January 24, 2008

Knee Pop and Long Leg!


After reading your letter about the popping hip, I was wondering if you could shed some light on a problem that I have been having. I have been having a popping sensation at the back of the knee. After x-rays and an MRI, I visited an orthopedic that told me that "he doesn't know what to tell me", he thinks it is my hamstring. The popping started back in October and since then has for the most part gone away, but there are times that I can still feel it "pop" or get a sensation as though it needs to pop. Do you have any ideas or suggestions that I can try? I guess I need to tell you that there is no particular exercise that bothers me, most of the time it happens I am just walking!

Thanks! Nancy

Good question – and – I'm happy to hear that the 'pop' is slowly going away. It's not unusual at all to find that the lateral hamstring is tighter than the others. For women, it has to do with the width of our hips and potentially tighter iliotibial bands. (The IT band connects from the muscles on the outside of the hip and runs down the outside of the leg to below the knee)

Are your IT bands tight? If so, I would work with a foam roller along the outside of the leg as well as the front and back.

Some dancers have some natural rotation that occurs at their feet while walking. You want to keep the hip/knee/ankle in alignment when walking, and that usually means facing straight ahead. You might note if the times you are noticing the pop if you are wearing shoes that perhaps shift your gait. I see dancers walk more turned out while in heels, for example.

It is amazing how often a favorite pair of shoes can be traced to some small tweaks and pulls. I'm not saying that is what created your 'pop' but simply when there is something going on that isn't a straight forward cause/effect – it is useful to broaden our observations to look for less common influences.

Next question…

I have a big problem standing in fifth position. I cannot seem to straighten my legs and still maintain a closed fifth position, mostly because one leg is insanely longer than the other one! My teachers are always telling me to straighten my legs and I just can't seem to do it. As a result, I grip my quads a lot to try and keep a straight fifth position. Then my teachers tell me to lift up and turn out to keep me from gripping my quads, but then I can't keep from tucking under. Will I ever be able to have a straight fifth with my uneven legs? What should I do?
Thanks! –Kelly

There is a simple solution to this problem, Kelly. That is to get a lift to put in your soft slippers of the short leg. I have seen this problem before when the dancer comes to see me and is having some knee, hip, or ankle problems on the long leg side.

If there is enough difference that you cannot easily cheat your 5th (I'm not encouraging anyone to cheat anything) that tells me you are standing unevenly between the two legs even in open positions.

Stand in first position facing the mirror. Slowly lower into demi plié. Do you shift to the longer leg side at the bottom of the plié? Now put something small – less than a half inch in thickness under your short leg. Repeat your demi plié. Does it look more even? How does it feel?

If it feels significantly better it would be worth going to the drug store and purchasing a pair of heel cushions and place one of them in your soft shoe. It is an inexpensive fix. Take the other lift and put it in your walking shoes and notice if you feel more evenly balanced as you go through the day.

Warmest regards,

January 8, 2008

Dancing Smart Newsletter: 1/08/08


Using a blog for the newsletter has gotten thumbs up! Thanks to all who emailed or posted a comment. Let's go right to the question of the week!

My ballet teacher told me I sometimes don't straighten my legs in élevé as much as I should. She said I needed to tighten my quad muscle. I thought I was doing that. What muscle is she talking about exactly? She said it is above the knee. Is that all I need to do to have stick straight legs? Is there any other way to keep my knees straight at all times?
Thanks, Val

I've got a couple of thoughts, Val. One is that you might have some weakness in either the quadriceps muscle or the calf muscles, or both. The quadriceps muscles are hip flexors and knee extensors. That means they bend the thigh towards the pelvis and they straighten the knee. Here are pictures of the quadriceps muscles and the calf
muscles. In the picture of the calf muscles, the gastrocnemius muscle has been cut away so you can see the soleus muscle underneath.

Start by standing in parallel, sideways to the mirror. Are your legs straight with the knees in line with the hips and ankles? You don’t want the knees to be behind the middle of the hip and ankle because they would mean they are hyperextended, and you don’t want the knees in front of the middle of the hip and ankle, because that means they are slightly bent.

I’m assuming that when you are just standing still – your legs are
straight. Now slowly start to rise onto the balls of your feet. As you rise, do your knees bend at all? If so, there is some weakness.

To address the weakness you can do two very simple strength exercises. The first is to stand at the barre on one foot and do slow single leg relevés and élevés. Make sure you aren’t gripping the floor with your toes when you do so. You can do them in parallel and in turnout.

The second exercise is doing very small single leg demi pliés, both in parallel and in turnout. You again don’t need to lower very far, or do very many repetitions before you notice the quadriceps tiring. If your thighs are sore the next day then that is a sign that you overdid the repetitions and pull back some.

The other comment I want to make is that knees come in all shapes and sizes and sometimes the shape of your knee makes it look like they aren’t straight. If you have knobby knees like the picture of a very famous actress that is shown below – they may not look straight when they are.

One way to see if you have a structural problem with straightening your knees (and I have only seen a few people who couldn’t straighten their knees) is by lying face down with the only the lower part of the leg off the table. Notice in this picture that the right heel is higher than the left? This is a sign of a more significant contracture in the muscles – or a structural concern.

Again, if you can stand with straight legs – or lie down with your legs straight, then you need to focus on strengthening the muscles around the knee and ankle for your élevé and relevés. Good luck!

Until next time,

Warm regards,


“ Education is the key to injury prevention”