So, you have knees that hyperextend. You’ve been told it creates a beautiful line, so surely it’s a blessing! But hang on, you’ve also been told it can cause knee pain, so is it a curse? Do you straighten your knees in first position? How to do handle those knees? In this post, I will look at some of the biomechanics of hyperextended knees and discuss some ways to keep your knees happy and healthy.
The perfect leg line – one of the ultimate goals of all dancers. Not just leg lines, though. We are obsessed with lines in the dance world! Lines are one of the defining elements of our art. They are what create a stunning photo. Lines are an important part of what makes our art on stage. In an effort to achieve the perfect line, dancers are often encouraged to push their knees and exploit any natural hyperextension.
What is hyperextension in the knees?
Knees that hyperextend are knees that go past straight. This is most often the result of hypermobility syndrome, which refers to a person’s connective tissues (namely ligaments and joint capsule) being looser than normal. This causes the joints to be less stable and move further than they should. Hypermobility syndrome is an umbrella term and a spectrum, from everyone who is a little extra loose to people that have wide-spread systematic problems with their connective tissue. But even a little bit of hyperextension puts the knee into a position that it’s not really designed to cope with.
The problems with hyperextension
Once the ligaments have stretch, they do not go back. So, once your knees hyperextend, you’re stuck with it. The problem is, all of the evidence tells us that hanging out in hyperextension increases your risk of pain and injury in the short term, and pain and excessive wear and tear (early onset osteoarthritis) in the long-term.
Evidence demonstrates that while hypermobility is common among amateur and student dancers, the percentage of professional dancers on the hypermobility spectrum is proportionally loweri. There is no evidence directly examining why hypermobile dancers end their careers sooner. However, it is widely acknowledged that hypermobility puts athletes at a higher risk of injury. Therefore, it is reasonable to conclude that a high rate of injuries among hypermobile students leads to short careers.
Another problem is that hyperextension is often valued in the dance world as aesthetically desirable. Thus, many students are encouraged to push their hyperextension, without understanding the damage they are causing and without being educated on how to protect themselves. As already discussed, this leads to long term problems with pain and injury and short careers. From a medical perspective, I would love if we could change this. Why should we be encouraging practices that are so unhealthy? However, in the real world, this ideology isn’t going anywhere any time soon. The best we can do for now is to try and educate young dancers on how to safely dance with their hypermobility.
How to keep your knees happy
So far, this all sounds like pretty bad news, I hear you say. HOWEVER, it’s not the end of the world or your dance career! As with most things, with a bit of education and some hard work, you can keep your joints happy and healthy.
The key to working with hypermobile knees (as well as any hypermobile joint) is to develop strength control. Your muscles need to be strong enough to support the joint as well as perform the movements you are asking them to do. Think of a pirouette – your quads need to help support the whole of your body weight in addition to supporting your knee joint. Here are a couple of exercises to get you started.
What you need to start with is amazing proprioception. Proprioception is the fancy word we use to describe your body’s awareness of itself is space. In practical terms, this means being able to feel when your knee is bent, straight, or hyperextended.
Start in sitting, legs extended, and practice “pulling your knees up” to straighten your knees without letting your heels pop off the floor.
Once you’ve mastered that, grab a theraband for this terminal knee extension exercise:
Tie the band around a very heavy table leg, at knee height, and wrap the band around the back of your leg, just above the knee. Then slowly straighten the knee only to neutral without going into hyperextension. Repeat 10-15 times. Then repeat with the band around the front of your thigh, again just above the knee. You can check out my video here for a demonstration of the exercise.
Also, be sure to check out my Top 5 injury prevention exercises. In that post, I teach a single leg deadlift, which strengthen your hamstrings and challenge your knee control.
Other recommendations
Don’t:
- Push your hyperextension, EVER! Don’t prop your foot up on a chair in oversplits. Don’t force your knee back. You already have loose ligaments, you really don’t want to loosen them further.
- Stand in hyperextension in class or in your everyday life. Don’t hang out with your knees locked back in hyperextension. Practice feeling what ‘neutral’ is, and then keep your knees straight, not hyperextended.
- Believe anyone if they tell you that you have to be hyperextended to be a professional dancer. There are many, many successful professionals without any hyperextension.
Do:
- Strengthen, strengthen, strengthen. The stronger your quads, glutes and hamstrings are, the better. With loose connective tissue, your muscles have to do a lot of extra work to protect the joint.
- Find a great teacher who knows how to help you work with your knees. If finding a different teacher isn’t an option, find an experienced therapist or coach who can help you learn to strengthen and control your knees and teach you how to utilize these skills in class.
- Save your hyperextension for non-weight bearing positions. Now, I would NEVER recommend pushing your knee into hyperextension, but if you feel you really must, please save it for a leg line en l’air.
Just because you are at a greater risk of injury, doesn’t mean an injury is unavoidable. Get busy strengthening and controlling those knees!
