Hyperextended knees

& how to control them.


Here’s the deal: the term 'flexibility' refers to muscles while the term 'hypermobility' refers to ligaments. 

Muscles and ligaments are two distinct types of tissues which perform very different functions in the body. Here’s a quick anatomy primer:

Muscles are contractile tissues that cross over one or more joints in your body. When a muscle contracts, it causes movement of the joint it crosses.

Ligaments, on the other hand, are short bands of fibrous connective tissue that connect bone-to-bone and effectively “fasten” our joints together. Ligaments do not contract or create movement in the body. Instead, ligaments serve as the “seat belts” of our joints. They are our back-up system to stabilise our joints if our body moves in a way that would otherwise take a joint beyond its normal range of motion. 

When we stretch, our intention should be to lengthen our muscles, NOT our ligaments. When muscles stretch, they return to their original length after the stretch is released – this property of muscles is called elasticity. However, when ligaments stretch, they do not return to their original length as well as a muscle does. If over stretched, they will permanently stay at that new length and are referred to as “lax”. Lax ligaments are longer effective as joint stabilisers and can be a source of injury and pain. 

It has always been the dancers dream line - that hyperextended line through the knee – but did you know it could be dangerous to stand with your knees hyperextended? Dancers with hyperextended knees - think about your pirouettes and turns… how many of you fall backwards out of your turns and cannot work out why?

Read on and find out more… 


 
IMAGE: maria chapman

IMAGE: maria chapman

 

Some dancers spend their lives trying to achieve more extension through their knees while others struggle with too much mobility and knees that are hard to control. Learning how to stabilise the knee in a good alignment does take patience and practice, but your dancing will benefit all round! 

Looking at the anatomy of the knee - if you over extend the knee, you risk stretching out the back of the capsule of the knee joint and the internal ligaments. If you are already a little bit on the “floppy” side (hypermobile) sitting into your hyperextension will cause these ligaments to stretch out further making the knee even more unstable (it’s a vicious circle!) As a dancer you need to develop an awareness of ‘pulling up’ not ‘pulling back’ when you straighten the leg. When you have hypermobile joints it is very important to learn how to not only control the joint in neutral, but how to recover when it does go too far. 

Good ways to practice this include: 

1) Sit on the floor with your legs extended. Slowly extend your knee to full range so that you can see how far back it goes. Lower your heel again and this time focus on lengthening the leg from hip socket to heel until it is just 1cm off the floor. Maintain this position for at least 10 seconds. Slowly lower and repeat. 

2) Next practice little pulses around the position you have found in the first exercise. Lower the heel to the floor, lift back up to 1cm off, then extend just a tiny bit more. Lower back down to 1cm off and repeat at least 10 times. This helps you find the control either side of your neutral position. 

3) Then repeat this in standing, either in first position, or when you have more control, on one leg. Stand in less turnout than you would in class and focus on controlling the knee into a tiny fondu/Plié, return to neutral. Then extend the knee slightly before returning to neutral, maintaining the pull up. (Thank you Lisa Howell for these exercise variations) 

The biggest challenge is to actually do this in class. Dancers with hyperextended knees will often find it challenging to keep their heels together in first position. Try having a maximum of 2.5 cm (one inch) between your heels and focus on maintaining the control through the knee. This is especially important when you begin to take one foot off the floor. Do not be surprised if you feel that your legs tire quickly – you are now learning to use your muscles to control your knee rather than relying on those poor ligaments and capsule at the back of your knee. 


 
image: sylvie guillem

image: sylvie guillem

 

Back to your turns…

If you think about your body as a tower of Jenga blocks. For every block you pull out of one side of the tower you need to counterbalance that with a block on the opposite side. If you think of your knee as one of those blocks being pulled out backwards you either need to start leaning forward as you turn or fall backwards out of it because your weight is not in the correct place. Learning to control your knee in that neutral alignment will stack all your blocks on top of each other again and you will find that your balance will improve. 

But what about those gorgeous lines you ask? 

When the leg is elevated in any position (not bearing weight), it is OK to allow the knee to hyperextend for that beautiful line. However, the dancer must always pull up the leg (using the thigh muscles, protecting the knee joint), whether the leg is weight bearing or not. Control of your joints is of utmost importance!

While it takes some effort to control hyperextended knees, once you can do this it will help improve your balance, turns and control.



 

Article written by Haydee Ferguson.

Physiotherapist with a dance history spanning more than 25 years.

Header image: Isabelle Ciaravola