193 Madeleine Shen Lopez: Knee anatomy, tree pose, hyperextension and curious questioning

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Kathryn Bruni-Young: Hey everyone, welcome back. Today on the podcast for the second time, I’m speaking to Madeleine Shen Lopez. Madeleine was on the podcast last season when we were talking about the neck and anatomy, and she’s back today. And today we’re going to be talking about the knees.

I recently made an Instagram post about tree pose and whether or not it’s OK to put your foot on your knee in tree pose and just more critical questions about that whole topic. That really got me thinking more about the knees.

Maddie loves anatomy, which you’re going to hear about. I thought she is just such a great person to have on the show and ask all the questions about the knees. We talk about tree pose, we talk about alignment, and whether the knee needs to track over the toes.
We talk about the Baugus Knee Position when the knee turns in. We talk about hyperextension, strength training, different types of people, different types of bodies. I think that you are really, really going to enjoy this one.

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All right, Everyone here is my interview with Madeleine Shen Lopez.

Kathryn: Madeleine, welcome back to the podcast.

Madeleine Shen Lopez: Hi, Kathryn. Thanks for having me again.

Kathryn: Yeah, I’m so glad that we’re doing this once again. I feel like last time you were on the show talking about the neck and the anatomy of the neck and everything like that, I feel like we just had so many great moments and we could talk about another part of the body.

Lately, I’ve been really interested in the knees and having more and more thoughts about the knees and the anatomy and the training. That’s what I wanted to talk about today. But the first thing I want to ask you, I’ve been following you online now for a little while. You’ve been doing these online anatomy classes, and it seems like you really have this passion for teaching anatomy and talking about anatomy.

And I’m wondering if you wanted to tell us a little bit about that and why you love this stuff so much.

Madeleine Shen Lopez: Yeah, that’s a great question. First of all, I just love teaching in general. And the interesting thing is I never thought to teach anatomy. It wasn’t until I started studying a lot of anatomy in chiropractic college and I would do classes to myself to study for my exams.

That actually made me enjoy the material so much more. Teaching has always been a way for me to, like, jump into the material and kind of bite into it a little bit deeper and get the juices. I don’t know if that’s a good analogy.

I think what makes me so passionate, is that I feel like a lot of the anatomical information that I share or that gets shared or taught is the stuff that we could know just by looking at our own bodies. We have these instruments that we live in all the time, which is our anatomy or our anatomies.

There’s something about knowing the infamous in some way, and then knowing it again in another way and then knowing it again and again and again and again. There are these moments where when I go to teach a class, I, like, go and decide which parts about, I don’t know, the shoulder will I share today?

Then I find these little pieces of information that I know about the shoulder that I just kind of take for granted. When I’m about to share them with someone, I’m kind of looking at this piece of information and I’m like, “wow, this is so cool. This piece of information is so interesting”. It’s just in my body all the time doing its thing every single day.

Something about that is just really magical thing. That’s what makes it so easy to get excited about, is that it’s like something that I’m living all the time. And so hopefully I can bring a bit of that enthusiasm to all of the other living anatomies out there.

Kathryn: Mm-hmm. When you start to teach people anatomy, like, for example, today we’re going to talk about the knees. If you were going to start teaching somebody about the anatomy of the knee, what are the types of things that you would want to share with people?

Madeleine Shen Lopez: I have a tendency to only start with the bony anatomy, which I think I would like to sort of start to shift from that. But the reason I think I start there often is that the bones are sort of out of all of the tissues, like the least changeable. It’s the most tactile, the stuff you can kind of touch and feel.

It’s easy if you’re not, you know, a manual practitioner to sort of feel your collar bone like it’s pretty hard and palpable. I like to start with the bones so that people can kind of understand the basics of where their skeleton lies. But I always start by talking about how different everybody’s skeletons are. When I go and say, the “tibia is shaped like this and connects with the femur in this way”, it’s sort of like you have to take it with a grain of salt, knowing that your anatomy is going to have these subtle differences that are unique to you.

That’s always the first thing I like to start with any part of the body; this wider sort of zoom out of like we are all different and unique. When we’re looking at this model version of the mirror of whatever body part to take that into account as we move through the different sections.

Kathryn: Why did you say that you are considering a shift away from this?

Madeleine Shen Lopez: I think because it can sort of box you into thinking in one way. it has. I feel like it’s boxed me into thinking in one way. And obviously, as a chiropractor, we focus a lot on the bones because that’s one of the main sorts of things that we focus on when we’re doing the manual therapy.

But as a dancer, I didn’t think about my bones at all. Basically, when I was dancing, I wasn’t thinking about how my bones were moving. I was thinking about how energy was flowing or how soft or firm my muscle tone was or those kinds of things.

It’s interesting how I sort of got drawn in with the bones because of how I formerly studied the anatomies. But now I’m getting more and more interested in what are other entryways. It’s always interesting to take new entryways because it’s going to give you a different point of view and get you asking different questions.

That’s sort of the goal is: how many different questions can we ask about the same thing?

Kathryn: How important is it, do you think, for movement teachers to know anatomy?

Madeleine Shen Lopez: That’s a really difficult question. I think it’s important. It depends on what the movement teachers practices are and how much responsibility is on their shoulders.

For example, if the particular movement teacher is working with folks recovering from surgeries or folks who have specific injuries, or older folks who have arthritis. It’s probably pretty important for them to know about the anatomies that are related to those issues so that they can safely guide their student or be able to recognize when something could potentially be harming their students.

That, for me, would be like the first thing that I’ll say. But for general movement practices, I think it’s I don’t know if important is necessarily the word I would use. I would use like enriching or supportive to being a movement teacher. And then the question is, what do you mean by, like, knowing the anatomy? Do I need to memorize every single name of every bone? Obviously, I think not. Do I need to know every single muscle and exactly where it goes and what it does? No.

But having general ideas about not even necessarily the mechanics, but the safety factors of the different joints so that the cues that we get used to using can actually have a basis in something that’s concrete and real. If we’re using, anatomical cues and being able to differentiate between, like, for example, saying the elbow needs to be in line with X versus saying, imagine that your arm is floating like a balloon. Right?
Those would be really different cues that would need different types of background knowledge to be able to be properly used in class.

Kathryn: Mm-hmm. I guess I was kind of asking because I personally do not identify as a human who knows a lot about anatomy, which is, I think, kind of funny because I spend so much time thinking about the body and the way the body adapts and blah, blah, blah. All of the things about the body.

I think the last time I had you on the show when we were talking about the neck, the way you were talking about anatomy made so much sense to me. It made me a little bit excited about anatomy again.

Madeleine Shen Lopez: Yeah, well, I would say, Kathryn, that actually, you know, anatomy really deeply. And I think that that’s where maybe I also hope to open up people’s ideas about what it is to know anatomy and what it is to study anatomy. I think that’s one of the reasons why I named my classes anatomy tea.

I’m trying to remove the pressure a little bit, like just coming out and like, let’s chat about the body. When I see you teach in class or when I take your classes or when I see your post on Instagram about the different ways to adapt different exercises, you are teaching anatomy in your own way. You’re not necessarily saying the femur and the pelvic bone, blah, blah, blah.

The way in which you’re talking about how the body moves and giving us options and opening our perspective about how our body can move or how we can explore that, I feel like that is one way of knowing anatomy. In the last sort of academic sense, if that makes sense.

Kathryn: OK, so we’re going to talk about the knees. I’m sure you could share many things about the knees and anatomy, but what are a couple of useful things that you want to start with?

Madeleine Shen Lopez: Yeah, man, I could talk about the knees for years. One really fun new sort of way that I’ve been thinking about the knees since the fall when I taught a course with my collaborator. We did a week on the knee. I started thinking about…because we had been talking about kinetic energy and the mass of the body and gravity and how how to negotiate our masses in gravity. How do I negotiate the mass of my head, the mass of my torso, the mass of my limbs, the mass of my pelvis in gravity? We always live in this sort of gravitational field.

I came up with this sort of big zoom-out. If we can imagine that you have a camera sort of on you and then you just keep zooming out wider and wider until you can see this sort of cartoon version of the Earth. You have the mass of the Earth and then you have your tiny, tiny mass on the surface of the earth. And most of the mass is between the pelvis and an up. If you compare the length of the legs and the length of the torso, the torso just has way more mass on the legs.

It occurred to me that the knees are these great negotiators, these great mediators between my mass, my physical mass, and the mass of the earth. When I’m standing, like right now, I’m just standing in front of it in front of the microphone here. I’m just imagining that instead of my body ending at the soles of my feet, imagining that I am the one with the earth.

My mass of the earth and my mass of, let’s say like torso blob, the knees are the part in between that helped me communicate how my body mass is going to negotiate its gravitational relationship with the Earth mass.

If I go to shift my weight onto one leg, suddenly that me, that one little me is now negotiating the mass of my body, which is not negligible against the mass of the earth, which is even more astronomically large.

Somehow this little knee, this little structure is allowing me to have this relationship with the Earth. My mass and the mass of the Earth to communicate with one another. And so every time I’m walking, if I’m walking down the street, every step that I’m taking that me is allowing my mass to communicate where it’s going to land with the Earth and how it’s going to land and how quickly. If I’m running, I’m having a different gravitational relationship with Earth.

If the terrain is a little bit different than me, is going to have to do way more negotiating to allow the mass of my body to come into communication with the mass of the earth. This sort of like big zoom out has given me a lot more questions and a lot more to think about in terms of the knee’s role as this negotiator, this mediator…between my relationship with the planet that I live on.

Kathryn: Why do you like to start with the big zoom out?

Madeleine Shen Lopez: Sometimes I like to start with a big zoom-in. I’m big with the zooming in and out. I think that there’s something really useful about looking at something really close and seeing what you can see so, so close, but then zooming out again so that you can put it into context. Zooming maybe even further out to see what context is that context in, because it’s not unrelated. Even if, like, the galaxy that I’m in is so far away from me somehow, maybe I can zoom out far enough and see, “oh, look, maybe this shape of the galaxy, the spiral shape of the galaxy has something to do with me”.

Then I can zoom into my cells and notice that same spiral shape in some of my molecules or some of the movements of my fluids. Somehow that zooming in and out can connect me with the context within and around me. I really love this zooming in and out. I find it’s a useful tool for learning too, because if you just zoom in, then it’s like you have this piece of information that’s like a bubble. But then like where does that bubble live? And it kind of stays in a bubble.

You might learn another bubble and you might not realize that those two bubbles are actually right next to each other. They could start talking and brewing more questions. But because you’re looking at them so closely, it’s like you don’t see that they want to talk. If that makes sense. I like doing that zoom-in zoom-out for that reason.

Kathryn: Yeah, I like the zoom out because I think so often when we go to a class where we know we’re going to learn the anatomy of the knee, we’re just so expecting one thing.

I think we’re expecting to first learn about the bones and the cartilage and the joint capsule and then alignment and positioning and stuff like that. What I love about the zoom out is we’re focusing on the knee and as you said, as it’s negotiating with body mass and the mass of the earth. When I think of those things, I end up thinking about the knee in a way that’s like, “oh, wow, that’s so incredible. And look at all these amazing things our knees can do. Look what they’re constantly balancing and helping us with and potentially responding to”.

As opposed to focusing on all of the bits and pieces and potentially what can go wrong with the bits and pieces, which is oftentimes where I see anatomy classes heading.

Madeleine Shen Lopez: Totally. And I think it also reminds us that there’s more at play than just the knee.
Even if let’s say…maybe after this big zoom out, we then zoom into the knee and we do look at the bones and we do look at the cartilage. We look at things that can go wrong. But it’s sort of like even if we know that things can go wrong. If we’re just looking at the knee, it’s like, “oh, no, like this is so bad. Now I can’t do X, Y, Z. Now my knee is like this incapable thing”.

Whereas the Zumar is sort of like, look at all the things your knee can do already. It’s doing them all the time. Then zooming in and being like, “OK, how can we fine-tune. How can we look at the more subtle? How can be more complex? How can we maybe get a little more specific or pick apart something and then put it back together?

Then zoom out again. Now looking again at the same negotiating picture, knowing X, Y, Z about the bones and ligaments, how can I then rethink this mediator role of the knee? Seeing how that zoom out suddenly shifted because now we zoomed in.

Kathryn: OK, so let’s go for the zoom-in. Why don’t you tell us about some of the structures of the knee that you think might be useful for our conversation?

Madeleine Shen Lopez: Totally. The first thing that I’ll say about the knee…I’ll zoom out a little bit first before we zoom in…is to note the branching pattern of the body. We have our trunk and then it branches into two legs and then the femur bone will branch into the two bones of the leg and then those eventually will branch into the toes. This branching pattern.

We can zoom out to the galaxies and you’ll see branching. You can zoom to a tree and you see branching. The rivers and the oceans have this branching. The branching begins the knee if you look at one leg. You have the femur is kind of this one bone that heads down towards the knee and you have the two condyles, which are the little knob bit on the end of the femur.

It goes from one bone to the two condyles. Already you have this branching happening. What I like to think about branching is that: things branch so that the two branches can do different things. Otherwise, it would just be one thing.

Branching happens for a reason. We have more than one finger so that each finger can be doing a different thing, which allows us to have more manipulation power and more motor control. Already in the knee, thinking about the two halves of the femur bone, the two condyles, having slightly different roles in the knees movement. Meaning that the knee’s movement is not going to be a monoaxial or a monoplane movement.

It’s going to have complexity. Instead of like a hinge. We often think of the knee like a hinge joint. The fact that there are two condyles informs us that that’s not it’s not as simple as that. It’s much more complex and allows for more negotiation. Thank goodness we have more complexity in the knee so that it has more tools to negotiate the masses. That would be one of the first sort of bony landmarks I would talk about as these two condyles, which meet with the meniscus.

A lot of people have heard about the meniscus because a lot of people have meniscus injuries, particularly the medial meniscus gets injured a lot. You have these to the meniscus, it’s like a cup, a cartilaginous cup that the little condyle sits in. And so you have these two cartilaginous cups for the two-branched condyles to sit in.

Because there are two structures that are doing two different things, allowing those two different things to happen is going to optimize the health of those menisci. Oftentimes we try to move in straight lines and so we end up ramming into one or the other meniscus as we’re moving in those straight lines. The knee actually has some rotation in it, which we often don’t think about.

We think about this hinge in a straight line, but it’s got a little bit of rotation, about like five degrees of rotation in the knee.

Kathryn: OK, I want to ask you about meniscus injuries. OK, so there’s a number of pain researchers like Greg Lehman and whatever. Lots of researchers are talking about the difference between calling something a meniscus injury and a structural change. Potentially a totally normal structural change. Obviously many people out in the world who have changes to their meniscus, who don’t have any symptoms, who don’t have pain, who don’t have loss of function, whatever, whatever, and like young people and quote-unquote, healthy people.

I’m wondering, how do you classify or is it even possible to classify like what is a meniscus injury versus national structural changes that are bound to happen?

Madeleine Shen Lopez: This is such an interesting question. I wonder this “natural changes that are bound to happen” like that sentence brings up so much curiosity for me. I’m so curious about what is a natural change and what is bound to happen.

Based on what? We live in a world that is new like the pavement era is relatively new, so bound to happen in a world full of pavement? Or bound to happen regardless of whether we were millions of years ago running around, not on the pavement? Does natural mean because of our humanness or does natural mean because of our humanness?

Kathryn: Yeah, totally. Totally.

Madeleine Shen Lopez: I love this because I’m so curious about all of those things. I think it also depends on who you’re talking to and who you’re talking about. For example, I’ll use myself as an example. At one point I had a hip thing. I think I remember why I got an MRI maybe it wasn’t anything anyways. And they’re like, “oh yeah, you have a tear on your meniscus”. No symptoms. Never had an issue.

They were like, “it’s really common. Most people have tears in their meniscus and they don’t even notice them. Sometimes they will on their own”. That’s what the MRI person told me.

Then that makes the question like, yeah, like I wasn’t feeling symptoms, but does that mean that my meniscus wasn’t injured? What does injured mean? Does injured mean that the structure of the tissue is less than optimal, or are we going to give it a different name? Maybe we’re going to give that like compromise or maybe we’re going to call it that natural change or whatever.

I think framing the context for each individual person is so important and can have a huge role in their prognosis. In terms of how well are they going to deal with their context. For example, someone who’s really scared of being injured and doesn’t deal well with an injury…saying that a meniscal tear is an injury can have a really bad toll on how well they actually recover from something. Maybe otherwise if you just said, “oh, it’s nothing, it’s a natural change”, maybe they would cope better.

I feel like there’s some sort of like messaging or like health marketing that needs to happen in responsible and positive ways. Where you’re sort of choosing how to define something for each person because those definitions don’t…I mean they don’t actually exist anywhere, even though we feel like they do.

What is health? You can look up the definition of health everywhere, but you’re still not going to have a clear idea of exactly what health is, because it’s so different for every person, for every culture. Even the words that are used to define health, then you have questions about those words. Then those words get defined by words that you have questions about. Do you know what I mean?

Kathryn: Yeah, totally.

Madeleine Shen Lopez: I don’t know if I side-stepped your question, but, yeah, I don’t know.

Kathryn: It’s such an interesting topic, I don’t think anybody really has the answers. Lately, because I’ve been so interested in that and like making some posts about it on social media and stuff, I’ve just been listening to different people, physios, researchers, podcasts about the knees.

It’s just been really interesting, like one podcast I’ve been listening to they were talking about the idea of a faulty knee position. A lot of research and papers will write the words faulty knee position. And just listening to different researchers debate whether or not it could be even possible to have a faulty position has really shifted the way that I think about the body.

Madeleine Shen Lopez: Totally, totally. I think I think what you’re referring to is this idea that the knee kind of naturally does its thing. And it’s actually really hard to make it not moving the way it’s supposed to move.

Kathryn: Yeah, yeah. Basically, I think when people think of “faulty knee position”, I think people think this valgus knee going in position. Right? Like that’s what everybody’s trying to avoid, whether you’re like a runner or in a yoga class. There are tons of messaging about making sure your knee tracks over this toe.

Based on the class you’re in, some people will be like tracking over the big toe. Some people say the pinky toe. Some people say right. There’s obviously a debate about which toe the knee should be tracking over. But I think the bigger message here is don’t let your knees go in, because if it does, bad things are going to happen.

I guess there’s debate over, you know, what can the structures of the knee adapt to be strong and resilient even as they’re going in during movements like squats or running or whatever?

Madeleine Shen Lopez: Yeah, this is really interesting. I’m going to zoom out again because I think that in this knee-in position, people get really focused on the knee and like what’s happening in the knee. Oftentimes I think that the knee is going in is actually not about the knee at all. The knee is just what you see. It’s like the result, you know, and it’s the result of a lot of things like we could point to at different joints.

But generally speaking, I think that there’s a question about how am I transferring the weight of my body to the earth? I’m coming back to that same zoom out of how is the weight of my body and gravity, the force that creates getting down to the earth and back up? What’s the most efficient pathway for that kinetic energy to travel through?

If I’m allowing that, generally speaking, like if my knees are bowing inwards, generally speaking, that means that my kinetic energy is leaning into the soft structures on the side, the inside of my knee.

Now, if I could train them to be strong enough to withstand that kinetic energy traveling through there, then that’s great. I could probably be fine with my knees going in. But generally speaking, bones are really good transmitters of force, because they are compression elements. They’re really good at transferring compression forces towards the earth.

That’s sort of my perspective on…not to say that I agree that I don’t agree that you should never let the knees go inwards and that you should avoid that position at all costs and your knees will explode the second they go inwards. No, not at all.

But I do think there is this idea of choice and agency. And so if I’ve only ever learned to walk around and move and sit and stand with my knees going into that valgus position, then I don’t have a whole lot of choice as to how my weight, how my mass is being negotiated with the mass of the earth. I only have one like mediating solution. I only know one way to get the two masses to talk.

Kathryn: Right.

Madeleine Shen Lopez: I can open up those different strategies to then decide in each situation how I want my knees. Like what tool are my knees using to help me with my body mass, communicate with the mass of the earth? Whether that means walking, whether that means just standing, whether that means jumping, whether it means sitting. I want to have as many tools as possible.

Opening up this idea of all of the different ways that the knee can move as well as practicing the most efficient ones. When I’m not paying attention to my knees and I’m chatting with a friend as I walk down the street six feet apart, can my knees do the negotiation on their own or do I need to be paying attention to them all the time? Have I practiced these efficient tools of communication? Even though every once in a while it’s fine if they communicate in sort of a less efficient way.

Kathryn: Do you think what’s efficient fo one person is going to look different from what’s efficient from another person?

Madeleine Shen Lopez: Absolutely, absolutely. I think for the vast majority of able-bodied humans who have who are within the sort of Gaussian curve of the norm, let’s say within one standard deviation from the norm, whatever that means. I think that there are some general rules that can be helpful for most knees, but that’s leaving out a gigantic portion of the population that will not go along those rules and for whom those rules will not work at all.

The tricky part is, even if you have completely within the norm knee anatomy slash context, you might not have within the norm spine context or completely within the norm, I don’t know, nervous system context. And so, generally speaking, these general rules you always need to take them with a grain of salt. But like Kevin O’Connor says, try them on like a costume. See how they work and then try on a different costume.

Kathryn: Kevin O’Connor is one of my all-time favorite people to interview for the podcast.

Madeleine Shen Lopez: He’s my most quoted person.

Kathryn: OK, I need to ask you about Tree Pose. I don’t know how many yoga classes you’ve ever taken in your life, but oftentimes we get to tree pose, and then the teacher says, pick up your foot, put it on your leg, but either put it above or below your knee.

I think that what’s behind the cue is we want to keep the knees safe and we think that putting pressure on the knee is going to be bad. We avoid that by not putting pressure on the knee. And obviously, I have a lot of feelings about this, but I’m wondering what you think about this?

Madeleine Shen Lopez: Yeah, I have a lot of feelings about this as well. I have a lot of feelings because I often feel when I’m doing tree pose, my other knee is the one that complains more frequently than the one that I’m standing on.

Kathryn: Interesting. I always find it interesting that they focus so much on the standing knee and my other knee I often have to…like every time I do tree pose I have to really listen to that other knee to see “OK, how is it today, how is my knee today and what kind of activity doesn’t need or what kind of tone doesn’t need to be felt to feel supported”. But I find it really interesting these like global statements with no context.

Madeleine Shen Lopez: I think that it can be dangerous to put pressure on the side of your knee if let’s say you’re in hyperextension. If I’m in hyperextension and if I’m leaning…like the foot that’s sitting against the side of my knee is really relaxed and all of the weight of that leg is pouring directly into the side of my knee, which is in hyperextension…I think that that’s a lot of force for a relaxed knee, for a relaxed leg to receive.

If the muscles are relaxed, if I’m just leaning into the joint, then the joint pops when the ligaments are the ones that are needing to mediate those forces, which isn’t their job. Their job is to tell you this is too much weight, which is often why it kind of hurts when you do that. They’re like, excuse me, can you just do something else? Can you help us or do we need more support? Right.

But if I’m putting my foot right on the side of my knee and my knee is all the muscles that support my knee are engaged and my spine is engaged, and I’m mediating gravity in a way that I’m not like a sack of potatoes, then I don’t see anything wrong with putting your foot on the side of your knee. Any different than beside your calf or on your thigh.

Kathryn: Yeah, like, OK, so I have lots of feelings about this, like one thing. I’ve been doing this. I’ve been standing in tree pose, placing my foot on the inside of my knee and I’ve been doing an experiment. I’m like, how much pressure can I even put. Like I’m not holding on to any walls. I’m not using any external leverage, just me standing in the middle of the room with my foot right on the inside of my knee, pushing as hard as I can.

From my experience, I fall over before there’s any substantial increase of load, like how much load can a human even generate in that position with no external things to hold on to? And is that amount of load actually significant enough to be dangerous given what the knees are designed to do?

Madeleine Shen Lopez: But here’s something that you need to remember. Your knee capsule is very smart and trained.
Also, your relaxed knee is not as relaxed as maybe another person’s relaxed knee. Even when you are doing nothing, your body tissues have a base tone in their tensegrity structure that is doing stuff for you to help you distribute that load.

Kathryn: Right, because of training.

Madeleine Shen Lopez: Yeah, for me, like when I see people who are very, very new to movement practices and whose tensegrity system is completely offline. Those are the ones where I see the leaning into the joint being more of an issue, because those joints, they are not necessarily tapping into the tensegrity potential that the tissues could have.

Whereas yours are just doing it all the time. Like you can’t turn it off actually, because you’ve trained yourself to not be able to turn them off. That’s something to remember, is that you and I are not necessarily the people we could experiment on to see what could happen.

For example, for me, I know that in hyperextension, I’ve had to train myself out of hyperextension. One thing to know about ballet culture, hopefully it’s changed, is that one really popular thing to do was to lean your leg on your heel on a chair and have a friend sit on your knee so that it would get more hyperextended. That was like a thing that we did as kids.

My knees are very hyperextended. If I allow myself to lean into my hyperextended knee, actually feel pain right away, because those structures are not they don’t have the tensegrity anymore. I don’t know if they’ll ever if I’ll ever get them back.

It’s a lot less than it was before because I’ve trained the musculature around to help add tension to that structure. If I’m in my hyperextension and I lean on the side of my knee, I feel a lot of force. The second I unlock my knee, even if I relax in an unlocked position, yeah, I can’t really make my knee feel any extra force if I like, even if I push down on my leg. Yeah, it’s true. I can’t really make it can’t get a ton of force there.

I think it depends again…it depends on the context of the person. Right. And how, how are their joints. People who have hypermobile joints, people who have soft tissue that’s a little more stretchy. People will have had previous injuries, people who just have less of a movement practice and less of that integral kind of resilience in their tissues. It’s going to be a different picture for them.

Kathryn: OK, so when you stand and you hyperextend your knee and then you put the foot on the inside of the knee, how can you tell that the feelings you’re having are coming from the load on the knee?

Madeleine Shen Lopez: As opposed to coming from something else?

Kathryn: I don’t know, like maybe like a sensitized nervous system feeling.

Madeleine Shen Lopez: I mean, when I don’t put my foot on my knee. I don’t I feel I don’t feel pain. And then when I place my foot, as I press more and more, I feel more and more pain. It doesn’t necessarily mean that I’m doing any damage or that it’s dangerous.

Kathryn: Right.

Madeleine Shen Lopez: But it’s definitely telling me that my body is communicating some sort of limit.

Kathryn: Cool.

Madeleine Shen Lopez: Even if it’s one that I’ve made up from training or from, I don’t know, from being scared of snapping my knees into hyperextension, which definitely hurts when that happens.

Kathryn: Yeah.

Madeleine Shen Lopez: Or from the trauma of of of feeling like I needed to change my body architecture by having friends like bounce on my knees in hyperextension as a child. Who knows what’s behind that. Maybe it is sensitization. Maybe it’s a bunch of things. There’s definitely no sure way to know. But there’s definitely a communication happening from my body to me.

Kathryn: Right. Yeah, yeah. Yeah. So OK, I have more questions about hyperextending.

Madeleine Shen Lopez: Yeah. For sure.

Kathryn: What do you think about training? I’m thinking about exercises like gym exercises that are like super controlled settings like, like knee flexion. I don’t know if you’ve ever been on a leg curl machine, but you’re basically there’s a load on your ankle. You flex your knee with the load. You straighten with the load.

Madeleine Shen Lopez: Yeah. Like a hamstring one? Like lying on your belly like at a slumber party and you’re bringing your knees up.

Kathryn: Totally. Super controlled. You can put the weight down, you can put the weight up. What do you think about using exercises like that to train the strength and resilience of the leg and knee through the full range of motion? Even if that includes a hyperextended range of motion?

Madeleine Shen Lopez: I think that can depending on how it’s done, I think it can be safe. It depends on what the body’s condition is like when you get to hyperextension and how far the hyperextension is. I mean, there is a point in hyperextension where you’re sort of beyond where the cartilage is meeting cartilage and where you’re stretching out the capsule in a way that’s not necessarily going to be helpful at all.

I don’t know if it will necessarily do damage, but I also don’t know if it’s going to be helpful. So, yeah, again, it depends on how it’s done. But I think that going to end ranges or beyond is not necessarily in itself dangerous. Otherwise, the body wouldn’t be able to do it. But we do it all the time, like going outside. Our sort of, quote-unquote, range of motion happens, and I don’t think it’s dangerous, I think it depends on how it’s done and how frequently, how repetitively we do it.

And also, like, what are we training our bodies to do as their baseline versus what are we training our bodies to be able to cope with if they need to? Right. That’s a really important distinction.

Kathryn: Yeah. Yeah. Oh, OK. So many knee-related things. All right. We asked about hyperextension. We talked about the tree pose. So one question I, I’ve been thinking about a lot recently is thinking about engaging muscles.

So I was definitely trained to like every pose you do, every movement, you do think about engaging your muscles and that’s the best way to do the pose. And I’ve just been kind of like trying to, like, peel this idea apart a little bit, because when I’m going about my daily life, obviously I don’t have to think about engaging any muscles and the day-to-day movements that we do or not. Well, I guess most of them at least are not dangerous.

Like, I’m reaching, I’m bending, I’m pulling, I’m squatting. I’m taking the dog over here, opening gates, closing gates, doing all these things, not having to think about my muscles. And I’m wondering what you think about this idea that we have in yoga and other movement practices that we always have to be thinking about what we’re engaging in order for the joints and maybe in this case, the knee joint to be safe.

Like if I’m standing and even if I’m trying to relax everything as best as I can, I feel like there’s still a certain level of engagement that’s happening that I will never be able to relax. And I guess I’m wondering, is that enough or do we need this additional engagement?

Madeleine Shen Lopez: Hmm. I think this is such a great question. And I love the word engagement because it’s so vague and that’s so important because I think it’s important to understand or maybe explore, like, can I think about my muscles as not only things that contract like that. Flex muscles don’t just flex, they also stretch. They also rebound. They also are elastic. And then they recoil.

They can have tone and they can have tension. And those can be really different. And they can also mix together. So like that feeling that you feel like I can’t fully relax like that would be like a base amount of time, but I don’t know if it’s necessary. Not like you’re tense, right? Yeah. Well, you can then tense your body and stand all the sand and you’re doing the exact same pose like let’s say you’re doing mountain pose, which is just standing right. That concept.

Yeah, we’re just doing it. I’m just doing tempos in front of a mountain. So if I just kind of relax my tissues and allow the minimum effort to just maintain the idea of the pose, and then I’m going to just like engage the muscles that I feel like I need to be there to do this pose. It’s first, it’s a very different experience. So just noticing those two poles and noticing that we can be everywhere in between.

And so throughout your daily life, like like you say, like you open a gate, you close a gate, you’re not necessarily thinking about opening or closing that gate. And contrary to popular belief like these are not dangerous things. But that’s often where most injury happens, is in daily life stuff. We’re not really thinking about habits that we just have, not in our brains, like not like, oh, I habitually always push with my right hand versus my left, but when I push the elbow flares out or flares in or whatever, like these, like mini these micro habits, those are often the things that will then generate like leaks in, in this tense security system.

So the security system of the body is where I think this conversation about like muscle tone or like muscle engagement can maybe go is like, can we talk about how the tensions of the whole body are communicating amongst themselves to support our structure as a whole architecture like the zoom out thing again, like zooming out to see that like I am an organism that has sort of like a coherent, cohesive structure in and of myself.

Like I just have a structure. Can that structure support what I’m doing daily? Right. So if I have a shoulder injury and then suddenly my one shoulder doesn’t have as much tone, then maybe a yoga practice where I’m engaging the tone of that arm will help make it so that when I do go and walk my dog and a. In the gate, that shoulder has the sort of baseline of tone that it needs to just do those daily activities. So, again, it depends on where your context is coming from.

Now, if you’re a person who muscles everything, who like literally to just, like, put down a cup of coffee, you’re like flexing your bicep as you put the cup of coffee down. Some people just have that sort of habitual tone. Then maybe your practice might actually be how little muscular effort can I do and still do the activity? How little muscular effort can I use and still do warrior two like can I do one or two without flexing my muscles versus someone else who maybe has very little time?

Can I flex all of my muscles during World War Two? Right. So it’s like can we play with that range and figure out what our system needs? And maybe it changes day to day or season to season, right?

Kathryn: Mm-hmm. So many things to think about, so many more things to say, so many more things to say. OK, this has been such a pleasure. I’m so glad that we made the time to have a conversation about the needs.

If people want to learn more about your work or get in touch, where should they go to do that?

Madeleine Shen Lopez: Yeah, yeah. I’m really happy that we made the time as well. It’s so great to talk to you. I love this exchange of perspectives and world. If people want to get in touch with me, I do have a website. It’s movinghealingbody.ca. I’m also on Instagram moving the healing body. And yeah, those are the places where you can find me.

I’m terrible with social media and I live in a place with very bad Internet, so I’m not the greatest social media person. But I do engage and I love when people write to me and we can chat about nerdy things and all that stuff is awesome.

Kathryn: So we’ll put all of those links in the show notes. Thank you so much, Madeline.

Madeleine Shen Lopez: Thank you so much, Katherine.

Kathryn: That’s our show. Thank you, everyone, so much for listening. If you’re listening on the Apple Podcast and you’re loving the podcast, please consider leaving us to review. All of the reviews really, really help. If you want to learn more about my work, my membership, my teachers’ course, or my new free course called Mindful Strength Foundations, you can head over to mindfulstrength.ca