Walking with Comfort and Confidence:
Developing the awareness of how form supports function
Healing Hip, Joint and Knee Pain
By Kate S. O'Shea MA
Kate had her first and only partial hip replacement in
1968 to correct complications from congenital hip dysplasia. She has been working with individuals for
over 20 years to enhance their physical balance, comfort, and confidence.
Most of us walk, yet few of us think a thing about it
until we are in pain. Suddenly all we know is that walking is not the same anymore, but we don't know
what to do about it. Difficulties develop from trying to avoid pain and compensate for weakness.
Understanding how your body is designed to move and support you can help. This article gives you
tools to learn how to walk with more balance, comfort, and confidence.
Walking is a process that requires structural support from our skeletal system propelled by neurological
organization, muscle coordination, and strength. Following surgeries and trauma our body naturally
protects itself by holding the injured area still. This unconscious "splinting" causes characteristic
unnatural movement patterns. I discovered my own compensations were not unusual when I was in a
ladies locker room years ago. I happened to notice that the woman next to me was holding her foot in
the same tense and clumsy position as I had before I began consciously to improve how I move. And,
she had a hip scar just like mine! Since that time I have seen many others using their feet and legs in
very similar ways. The odd foot use helps stabilize the leg that is being used like a stick instead of a
flexible, living part of the body.
Your skeleton is your natural support system. Understanding how the shapes of our bones
participate in the process of walking helps us regain the smoothness and ease in our movement.
Following are some basic ideas to keep in mind for improving your gait. I focus on the feet and hips
because if the foot/hip relationship is good, stress is reduced in the knees and back, and your gait will
Balance from the feet ...Up
Attention to the feet is often the single most useful tool for correcting walking problems and discomfort,
in my experience. The feet are the foundation for all other aspects of your support. The way you use your
feet affects the stability of your ankles, which in turn stabilize your knees and hips. Many people walk on
only part of their feet, often getting very little balanced support from the whole foot. The shape of
your foot provides you with a broad base of support, when you member to use it.
The key is to think of the four weight-bearing points of each foot, and balance your weight between
them. Developing a sense of the width of your heel is especially important. Balanced placement of your
heel stabilizes your leg. People often walk as if their heel is narrow, like a high-heeled shoe. This makes
it easy for the ankle to collapse inward or outward. It is possible to learn to be conscious of how your foot meets the ground and easily improve the balance of the ball of your foot, heel, and ankle.
A simple way to improve the use of your foot is to increase your awareness. For a reality check, grasp
your heel and feel how wide it is. Stand and notice how you are using your heel. Next, be aware of how
you are standing on the ball of your foot. Be aware of how your leg is being supported by each foot.
Where are the imbalances? Imagine how your walk is affected by those imbalances. Your foot is
designed to provide a broad base of support. Next, feel the four weight-bearing points: the base of the
big toe and little toe, inner and outer border of the heel. Now try walking with your new perspective.
Central support from your hips
It is essential to understand the true location of your hip joints to understand how they function. Many
people are unclear about this most basic element of their support. These ball and socket joints are
placed lower than most of us think. To discover this in yourself, bend your knees slightly, keep your back
straight, and lean forward about 45 degrees, letting your buttocks extend behind you. Put your fingers in
the crease that is created in the front. Your hip joints are located in that crease.
My favorite fact about hip joints is that they are just as far apart as your ears - you can use a pair of
eyeglasses to measure. This relatively narrow width between the hip joints provides a central core of
support for your body. People often point to their waist, or the widest part of their seat, when they are
asked to locate their hips. Neither of these places provides stability to the body when you think in
Learning to feel the central nature of your support gives a feeling of balance and collectedness that
transports energy up through the hip joint and pelvis, and up through the spine. This sense of central
support gives you more balance and freedom as you move.
The spring in your step
In addition to support, a naturally fluid gait needs a sense of roundness. The back of your femur (thigh
bone) is arched to facilitate an easy forward swing when walking. The underside of the bones of your
feet are arched, adding spring to the femoral arch. I like to think of the arch of the femur easily propelling
my leg from behind, like a wheel, as I move forward. Actively using your toes as your foot comes off the
ground with each step adds momentum and spring to your step. You can practice this first by standing
and lifting your heel off the ground by pushing down with your toes - like going up on tip-tip one leg at a
time. Then try walking using your toes more actively. It may feel odd at first, but it is worth playing with.
You can also use your toes in this way to help gives added strength and momentum when climbing
stairs. Active use of your lower leg in this way helps avoid overworking the thigh muscles.
Some people tend to walk with their toes pointing either in or out (pigeon-toed or like a penguin). One
way to correct this is to direct your knees straight-ahead, not worrying what your toes are
doing. When your knees are aligned, your feet naturally track forward. I have found that this method
is often most easy on the body. If you focus on controlling your foot it can create tension in the hip.
Try it and use what works best for you. The less tension we create the more easy and natural our
One of Newton's basic laws of physics is that "for every action there is an equal and opposite
re-action." Applied to walking, every time you step down an equal force is carried up through your body.
This force is most direct and efficient when your body is well aligned. The points listed above will
prepare you to feel the lift from your feet through your hips and up your spine, propelling you forward and
up. It takes practice, but it is worth playing with until you feel that lift.
Other things to play with...
Rehearse changes of position in your mind before you do them. Imagining your movement first
prepares the nervous system, muscles, and bones for action. During recovery it is easy to move too
quickly without thinking. Turning abruptly, for example, can throw you off balance, force you to
catch yourself, and sometimes cause momentary or ongoing pain. Learning to move consciously will
always benefit you. Before you move, imagine the easiest and most efficient way to accomplish the
movement. Feel yourself doing it several times before you actually move, feeling the movement in
your body. This rehearsal process is very useful when changing positions in which the transition can
tend to be uncomfortable or awkward, like moving from sitting to standing. Take your time, be patient,
and allow yourself to adjust to the new position. Be open to the possibility that you can move
Remember to care for the joints neighboring any area of difficulty. When one joint is hurt or immobilized your other joints and limbs adjust by moving in new, sometimes odd, ways. This can create other discomfort and future
problems. For example, my left hip was the one operated on. To compensate for slight
limitation in my ability to rotate from my hip, my left knee has exaggerated its natural range
of movement for many years, weakening it slightly. In addition, my right leg, which I
depended on so heavily before I learned to balance my walk, tends to be more tense and
muscle bound. I take special care to keep those overworked places comfortable, and
continue to improve the use of my left hip, so that it will pick up its rightful responsibilities.
Notice your pleasure, as well as your pain. Become aware of what parts of your body feel
good. Learn from those places! What is a "good" feeling? How it does get there? Can
the goodness be expanded? Frank Wildman, Feldenkrais Method trainer, has developed a
pleasure/pain scale, which instructs the student to find two pleasurable associations
with their body for every pain noted. Try this out. Make up your own questions. Discover
everything you can about your comfort. I'll bet your discomfort has gotten the bulk of your
Move to your favorite music. Allow the music into your body. Feel how your body would like
to move. Move with lightness. Let go of your ideas about how you should move. Enjoy
yourself and your movement just as it is now.
If you have a pain, listen to it. How does it sound? Hum or sing the tone you feel. Match
the feeling in your body with sound. Imagine that the sound can move out through the point
Conscious walking can be a meditation anytime, anywhere, to enhance your comfort and confidence.
It is matter of being an alert, compassionate, and knowledgeable driver of this vehicle - your body. You
can use the body's innate intelligence to move naturally when you help it by being more present,
catching patterns of tension and compensation. In my case, I have an unstable knee due to reduced
sensation caused by surgical nerve damage. I focus my attention on the bone in the numb area of my
high, which brings the wholeness of my leg back into focus. I feel my whole foot participating in each step. When I do this, my knee is more stable. My expanded awareness helps me improve the strength and smoothness of my gait. Increased awareness makes exercise more fun and interesting, too: When I swim I imagine my bones cutting through the water (imagine a swimming skeleton!). This makes me laugh, allows me to check my alignment, and often increases my
My body is my friend after many years of an uneasy relationship. I know that my acceptance,
understanding, and care of my physical self increases my comfort and nourishes me body, mind,
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