No — they will see it and they will admit it. I tell them, this is a straight knee and this is the position you must strengthen while standing on the leg. (No need to worry about the leg in the air, no danger there I think.) From then on they know how to strengthen their position, and can work on it on their own. (If they will — just let them not get into a class where the teacher is telling them to slam the knees back!)

    A 16-year-old student came to me once who, when she stood in second position, her knees touched. I explained the problem to her, but I felt this was beyond my ability to help. She left soon. I could only hope she found a better way.

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