As part of an effective course of exercise and treatment for patella maltracking and knee problems, stretches help maintain correct movement and prevent persistent imperfections in movement. The following guide explains a special lower leg stretch (a calf muscle stretch) that will help improve how your knee moves in relation to the foot.
Why this stretch is so important
The stretch itself is very simple. The reasons for doing it are not, however, but are worth understanding to ensure you perform the stretch correctly.
Sufferers of knee pain resist bringing the knee forwards (because it hurts), so the lower leg muscles are rarely stretched properly. Without regularly stretching the lower leg muscles, they cannot lengthen when required. But we must make such movements requiring that flexibility, even in situations as simple as occasional steps in our everyday stride – and if your lower leg muscles aren’t accommodating, dangerous compromises will be made.
When the under-stretched leg muscle can’t lengthen properly, you compensate in other ways. This might mean achieving the correct flexibility by turning the foot out slightly, turning the shin in slightly and collapsing the arch of the foot. This leads to the knee caving in, moving inside the foot. As we know from the causes of patella maltracking, and the theory behind sitting with correct knee positions, if your knee moves inside the foot, the inner-quad muscles (the medial muscles) aren’t used properly and the imbalance can cause potential patella femoral pain.
So why do this stretch? Stretching the lower leg in the correct way helps you safely challenge the positions your knees will need to occupy in your course of corrective exercises (such as for sissy squats). It serves two purposes:
- To make it physically possible to position the knee correctly into dorsi-flexion.
- To reduce the inward caving knee movements caused by the compensations associated with limited flexibility.
It’s important that it’s done in the right way, as we’ll explain, because other stretches (or incorrectly performing this stretch) can encourage the wrong angles and make matters worse.
The correct starting position
The goal of this stretch is to lengthen the calf muscles, such that you can decrease the angle between your shin and foot. To help intensify the stretch and decrease the angle further, it is best to start with your toe raised, which can be done in one of two ways – either place your raised toes against a wall with your heel on the ground, or place your toes on a block.
When using a block, the height you use may vary depending on your ability, but essentially as you progress the higher you can raise your toe the better. Place the toe on the block with your foot angled slightly inwards. If you place the ball of your big toe on the edge of the block, this should put just enough of your foot on the block to give you both balance and effective leverage. Angling the foot inwards is key and should be applied whether using the block or wall variant of the stretch.
Performing the stretch
To begin, before bending the knee or changing the position of the leg, twist the knee out by rotating from the upper leg. This is a subtle movement, which you can think of as twisting the patella (knee cap) to the outside.
With your knee and foot in the correct position, push the knee forwards, in line with the outer edge of the foot. Done correctly, the knee should travel over the outside of the foot, decreasing the angle between the shin bone and the foot. Push as far as you can and hold the stretch. Doing the exercise facing a wall, you can use your hands for balance if required. As pictures are not the ideal medium to demonstrate this stretch, which requires considerations of depth, please do watch our video for an accurate demonstration.
It’s crucial to keep the knee moving outside the foot. If you allow the foot to turn out, the knee will move inside the foot, which causes the knee to cave in. Often, people perform a calf-stretch this way mistakenly thinking it is beneficial, but in fact pushing your knee into the inside angle will only make matters worse. For example, it can encourage collapsed arches of the feet and cause the knees to collapse in during squatting movements. Both these problems can contribute to patella maltracking.
Progressing your lower leg stretch
Progression with this stretch will occur as you continue to decrease the angle, pressing your knee further over the foot. You may also progress by gradually increasing the height of your toe, and by trying a straight leg version of the stretch, not bending the knee. However, the bent knee version of the stretch is the most effective for our interests, as we use the bent knee position for full squats and sissy squats, the most powerful exercises available to permanently correct patella maltracking.