knee pain

The phrase “it takes a village to raise a child” is thought to originate from an ancient African proverb. 

As I have grown into being a parent, uncle, and beyond, I have realized that this quote extends to any age. I have directly experienced this with my own posture journey—my own family “village” has helped me and others dear to me find a near pain-free life through the Gokhale Method®.

Annoying body pains were affecting my fun in life

In my late thirties, a stream of inflammatory pains permeated my body, including back pain, shoulder pain, knee pain, and—worst of all—plantar fasciitis in my foot. While these weren't absolutely crippling pains, they were painful enough to keep me from enjoying life as I gave up my favorite hobbies—tennis, golf, and playing the piano.

I visited numerous renowned doctors in California. They genuinely tried to help, but nothing resolved my pain. So I began searching for other solutions.

Finding Esther’s book, 8 Steps to a Pain-Free Back

In 2012 I bought Esther’s book, 8 Steps to a Pain-Free Back, as it was highly recommended on Amazon. 

 
The book that helped me, 8 Steps to a Pain-Free Back.

In particular, what caught my attention was how traditional and tribal communities across the globe do not have the level of musculoskeletal pain that we are seeing in modern society. The book explained how their cultures have preserved our natural blueprint for healthy posture over the centuries, while industrialized societies have lost it. 

This made a lot of sense to me, because as an American with Indian heritage, I used to visit India a lot and noticed that many traditional communities there do not have body pains as modern cultures do. There were people in their sixties and seventies doing manual labor regularly without pain.   

As an Indian-American, I visited India often as a child, so I could relate immediately to the images like this one in Esther’s book that showed people with traditional posture performing physically challenging tasks with relative ease.

I then took the Gokhale Method Foundations Course. It took me a couple of months to meaningfully understand the core concepts. And then I felt significant pain relief for the first time in a long time and knew I was onto something. I began playing sports and music again! I was so happy. 

The Gokhale Method Foundations Course helped me stand, walk, sleep, and sit comfortably. Before the course (left)) I would sit with my pelvis tucked, back rounded, shoulders forward, and my neck compressed at the back. During the course I began to change this, learning to antevert my pelvis and stack my spine.

Helping each other out posture-wise

I shared my Gokhale Method story pretty regularly with family and friends. My family—perhaps knowing that I am a rather talkative person—would give me the “ol’ eye roll” when I talked too much about Gokhale posture!

That said, many of my family members nevertheless found the Gokhale principles intriguing. For example, my wife spent much of her childhood in India—and also learned the Bharata Natyam Indian dancing which Esther draws from—all of which gave her good posture and a relatively pain-free life. Equally importantly, it gave her a keen eye for good and bad posture. So she was able to provide excellent feedback to me as I kept trying to improve my posture with the Gokhale Method principles I was learning.

However, my sister Annissa grew up in America, and began experiencing hip and other arm pains as an adult, which was hard for her as she is a keen athlete. She realized that her posture might be the root cause. She learned the Gokhale Method with Esther’s younger daughter, Monisha, and started feeling meaningful relief. She is now a regular participant in Online Alumni Classes, which help her to keep healthy posture on her radar and continue refining it.

My sister Annissa (shown here with her PostureTracker) likes to use her Alumni membership most days—it makes checking in on and refining healthy posture comparatively effortless—and fun!

The next-gen

Interestingly, as my daughter Saya became a teenager, my wife noticed that her posture began to deteriorate. We were concerned that our daughter’s posture would worsen further when she went to college, leading sooner or later to inevitable pain and discomfort. Trying to offer advice and corrections to our daughter just caused a lot of frustration for both of them. 

When our daughter turned 16, we suggested that she learn the Gokhale Method before going to college. For her it was perfect to take the online Elements course. The fact that it was 18 compact 13-minute Zoom sessions worked perfectly for her busy high school life. Her posture markedly improved with Gokhale Method Teacher Kathleen O’Donohue.

We were so encouraged that we also asked our 15 year old niece Riya to take the course. She did the Elements course as well, and her posture improved too! 

Bringing different generations together with the Gokhale PostureTracker

In the last year, my daughter, sister, and I were really intrigued by the PostureTracker™ wearable, which gives real-time feedback on your posture by displaying the feedback from two highly accurate sensors on an app. My daughter and I did the first online Alumni PostureTracker class during the summer before my daughter headed to college. 

My daughter Saya is a young Gokhale Alumna, and has taken her PostureTracker with her to college. She has real-time feedback on her posture wherever she wants it.  

We then bought the PostureTracker (which comes with one-to-one tech assistance) for my sister Annissa’s birthday. She loves it and uses it most days, including in her Alumni Classes. When we all get together, we often have fun correcting each other’s posture and also talking about our PostureTracker experiences.

The village beyond my family

Beyond my family, my “village” extends to the Gokhale Alumni community too. I have truly enjoyed and benefited from the collective curiosity and wisdom of the 1-2-3 Move classes. The teaching and follow-up questions and answers have been so helpful and insightful. I will never forget Gokhale Alumna Mary Walsh’s saying, “Good things come to those who ‘bean-shape’ [their feet],” which really captivated me and continues to help me in my own posture journey.

Here we are on the 1-2-3 Move class sometime in the COVID winter of 2020–21. The online community we forged back then has continued to thrive and be a great resource for everyone on their healthy posture journey. There is a 7-day free trial open to the public. 

Best next action steps for newcomers

If you would like insight on your posture, consider scheduling an Initial Consultation, online, or in person.

You can sign up below to join one of our upcoming FREE Online Workshops. . .

Josephine Baker dances the Charleston

The knee bone is "connected"
to the gluteus medius

 Can you sing "Dem Dry Bones"? If you don't know the spiritual by name, I bet you can intone at least some of the lyrics:

…the foot bone's connected to the leg bone, the leg bone's connected to the knee bone, the knee bone's connected to the thigh bone...

Beyond the direct structural connection between the "knee bone," or patella, and the "thigh bone," or femur, is another connection that will be of particular interest to athletes and other individuals afflicted with or susceptible to patellar femoral pain syndrome (PFPS), a disorder often referred to as "runner's knee." And this is the connection between the knee and the gluteus medius, the muscles situated above and toward the outer sides of the much larger gluteus maximus muscles. 

How to locate the gluteus medius

If you read my Samba Your Way to Beautiful Glutes post or joined my Samba webinar in November, you'll know how to locate these paired muscles, and you'll appreciate at least some of what they do. (If you'd benefit from a refresher, click and scroll through the Samba post, where you'll find a 6-point list.) 

 Gluteus medius muscles, pelvic anteversion, and knee health

This Burkina baby was patterned to
externally rotate his legs as he was
carried on his mother's back

According to modern conventional wisdom, it's considered normal for young children to have inward-turning knees, which are expected to straighten out by about age 7. What I've observed in village Africa and other nonindustrial cultures is that because children are carried on their caregivers' hips and backs, children's legs are externally rotated from the very youngest ages.

In contrast, in the US and other modern industrial cultures, the  internal rotation of the legs is often maintained into adulthood. 

Internally rotated legs
are common in modern
industrial cultures, even
in adulthood

Because the gluteus medius muscles are external leg rotators, strengthening these muscles can counter internal leg rotation, helping  the kneecaps to align and track better. (To check the tracking of your patella, sit down, place your palm over one of your knees, and then flex your leg to feel and follow the triangular kneecap glide up and down along the end of your femur.) Strong gluteus medius muscles are important because people whose "glute mēds" are underdeveloped are at increased risk of knee and other lower-limb injuries, including patellafemoral pain syndrome. Preventing PFPS, or managing its painful symptoms if the problem has already occurred, are just a couple of reasons why--when you stand, walk, and run--you want to use your glute meds and externally rotate your legs.

In addition to promoting knee health, external leg rotation 
also facilitates an anteverted pelvic position and a
well-stacked spine

Gluteal muscle activity and patellofemoral pain syndrome (PFPS)

Knee pain is nothing new; this Greek votive
relief for the cure of an injured knee
dates back to 100-200 AD

If you've ever felt a dull, aching pain under or around your kneecap where it connects with the lower end of your femur, you may have experienced patellar femoral pain, especially if the pain occurred when you were sitting for a long stretch of time with your knees bent, or you were kneeling, squatting, or walking up or down stairs.

And, if you have been diagnosed with PFPS, you're not alone. Gluteal Muscle Activity and Patellofemoral Pain Syndrome--A Systematic Review, which was published earlier this year in the British Journal of Sports Medicine, confirms the connection between the knee and the gluteus medius. By synthesizing electromyography (EMG) measurements of the gluteus medius muscles during a range of functional tasks as reported in 10 case-controlled studies, all of which evaluated EMG activity of the gluteus medius, the authors strove to elucidate the relationship between gluteal muscle activity and PFPS. Among their observations and conclusions:

In a nutshell, if you have good strength in your gluteus medius
muscles, your knees will be in better shape.

• Patellofemoral pain syndrome is one of the most common presentations to sports medicine practitioners; of 2500 presentations to sports medicine clinics 25% of all injuries were PFPS
• Individuals with PFPS exhibit reduced gluteus medius and gluteus maximus muscle strength
• Growing evidence supports the efficacy of gluteal muscle strengthening for PFPS and gluteal-muscle strengthening programs have been associated with positive clinical outcomes

Walking is connected to healthy knees

Walking is something most of us do a lot, although according to the 2010 study Pedometer-Measured Physical Activity and Health Behaviors in US Adults, the 5,117 steps Americans typically take each day are not enough--and in fact represent thousands fewer steps than those taken by our counterparts in Australia (9,695 steps), Switzerland (9,650 steps), and Japan (7,168 steps). But even if  we step just 5,000 times a day, if we engage our gluteus medius muscles with each step, that's still a lot of repetitions to help "re-architecture" our legs and minimize the risk of PFPS. 

           
Ancient Greek coin features Apollo (with anteverted pelvis!                      

The pelvis serves as our postural foundation, and one of the keystones for healthy postures is to allow the pelvis to be anteverted. When your pelvis is anteverted and your "behind is out behind you," then the whole pack of muscles that includes the hamstrings, the gluteus maximus, and the gluteus medias can work to advantage, strengthening themselves, inducing circulation in the appropriate places, and bearing stress.

Eadweard Muybridge's 'human male walking'
demonstrates strong gluteal action
in the rear leg

This rear view of the
subject above shows his
healthy external leg
rotation

Beyond this, the relationship between external leg rotation, pelvic anteversion, and the action of the gluteus medius is cyclic. In order for the gluteus medius to be in a position of mechanical advantage, some degree of pelvic anteversion is required. And, if we are to believe the observations summarized in the British Journal of Sports Medicine review, strong gluteus medius action relates to a diminished risk of PFPS.

The interconnectedness between external leg rotation, pelvic anteversion, and strong gluteus medius action is beautifully illustrated in the detail of Muybridge's "animal locomotion" photo and "film" to the right. 

"Dem Dry Bones"

Bottom line, the knee bone is connected to the thigh bone, but it's also connected to the gluteus medius, and this is a fairly direct connection because these paired muscles externally rotate the legs. Finally--not just because the lyrics are right on point with this lesson, but because he plays and sings so artfully and with such a great sense of fun--I hope you'll listen to Fats Waller's wonderful take on "Dem Dry Bones." 

Join us in an upcoming Free Workshop (online or in person).  

Find a Foundations Course in your area to get the full training on the Gokhale Method!  

We also offer in person or online Initial Consultations with any of our qualified Gokhale Method teachers.

Image Credits: Josephine Baker Dances the Charleston, Wikimedia Commons; The Bath, Charles Degas, Wikimedia Commons, Public Domain; How to Locate the Gluteus Medius, Esther Gokhale; X-ray of "Knock Knee," Biomed Central, Wikipedia; The Spinal Cord, Bruce Blaus, Wikimedia Commons; Greek Votive Relief Knee Injury, Marie-Lan Nguyen, Blacas Collection, Wikimedia Commons; Female Jogger, Mike Baird, Creative Commons; Human Male Walking (animation), Eadweard Muybridge, Wikimedia Commons; Animal Locomotion, Eadward Muybridge, Wikimedia Commons;  AncientGreek Coin: Classical Numismatic Group, Inc, Wikimedia Commons