"Wobbly" knee - loose ligaments

[lilya]

My left (non-dominant) knee has decided to let me know that my gait (most likely) is not ideal. I've tried to protect my knees as much as I could, and generally avoid any high-impact activity. However, according to the physician, there's excessive laxity in the ligaments of the left knee, especially the lateral ones, with an added bonus of a mild kneecap tracking issue - the kneecap occasionally travels sideways, possibly as a result of excessive internal rotation of the knee allowed by the loose ligaments... I noticed this a few days ago and I will be doing physiotherapy starting next week; also, I just got a hinged brace to give the joint a bit more stability.

I read http://bellydanceforums.net/threads/10818-Torn-ligament-( (thank you for the ideas I found there! I know it's been several years, but I hope your ankle healed without issues or reoccurrences, Amulya!). I was wondering if anyone has had something like this - technically not a major injury right now, but with potential of becoming one down the road - and if they tried to dance through it... There's definitely discomfort in the knee when the left leg is the standing one, and the isolation of horizontal figure 8s, for example, is visibly poorer as I instinctively try to protect the knee. I just feel like donning the brace and trying to practice at least on one side (probably not a very good idea...) I understand that the risk of tearing the ligaments is low, but I think the healing may take longer if I stress the knee. On the other hand, physiotherapy will most likely involve muscle strengthening exercises for the quads, hamstrings and calves, so I wonder if there are elements that may actually help as long as I make sure the joint is stable enough...

 

[Daimona]

Short answer: Ask your physiotherapist. Demonstrate the move, explain how it feels and your concerns and ask for his/her advice.


IIRC any movement that includes twisting the hip, such as a horizontal fig 8, will cause strain on the knees.
If your isolations skills are good and you still want to practice movements involving twisting the hips, go to the pool, submerse yourself in water and practice it without standing on the bottom. Disclaimer: I'm not a physician, so you do this at your own risk.

 

[lilya]

Thank you, Daimona! I can't wait to see the physiotherapist, he's done a great job with my broken wrist not too long ago (that was a soccer incident ). I'll show him as many moves as I can and I hope he gives me some exercising homework... Practicing in the pool is an excellent idea too, I was planning to go tomorrow and check out what I can do safely as far as swimming goes, now I'll try adding a few dance moves as well.

 

[Zorba]

I had a dance sister who had something like this body-wide. The build-up of core strength was the only thing holding her together!

 

[Greek Bonfire]

What Zorba said. Believe me, I didn't have any trouble with my knees until I started Polynesian dance, and then with flamenco, it put even more stress on my knees.

 

[lilya]

So it is possible to strengthen the muscles enough to have them "shield" the joints, at least in part... Zorba, your dance sister made me think of a friend of mine who spent a few years and saw several specialists for her general pain and extra joint "flexibility" - only genetic testing could find the reason (Ehlers-Danlos syndrome in her case)...

Greek Bonfire, I hope you have not had an injury! I've rested for a few days and tried to find more info on yoga for bad knees - came across a nice explanation, first at https://yogainternational.com/article/view/yoga-therapy-for-your-knees1. I'll run this by the physiotherapist, too, and come back here with any extra advice he may have...

 

[Zorba]

Zorba, your dance sister made me think of a friend of mine who spent a few years and saw several specialists for her general pain and extra joint "flexibility" - only genetic testing could find the reason (Ehlers-Danlos syndrome in her case).

That name sounds vaguely familiar - that *may* be it. She could basically relax a given joint, re position it in any position desired "natural or not", and then re-engage her muscles! Some of it was cringe-worthy!

 

[lilya]

Ah, I can't imagine - as my physiotherapist pointed out today about me: "flexibility is not necessarily stability".

The key points I took from my appointment may sound very common-sense, but I have to remember to follow at least the latter two to the letter:
- discomfort/pain around one joint could be reflecting an imbalance somewhere not necessarily very close to that joint (even the lower back may have something to say in a case of knee pain);
- always drive the movement the way it's supposed to be driven, even if it looks good using and/or seems obvious to the muscles that are "ready to help" (in my case, I knew that my cycling-built quads try to take over inadvertently and had been working to fix that, but I should try to train other muscles independently of dance if I want that to really happen);
- if you need padding and it's not supplied in class, bring it and use it; if something really doesn't work for you, don't try too hard to overcome your discomfort (even if right now you may be the only one in class who cannot do a specific move).

Case-specific details: it turns out that yes, for me it's most likely a funny gait, courtesy of several weak muscles, together with overtraining (that sounds funny too, having started from almost zero once more) - basically I was exceeding my body's capacity to adapt to movement and compensating weirdly. In particular, I'm not impressed with my glutes, which my physiotherapist thinks are the weakest link. Who knew that hips are sort of supposed to stay parallel-ish to the ground even when walking, also thanks to these muscles?

He even knew some moves, undulations and hip twists included! I also asked about kneeling: we do a bit of floorwork in class, in fact last class had a bit of a focus on glutes, including sitting on heels, which I'm not able to do comfortably/properly these days thanks to the soft tissue on my thighs - I must have placed more stress on the knees, all while trying to push the hips down. That I shouldn't do (especially not on a surface for dance training; I used to bring a mat to class but chickened out of that lately).

Planking/push-ups on the knees (with padding), figure 8s and hip-twisting in general with a solid core should be alright and he doesn't want me to take a break, but strengthen the glutes and the core.

Homework is an exercise I would describe as resembling a yoga chair pose (but with hands on the hips) traveling sideways with feet parallel, plus, of course, my least favourite exercise in the whole wide world - the plank.

 

[Zorba]

Its amazing to learn that something you've done or dealt with your entire life isn't "normal". It took me many years to figure out my vision isn't "normal" - I lack "normal" depth perception, which meant I could never hit a softball because I didn't know where it was! But I didn't figure that out until I was an adult. So I grok your amazement about parallel hips!!

All good teachers will tell you to NEVER do something in class that would hurt you or be beyond your body's capabilities. As for floorwork, I just gotta have knee-pads, my bony knees don't like it otherwise. We won't discuss getting back up! Thank Goddess skirts hide a multitude of evils...

 

[lilya]

Very much liking the "grok"! Stranger in the strange land of one's own mechanics... Or, as it occurred to me earlier, took me a few decades to realize I'm not particularly good at walking. Thank you also for the realization that my next purchase should be knee pads (that fit well), way more portable than a mat.

I forgot to mention that the physiotherapist also strongly recommended Pilates (I had started reading http://bellydanceforums.net/threads/19069-Pilates-or-Yoga, but I've never tried Pilates, so I cannot say much there.)

 

[Shanazel]

I've never done Pilates either but my daughter greatly benefited from it. She has lower back scoliosis.

 

[lilya]

I watched a beginner class today on Datura (taught by Ashley Lopez - I followed her beginner yoga class once not long ago and liked her teaching style). Seems very effective. I'm very glad to hear it helped your daughter. My brother also has lumbar scoliosis and he was just telling me this morning that missing a couple of "back days" at the gym almost brings his spine back to square one. I'll tell him he must have a look-try at Pilates... and I'll do my "trying" part on Saturday.

In the meantime, belly dance tomorrow, first class after the knee issue started - I'm a little afraid of the figure 8 drills. Tonight I had Bollywood fusion class (beginner level, pretty intense for me but I can get away with much less twisting) and I felt like I was taking a lot more time than usual to think about the movements and how I drive them. I sort of knew that I rarely get as sore in the upper body/core as I do in the legs, but it seems like I'm connecting the dots much more acutely now.:redface:

 

[lilya]

I realized I have a few thoughts (or, as I hear sometimes from my family in Romania, "she has few ideas, but they're fixed") about the recovery process so far.

The lowest point was a couple of weeks ago when my right knee figured to join in the fun and I had a few days of constant pain around both kneecaps - that was quite scary and I kind of gave up going up/down any sort of stairs; if really needed, I can tackle stairs sideways. This is what I have been finding potentially helpful (I half-seriously thought about trying one at a time for the sake of a "clean" experiment but, oh, well):
- physiotherapy - now weekly;
- Ashley Lopez's Pilates beginner class on Datura, once or twice a week, with a bit of support from a couple of books (Joseph Pilates' "Return to Life through Contrology" - what a delightful writing style! - and "Ultimate Pilates" by Dreas Reyneke);
- glucosamine-based supplement, daily;
- swimming, twice a week (and practicing belly dance moves in the water is really fun!)
- biking everywhere. I was feeling guilty about keeping my seat fairly low - almost every bike connoisseur my bike has seen felt the need to tell me that I need to be able to "fully extend" my legs when riding. That may be a little inaccurate and a little less ergonomic than still having a tiny bit of flexion at the bottom of the pedaling cycle - sort of a "bend your knees!"-quality to the angle of it, which is what I was doing right. What I was doing wrong was letting my knees slack outward/inward at times...).

Overall, feeling mostly well lately yet sort of fearing a falling back into my less mindful way of moving about...

 

[Zorba]

Ashley Lopez is da bomb! If you have a chance to see her perform, by all means don't miss it. I was at a showcase once upon a time where she was called the "b-word" by the MC - in the most awed and loving sense of the word. Everybody in the hall, including the MC (an accomplished dancer), were just floored - she was incredible and did something very, very, very few dancers can:

You know how a some of the more flexible and fit dancers can do a backbend, and lower themselves to the floor in a Turkish fold? She did one better - maybe two better. First she did the lower down - S-L-O-W-L-Y. BUT - she never touched the floor with her shoulders, she was down in a Turkish fold, hovering a couple of inches above the floor, and if that wasn't awesome enough: THEN SHE CAME BACK UP!!!!! As in to standing position. The hall went nuts! There wasn't a soul there who didn't walk out a COMPLETE fan!!

I took one of her classes at this event - nice gal, great teacher. She has cool tats too!

 

[lilya]

I LOVE her! I could just "see" in my mind what you described so, so well. I've been daydreaming for a while about seeing her perform live someday. She was in Bucharest for a TribalFest a few years ago, right before I went to visit. Boo me... I had been semi-lurking on Datura for a couple of years with a basic account (non-paid), watching teasers and reading the blog, and it was her recent choreo for "Viaje" that finally made me join. Then I saw "Twilight on the Nile" (teaser and full choreo student montage) and... that floorwork! I couldn't stop watching it over and over. Phenomenal dancer and as a teacher in the online classes I've watched/tried to do she comes across just as you said, genuinely nice and kind (I think I got that feeling from how much attention she seems to give to not causing or forcing the body through an injury; turns out she's actually trained in Stott Pilates for injuries and special populations).

I find that intricate upper back tattoo almost hypnotizing.

 

[lilya]

This amazing photo of Ashley Lopez reminded me of Zorba's story about her just one post above. https://www.instagram.com/p/Bh9z8digdcZ/