When you stand in your 'normal' posture, do your feet rotate in, out, one in, one out or are they parallel? Another way to ask the question is, are you duck toed or pigeon toed? Stand, look, and answer. So, which is it? In either case the issue of rotation is not in your feet or your ankles. You need to head uptown to find the cause—rotation in the lower leg originates at the hip joint.
A student of mine started yoga classes about six months ago with knee pain—meniscus issues in one knee and pain and mobility issues from lower thigh to just below the knee on the inside of both legs—but there had never been any injury. He also had massive external rotation and foot supination (rolling of the foot towards it’s outside edge) when standing. We started with simply trying to find a new 'normal' in Tadasana (Mountain Pose). As his body awareness increased, his foot position changed drastically, and in turn, so did his posture.
After a month or so, he was having less knee pain generally, but still felt unstable on the inside portion of his knee. He then mentioned he rode a recumbent bicycle for exercise. Woah! Brakes on! What? New information! I asked him about his foot position when he clipped or strapped in. Did he put his feet in a parallel position or did he just strap in? He answered he just strapped his feet in, no correction. There it was!
He was externally rotating his hips while riding the recumbent. As a result, instead of using the muscles of flexion and extension (quads, hamstrings, glutes and calf muscles) he was recruiting his external rotators and abductors while stretching (weakening) his adductors. The point where one external rotator (the sartorius) inserted into the bone of the tibia was the exact spot of his pain. I asked him to make his feet parallel on the recumbent machine and focus on flexion and extension of the hip and knee, with no side-to-side movement from that moment on.
Three weeks later the knee pain was totally gone and we got to strengthening those weakened abductors and adductors. One of my favorite exercises for this is the Yoga Tune Up® Prasarita Lunges. You fire the outer thigh muscles to push you, the inner thighs to pull yourself from side to side or use the muscle groups equally. One great dynamic movement, two muscle groups, three ways to create balance in the hip. Talk about bang for the buck. Check it out!
Heidi Broecking, 200 hour YA-RYT, is a certified Yoga Tune Up® Instructor. When she is not with her husband and son, she loves to geek out on anatomy and ride a road bike, really fast. As a cyclist and member of the Gruppo Sportivo-Gran Fondo New York cycling team, Heidi looks to yoga to develop concentration, focus, balance, flexibility, patience and strength on the bike. She uses her knowledge to increase the speed and effectiveness of recovery as well as performance for both her athletes and herself.