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Writer's pictureChristine Ruffolo

Knee Findings: Hinges and Rotation

Joint ‘popping’ is a curious thing.  It alarms without hurting.  Especially when you realize it wasn’t there before.  You notice something is different when you do that particular thing in that particular way.  The different becomes ‘less than’ when you have a smooth and silent side to compare it to.  Sounds somehow seem to compliment feelings so much more than visuals, especially when they are identified as a threat.


A post shared by Chris Ruffolo (@ruffolous) on Jul 11, 2017 at 9:06am PDT


My left knee often claims a lot of my attention and experimentation.  I tore my ACL almost a decade and a half ago and got it surgically repaired with a piece of my hamstring.  What I didn’t know then that I know now, is that relearning to use the knee and the muscles around the knee was made particularly foreign because I had a different hamstring.  That’s what nobody tells you and you have to figure out on your own, if you dare to keep questioning and remain confident that more answers come from more questions.


I relied on my strong calves to assist in knee flexion for a long time.  Removing them by pointing the toes shows a stark contrast in strength and control.  Extending the hip in this position made things even more difficult and highlights further functional weaknesses.

F I N D I N G S

1.  Rotation is vital to knee health

Rotation is the least trained movement of the knee, and also the one most injured in.  Knee rotation, though, cannot happen on it’s own nor in an open-chain (free-floating) format.  It is dependent upon creating torque through the ground and it’s surrounding parts.  Limitations in the tibia and hips cause excessive force to twist through the knee, and standing adds load.  Since single-leg positions place the most weight on a singular knee, the examination and training of rotational feels, both straight-legged and knee bent, is worthy examination for both performance and prevention.


Notice how the stance changes, as does the action of the foot and pelvis as bilateral movements become unilateral.  As the original popping test via instagram revealed, internal rotation — either getting or keeping — held my interest most.

Stacked joints with the knee extended naturally place most rotation through the hip and the shin.  Rotations with knee bent (specifically loaded, as in the low sit or bottom of a squat) cancel out a lot of the hip assistance, exacerbating torque through the shin and knee.  The shinbox get up is a good example of this.  The knee becomes the pivot point through the ground, and if the foot creeps away from the crotch at in attempting this, the leg resembles more of an L-lever, really cranking up the force through the knee. The ability to flex the knee enough to get the butt to heel allows the femur and tibia to rotate synergistically throughout:


The foot and toes stay pointed.  Pulling up on the toes would create another L-lever through the ankle — something to be avoided when you’re trying to find the simplest means to make joints work nice.

2. The hips, feet, and ankles should do more work than the knees

Though the knee is the only hinge joint in the leg, the others are often treated like hinge joints.  Walking and sitting, arguably the majority of human movements, tend to follow the same plane, folding along one line in one direction.  Because the toes, feet, ankles, and hips can do so much more motion-wise than the knee, we should let them; especially when the action follows along the natural bend of the knee.  Tight ankles and hips are much more common than a tight knee.  Where range and load-bearing is available, range and load-bearing should be used.


Super flexion can occur (butt past feet) when the stress is primarily placed on the feet and ankles.  Sitting on the tops of the feet encourages the hamstrings to act, while loading the toes and balls of feet emphasize work to be done by the anterior ankle and lower compartment of leg.

The hips, quads, and hamstrings have a delicate relationship when it comes to deep squatting.  What drives the movement and/or how the movement takes place matters when the movement is a concern.  Since the popping or delicateness existed in the front of the knee, I theorized that the front side of the thigh, quadriceps and hip flexors, should be relaxed.  The backside of the leg, then, must be asked to contract. 

Still, the vectors had to align.  A squat is not a leg extension or curl.  The hips drop and the heel is pulled to butt.  One acts vertically while the other is horizontal.  This drop-relax + squeeze-contract sequence worked wonderfully when practicing a steady and quiet skater sit that eased into a low pistol get up:


Relax quads to drop the hips until you feel the slightest bit of discomfort.  Use hamstrings to squeeze butt forward towards heel.  Once secure, repeat relax-contract cycle until desired depth is reached.

I had always struggled with the bottom of a pistol on my left side.  Using this strategy made it auspiciously simple.  Much more than the achievement of a move, I am interested in what developing a move can teach me about my body.  Even in success, I noted that my upper body likes to twist.  Rotation seems to lie in all the places struggle resides.

3.  Adductor tightness is a big deal

A tight inner thigh throws off the structural balance and function of the leg.  Favorites form.  The foot is pulled closer to the midline of the body than necessary.  Wide or horse stance movements combat this compensation.  Getting the knee to orbit the foot (as the hips sink) is an effective way to train rotation outside of an aligned position.


Taken from a fighting monkey workshop.  Their single leg rotational balance warm up is also terrific.

Overactive adductors also pull the ball of the femur out of the middle of the socket, making it difficult for the hips to drop.  My left adductor was tighter, and it normalized my right hip taking more load.  It acted as a black hole, sucking in my weight and pulling my mass over into it.  My right hip could get lower and accepted this lateral shift.  I centered my squat by using the left hamstrings to pull instead of my right quad to push, furthering engagement of the ‘weak’ muscles around my ‘weak’ knee.

The tight inner thigh also limits internal rotation, making bottom squat knee taps problematic.  Starting in a half frog, I used my torso lean as a mechanism to draw out the excess tension.  Left adductor released, I could sit evenly without extra effort.  Furthermore, I could internally rotate the left leg from the shortened position, and load my left side enough to let the right fall to the floor unhindered.


Our bodies are constantly communicating.  As much as we know when something is right, we also know when something is not right, even if we can’t describe it yet.  We don’t need words or a thesis to experiment.  The senses and measures that allow us to feel give us every right to make interpretations.  The insights we gain aren’t secrets or musings, they’re details.

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