Sharp Knee Pains

Seif_knee anatomy01Over the past couple of days, I have had to stop practicing due to experiencing sharp knee pains. Now, this is not a new thing as I have always had knee pains, which I attributed to my high flying, low stance training Wushu days. However, the only major difference in my training is that I have been focusing on Chen Taiji instead of Yang Taiji…

Over time, I became a bit leery about Chen Taiji due to the high emphasis on side-to-side motions within the form and stances. In fact, the signature Chen stances (lazy tie coat, single whip) are all side shifting stances. While at first, this may seem like no big deal, but IMO, my knees feel MUCH better if I do forward-back motions instead of side-to-side motions. Perhaps this is a sign of fate, eh?

Based on the picture of knee anatomy, a majority of my knee pains feel like they are coming from the medial and lateral meniscus. In an article called, “Runner’s World: My Knees Ache” I could have Patellofemoral pain.

[A] Patellofemoral pain can be caused by alignment problems, damage to kneecap cartilage, overpronation, or muscle/tendon weakness or tightness. … Strength training, wearing a knee brace, taping your arches or wearing an orthotic, and replacing worn shoes or wearing motion-control shoes can help.

I used to wear those Polyurethane knee braces but then took those off. I have been trying to pay careful attention to the alignment of my knees, especially the knee to toe alignment.  I have switches shoes and now wear indoor soccer shoes with high arch support for training (though doesn’t help when I train indoors, which is most of the time). 

However, one thing I notice is that I feel the pain pretty sharply during side-to-side motions (as stated above) and during transitional movements within Chen, especially during the transitions that include the foot stepping out sideways. 

I found a passage that talks about “Q Angle“:

2012_f3Q Angle. Although some investigators believe that a “large” Q angle (Figure 3) is a predisposing factor for Patellofemoral pain, … “normal” Q angles vary from 10 to 22 degrees …

— Source: Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment

Does this mean the knee should not move more than 22 degrees sideways? Perhaps my hips and butt muscles aren’t strong enough leading to insufficient support during knee tracking?  Alternatively, I have often heard that if your hips are not loose and flexible enough, then your knees may hurt and to raise your stance until you attain a certain amount of flexibility and softness in your hips/kua. In my own practice, I have raised my stance to the point that I bend my knees maybe 15 degrees (very high stance compared to the chen 90 degree parallel thigh goal…) and I still encounter the issue.

Anyhoo, I think my solution will be to cut back on Chen Taiji and start doing some stretching and strengthening exercises shown on the FamilyDoctor.Org website.  Oh well…


About wujimon

taiji, meditation and health
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19 Responses to Sharp Knee Pains

  1. I have had this problem before and I have seen it in many Chen students. I think you are correct in pointing out that the problem is often related to hip flexibility. Basically, the knee ends up compensating for the lack of movement in the hip. The knee should never rotate, only bend up and down.

    I wrote two short posts on this point in June you can find them here:

    I hope this helps and… tell me what you think.

  2. wujimon says:

    @Jean-Philippe: One of the things about the Hong Method via Chen Zhonghua is the strong emphasis in that the knees can only move up and down, not side to side or rotate. As such, I feel the Hong Method directly addresses this issue.

    I would agree that a flexibility in the hips is required to be able to effectively move the knees up/down (as done in the Hong Method). However, one of the main differences is that Hong method really does not shift weight as much as other styles, per se (IIRC). As such, I think it’s a little hard to apply this method to styles that focus on weight shifting.

    I did check out your posts and really like the take on bending at the knee instead of at the ankle.

  3. @wujimon: Good point: the principle is hard to apply to styles other than GM Hong’s Method, especially those that emphasize a weight shift.

    I had another thought: instead of focusing on making the stance higher, it might be a good idea to make your stance more narrow so that you can work on hip flexibility without twisting the knee.

    Good luck and I hope your knees get better!

  4. wujimon says:

    @JP: I’ve played around with the narrower stance and still same issues. Thanks for the tips 🙂

  5. Shang Lee says:

    My recent experiment with this led me to realise that i’ve never used the thigh back muscles. Those muscles seem to be left out altogether, creating a great strain on the front thigh muscles leading to the knee. I realised this through a very low stance (very close, if not 90 degrees) while making sure that there’s no “protrusion” in the kua area. I didn’t last a few seconds, but the kua was definitely relaxed. Let me know if you have more luck if you do try this.

  6. Taijiquan in Tampa says:

    Most of what I might say has been said here already (especially about the hips), the only other thing I can think of is that you might try these movements with the toes more forward and gradually turn them out as you gain strength & flexibility. I assume from your studious nature that you are focusing on stretching and have a good routine that ends with splits?

  7. wujimon says:

    @ShangLee: I have actually raised my stance to only have perhaps a 45 degree bend instead of 90 to compensate and I still get sharp pains. I have had hands-on corrections before, so I feel my stances are not bad.

    @TaijiTampa: I actually feel more of a strain when both feet face forward resulting in feet being parallel. Have you tried doing some silk reeling exercises in this manner where you do a 15 degree turn in waist, shift to other side, 15 degree turn again? Quite difficult IMO. As for stretching, I do stretch but I cannot do full splits right now 😦

  8. Taijiquan in Tampa says:

    In my yang silk reeling basics I do that with feet facing forward and more than a 15 degree turn in the waste, probably approaching 45 degrees. I typically do a one-handed wave hands motion to go with this. It can be tough on the knees, and there are lots of details with regards to keeping the twist in the hips and ankles and the weight in the feet. Perhaps I am doing it “wrong”, but I don’t keep my knees over my feet/in-line with my feet in this process, I just make sure they dont go outside of my feet, and I make sure the knees aren’t recieving pressure to bend sideways.

    When you do splits, you do both forward and side splits? My stretching routine ends with a three-part split where i split foward, then turn (without undoing the stretch) to one side, then the other. Not fun, but it ensures the flexibility it well rounded.

  9. Taijiquan in Tampa says:

    One more thing about the yang silk reeling basics, when the weight is mostly on one leg and I am turned not-quite-45-degrees toward that leg with my waist/shoulders, the knee of the leg with most of the weight on it is pointed forward with the toes, whereas the knee without much weight on it is pointed with my waist. That knee turns back towards front as I move my weight back to that foot.

    Hope this helps..

  10. wujimon says:

    @TaijiTampa: I always try to make sure my knee points in the same direction as my foot and that my knee does not extend beyond the instep of my foot. As such, I shy away from certain exercises. For me, when the knee and foot are not inline, I feel a torque in my knee. Thx for the tips 😉

  11. wayne hansen says:

    the knee is the only fully hinged joint in the body,it has only one direction.
    i dont even allow my students to do knee rotations.
    most people in tai chi turn from the hips not the waist.
    if you turn from the waist your pivot point is the base of your spine.
    if you turn from the hips your pivot point is your knees.
    this goes against the taoist principle of protect the hard work the soft.
    the teeth and the tongue have many battles,the tongue often bleeds but in the end the tongue remains and the teeth are gone.
    work the waist protect the hips and knees.
    think of the body like a tank ,the tracks carry us forward and can turn with some difficulty,but it is the turret that fires .
    the hips and legs are the tracks and motor,the waist to shoulders the turret and the fist and arms the progectile.

  12. wujimon says:

    @Wayne: Thanks for your comments and I appreciate you breaking out in detail your point about turning from the waist. One thing that has helped me is something I got exposure to in Chen style, that is folding into the kua. I see this as also being relevant in Yang style too. I idea is very similar to your own, probably a difference only in semantics. The idea is to keep the toe and knee in line with each other and turn from the waist by folding into the kua.

  13. wayne hansen says:

    it is my definition of the waist that differs from most.
    the waist is the area [soft tissue] above the pelvic crests to the shoulders.
    the hips are the pelvic girdle.
    the point being the hips and legs belong to the earth [stability]
    the abdomen and shoulders/arms belong to man [flexibility] and
    the head belongs to heaven [pressing ].
    think of a javlin thrower or a pole vaulter,the hips travel in a streight line,
    the power is supplied by the waist and the head remains still for focus.

  14. Wayfarer says:

    Hi Wujimon,

    I don’t know if you’ll get a comment on a post this old, but I have zhan zhuang question that has to do with my knees and I was wondering if you could help me…

    I’ve been doing zhan zhuang for several months now and it’s been wonderful, but I’ve noticed in the past week or so I get a sharp pain in my right knee after doing the forms. The pain is not excruciating, but I do have some difficulty bending that knee all the way down right after.

    Does it sound like I’m going too low in my stance?

  15. BC says:

    I practice the Hong method via master Chen Zhongua. I have been doing many exercises and continue to correct any pressure in the legs/body/joints. When I began my practice I noticed that my energy sat low, leg, knees and as I progress it has progressed up my body to rest in various spots some comfortable some not. Knees obviously are not so I continue to find ways to correct it.

    I have noticed that I will reach a threshold (after many days of long practice) where I start to where out. I rest and then after a while I noticed when I practiced for a while with many repetitions, wore out going up stairs was difficult without pressure in the knees.

    What I have finally figured out as my body mechanics and energy transfer is understood better is that
    A. The silk reeling done lots will affect weak points until you learn to transfer energy correctly, and by doing this the joint or area in question must not move so the energy passes though and does not get “trapped” in the movement of the joint. As you continue this push/rest process eventually you get stronger.
    B. You control where your energy sits. So as your understanding gets better you can place you energy higher. The exercises basically destroy any upper tension draining your core strength to the ground, it cannot stay there and the transfer of energy to the ground should be your opponents and not your own. So when that is finally understood, you start placing your own energy back where it belongs (regular core building exercises work well as silk reeling works you too deep) so that you become very strong, keep your energy still so it doesn’t telegraph to your opponent, your opponents energy passes through your very still, strong, fixed form to the ground.
    C. Finally, I used to apply my taiqi movement to everything in my everyday life…however I have finally found (although this was needed to internalize the movement and techniques) that the body is designed to move a certain way under normal movement, regular core exercises help us get back to that, taiqi, silk reeling work towards a specific goal, technique and build pressure to achieve martial results… in other words when taking the stairs, walking, doing sit ups, eventually your taiqi will help you understand how to track all movement, but it is your job to separate your taiqi movement from normal everyday let my body do what it was designed to do movement…

    next time you go up the stairs….right foot first steps up, upper body lifts (core, back, flank etc.) on left side pulls the left hip up allowing the left foot/leg to raise with out having the right foot push the body weight up, put your energy up in your opposite shoulders or out the top of your head…then repeat, almost like the common chi gong exercise where you swing the arms side to side, don’t trap the energy in hips but allow the foot energy to swing diagonally across/through body into the opposite shoulder…when this is figured out, you start to heal the lower body…relearn to use your upper body to support your lower after doing your taiqi.

    Rest! Remember conditioning in kung fu is never easy and to achieve profound results sacrifices must be made and a lot of the conditioning is very uncomfortable…Olympic athletes do not enjoy painless training to achieve great results, taiqi masters do not enjoy a perfectly aligned energy transfer at the beginning, sure they can say once they are a master that it’s this and that and no pain, but rest assured it was not always pain free! All internal, not balanced, all external not balanced, some internal balanced with some external and voila…I feel better already…

    Take care!

  16. wujimon says:

    Hi BC:
    Great comments and thank you for sharing your own experiences. I quite enjoyed reading about walking up the stairs and the transfer of energy 😉

  17. Pingback: The Causes of Sharp Knee Pain | Natural Health Answers to Joint Pain Problems |

  18. Luke says:

    Hey, just read your article about knee pain in Chen style… Chen is a very precise art and most teachers arent good enough to pass on such specific knowledge. Knee pain is very common in Chen style because most don’t know how to align the feet, knees and hip joints correctly. I practiced for a few years incorrectly and ended up with bad pain in my right knee. Then I met a student of the son of Chen xiaowang, and knee pain totally gone because I now understand how to sit into my Kia and release pressure from the knees, and take it down the back of the leg instead. Find a true teacher and you will find something amazing in Chen style. All the best.

  19. SanFeng says:

    The key for me is this: the kua is supposed to rotate, not the knees. It is hard to explain in words but I’ll try. So here’s what I do, prior to shifting from side to side, start by consciously holding immobile the knee joint and everything below. When beginning to shifting for example from left to right, there are two steps that I take:

    1. While holding the knees and everything down below immobile, make the kua pivots first. For example, if my weight is on the left leg, without shifting weight, first pivot the kua causing the right buttock to project toward the right rear diagonally. I do this by pushing with the left leg. So the area that connects my left thigh with the pelvic region opens and the area that connects my right thigh with the pelvic region “folds”.

    2. When the kua pivot has been done, while maintaining the “fold” on the right side, then shift the weight from left to right, again by pushing with the left leg ( do not pull with the right leg). The pivoting of the kua already shifted some of the weight onto the right leg. Once the kua has been pivoted, the left knee will move in a straight line without any rotation.

    In the beginning these movements are exaggerated but will smooth out with practice.

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