Do your knees hurt with simple activities like standing up from a chair, or going up a step? Understanding some simple mechanics of the knee and remembering one simple instruction may help you prevent pain in a big way. Just remember this, Squash the Orange! Not sure what that means? We’ll tell you!
First we have to understand the ways our muscles work in order to know what causes our pain with activity. Usually we think of our muscles working only one way. Take your bicep for instance. Most of us know that the bicep bends our elbow, but did you know it also controls how fast the arm straightens out?
This is important to understand especially when it comes to the mechanics of the knee. Our quad is the big muscles on the front the thigh that extends/straightens our knee. It’s the muscle most of us think about using when we go up a step or stand up. But if the quad is the only muscle working we’ll develop habits that can cause pain in the long run. If we only use the quad without balancing it with others muscles, we tend to snap our knee into hyperextension. This puts increased pressure along the front of our knee joint and increased tension in the posterior ligaments and joint capsule.
Co-Contractions
Remember, muscles work in both ways! So not only do we need a set of muscles to perform the action, we also need a set of muscles to control the action. The hamstring is just as important in this situation as the quads. The hamstrings are the set of muscles that bend our knee, but they also control the rate at which the knee straightens out. Both set of muscles working at the same time is the key to controlling the motion and pain; CO-CONTRACTIONS! Not only do co-contractions create a more fluid movement, it helps create stability and limit excess stress on the joint itself.
Squashing the Orange?
So how do we get both muscles working at the same time? One strategy we use with our patients is called SQUASH THE ORANGE! A simple change in where you put pressure through your foot can help turn muscles on or off higher up in your leg.
Where is the orange?
When we say “squash the orange”, we want you to pay attention to your midfoot or what most people call the arch of the foot. Most people tend to load through the front or forefoot (balls of your feet & toes). We encourage people to spread the load through your whole foot.
Squashing?
Start by sitting on the edge of a chair and slowly rounding forward. Reach one hand to the opposite inside of your shin. As you lean, keep the whole foot pressing gently into the floor (remember that full footprint picture). You should feel many of the muscles in your leg engaging. We are targeting the hamstrings as you lean forward and press your foot down. You can use your other hand to feel the muscle on the back of your thigh. You should be able to feel it tightening up as you put more weight forward. Not feeling that back muscle? Keep trying!
Once you’ve got this down you move on to doing it in a standing position. Check out the video below for more information on getting up a step. Encouraging the hamstrings to fire at the same time as the quads creates a balanced dispersed load through the knee joint as you carry your weight up a step as well as standing from a seated position.
Still a little confused? We are happy to teach you and give you more pointers about how to minimize the strain through your knees so you can manage those hills, stairs and anything else you put your mind to! Just give us a call at 301-539-3807.
