Let’s do a simple test. Get on all 4’s on the floor like a puppy dog. Slowly rock your body backward until your bottom is sitting against your heels and the tops of your feet are flat to the ground. Now sit up with your body so that your body is upright without your hands on the ground and you are sitting bottom to heels with your knees fully flexed, just like the pictures below.
Comfortable? Painful? Can you even get into this position? If not, why? If you can sit like this how long do you think you could stay there?
This position is one of my favorite tests and treatments for knee pain. Very few people who I see with knee pain can sit comfortably in this position for 5 minutes or longer. Many people may be thinking right now that this position has got to be bad for your knees and that’s why it hurts, and no one should do it. I completely disagree. We need knee flexion, especially full knee flexion. We need it to squat, bend and move, yet we think it’s bad for us. Watch your kids, they sit like this. Go to South America or Asia and watch villagers work, they do it too. Full knee flexion without pain is normal and you should be able to do it. If you cannot sit like this it could mean the muscles around your knees are too tight, it could mean your knee is arthritic or it could just mean that you are approaching a knee problem soon. Either way, it’s time to take action.
I have a friend who has been to the Shaolin temple in China. We have had many discussions about how the Shaolin monks address knee problems and how they prevent them. One of their favorites is to sit in this position until their legs go to sleep. Then they get up and let the blood flow back in, stimulating circulation and improved recovery. I have performed this extended sit many times and it works for me every time. It’s not the most fun thing in the world, but it works. I don’t recommend doing this unless you know you are healthy and can sit in this position comfortably for at least 5 minutes. Even then, I would consider consulting a professional before making this a regular part of your routine.
There are many ways to start a routine to eventually be able to sit like this. You can start with pillows or blankets under your knees and over the course of weeks to months work your way down. You can use yoga blocks or even your hands. There are even other positions and other exercises that I often recommend for people who have too much pain to even get into this position.
I sit in this position every day, multiple times a day to maintain my knee health. I sit like this when I talk to patients while playing with my children or just when I am hanging out at home. I’ve undergone ACL reconstructive surgery due to a contact basketball injury (a guy clipped me when going up for a layup), so I must take steps each and every day to help myself. I hope you choose the same.
May your knees forever be healthy!
Robert Newhalfen, DC, DNSP, DNSET, GRIP
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