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Your Unruly Knees 

Your Unruly Knees 

March 2016 

Boulder is full of very fit folks, but fit though they are, I often see runners whose knees collapse to the center as they run, walk or squat. It looks painful, and honestly, it probably doesn’t feel so good either. Here’s the confusing part: they may have done monster walks and clams ad nauseam, their core seems strong and still they collapse. What gives? 

Here is a situation where less is more. Here is whe re timing and coordination of movement trumps strength. You are designed in beautiful ways – and when everything works as it should, you activate one muscle and another fires to help stabilize you. Voila, you have flawless movement. In a perfect world, it happens effortlessly and automatically. 

But sometimes things fall apart. You have an injury, you have a child, you develop faulty breathing patterns – a myriad of things can disrupt normal movement. When that happens – the synergists – those muscles that fire in concert with others – don’t do their jobs.

That’s where our detective work comes in. Finding the deficits and creating a situation where things start to fire in the right sequence makes a huge difference. And it almost always starts with breathing. 

Yes, hip strength is important to prevent the dreaded knee collapse, but it’s part of a whole package of integrated movement where strength is less important than timing, sequencing and graded contractions. Cross fit might be crazy-fun, but if you don’t have the refinement or timing down, you’ll collapse. Your form will suck, and pretty soon, so will your back, hip, knee or shoulder. 

Lots of exercise buffs 

hate slowing down. 

They hate the idea of 

stepping back from 

INTENSE. I am one of 

those. But, honestly, it 

shocks me how quickly 

one can ramp it up 

again with just a bit of 


That very fit woman who collapses? Though she has abs of steel, she also has long-standing hip tightness and a collapsing knee that sometimes hurts. And she could never do the clam because it set off ITB tightness every time she tried. She couldn’t make her glute fire. 

That’s when a trained eye can help you see what’s going awry, and a skilled therapist can guide you through the changes you need to get better. 

We adjusted posture to set her up for success. Then we practiced lower costal breathing and once she got that, we made sure she knew how to allow the pelvic floor to relax during the inhale and close and lift on the exhale. She started the exhale before she moved. That activated the pelvic floor to create an anchor from which to move. Here’s a mnemonic: Blow before you go.Piston Breathing Refining the Clam 

With just a few changes, she fired her glute like she never had, and the ITB did not get tight. We made sure her synergist muscles were activating too. With each little tweak, her “clams” got stronger and easier. Really, this happened in seconds. That can’t be brute strength – that has to be motor control and timing. 

You start with conscious awareness and quickly your body learns how to make the movement automatically. When things begin to happen in the right sequence, without your conscious attention, you can finally start to take charge of your unruly knees.


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