Dispelling the Myths of Alignment: Part 1 – The Tibia

TheSwami Sivananda standing in Tadasana: the pose of the mountainre are no universal principles of alignment. (I might as well get the controversy started right away!) There are no universal cues that work for everybody, because there are no universal bodies. Any cue that demands, “everybody must place his or her feet parallel” is missing this basic fact. To be clear, there are principles of alignment, but what is important is to discover the principles of alignment that work for your body, not for other bodies. We can illustrate this point by investigating the question: “Where should your feet point in a yoga pose?”

Hands up all those who believe or have been told that the feet should be parallel, and perhaps even together, while standing in Mountain Pose (Tadasana). For you, that may be exactly the right answer, and for many people this is the perfect alignment cue. But for many other people this is an artificially constrained placement of the feet dictated most often by aesthetics and not function. For many people the feet should not be pointing forward and together, and we will discover why in a moment. You are not average! So, cues that work for the average person may not work for you. [See Box 1: Who Are You Calling Average?]

The feet are part of the extremities of the body: when we focus on what the feet and hands are doing, and try to change their positions to fit an preconceived image of what a pose should look like, we are forcing the tail to wag the dog. While the position of the feet can be important, this is the least important aspect of a pose, because there are considerations closer to the core of the body that dictate where the feet should be, if we want the body to be in a natural, or neutral position. The shape of the tibia (shown here), the twist of the femur, the orientation of the hip socket have a far greater bearing on where the feet should point than how the feet look, if our objective is to follow a functional yoga philosophy. There is little room for aesthetics when the intention of your yoga is to gain or maintain optimal health: instead we need to look at what works for you, not what looks good on someone else.

We will examine just one of the many aspects of how the position of our feet is dictated by our body’s unique anatomy: the torsion of the tibia. [1] Torsion means “twist.” There are no straight lines in our body: everything grows in curves to a lesser or greater degree. This means that we have no perfectly straight bones: all of our bones have some degree of twisting or curvature. Examine the two tibias shown in the picture above. These are two right tibias, which are the shinbones of the lower leg. Do you notice any differences between them?

The tops of the bones are at the top of the picture: this area is known as the tibial plateau, where the femurs are supported. If you are sitting, you can palpate this area by bending your knee past 90 and feel the front/bottom of the knee. The point to notice is that each tibial plateau has been arranged parallel to one another and they are both lying on the black table, keeping then completely level. The bottom of each tibia, however, is quite different. The bones end in the “ankle mortise.” This is the bottom part of the tibia that sits atop the talus bone. Notice how these two ankle mortises do not point in the same direction. Since these are right tibias, this is the area that you feel when you touch the inside of your right ankle. Knowing this, and with a little 3D spatial visualization, you can see how the person who had the tibia on the right would have had his foot pointing pretty much straight ahead but the owner of the left tibia would have his foot pointing to the right.

Let’s illustrate this by adding some annotation to the image. With lines drawn in you can see angular differences: the tibia on the right has a torsion of about 12 while the one of the left has a torsion of about 26%. The difference between these two tibias is about 14%, which is considerable. Many studies have shown that this falls within a normal range of human variation. In fact the tibia on the right, with only 12% of torsion is much more unusual than the tibia on the left. The average tibial torsion is around 23 to 38 depending upon which study is cited. [2] What this means is – the person with the tibia on the right, who is more likely to have his foot naturally and comfortably pointing straight ahead, is in the minority. Most people have a far greater tibial torsion than this guy, meaning that, all other things being equal (which they definitely are not), their feet will want to point more outwardly. But, the most common cue from yoga teachers regarding the feet is to have them pointed straight ahead: in Mountain Pose, in Down Dog, in Bridge Pose, in Wheel, in Chair Pose and in so many other postures – students are guided to keep their feet pointing straight ahead. This may not be the best instruction to offer.

Why did the human body evolve to have the feet splayed apart like this? Is this some abnormality that a good yoga teacher will correct for us by insisting on having our feet pointing straight ahead? It turns out that, for upright standing bipeds, having a significant amount of tibial torsion is quite a good thing. When the feet are together, the center line of gravity is more towards the heels and our base of support is narrow. When the feet are turned outward, the base of support is wider and the center line of gravity moves more towards the center of that base. [3] Notice a sumo wrestler just before the action begins: their feet are turned out, and their knees flexed. Baseball players also adopt a wide-legged stance: they are ready to move in any direction. Runners, on the other hand, have their feet closer together and pointing straight ahead, because there is only one direction they plan to move, and that is straight ahead. One position is not “right” – positioning of the feet depends upon the intention we have: not the look but the feel.

If you practice people-watching, notice where people place their feet when they walk or run. Generally, most people will point their feet straight ahead. That makes biomechanical sense: when walking or running, we want the thrust of each step to be as close as possible to the direction that we intend to move. When you see people standing still, perhaps waiting for a traffic light to change, they will more often have their feet pointing outward: this too makes sense if your intention is to minimize the effort needed to maintain balance while standing. But, if everyone has some tibial torsion, which tends to point the toes outward, how can people walk with the feet pointing straight ahead? The answer is internal rotation of the leg at the hip socket. To compensate for tibial torsion we have to internally rotate the whole leg. We will discover in future articles that not everyone has the ability to internally rotate their femurs enough to bring the foot in alignment, thus you will notice some people you watch walking do not point their feet straight ahead: they need to walk with the toes pointing outward because of their unique anatomically structure. [See Box 2: An Exercise in Empathy to understand what these people are experiencing in a yoga class when the teacher insists they align their feet “properly”.]

When you stand in Mountain Pose with your feet parallel and together, do you feel balanced, comfortable and ready to move? Then your feet are probably just where they need to be. Or do you feel off-balance or uncomfortable standing like this? Finding out what is the correct alignment for your feet given your unique anatomical structure requires some attention and experimentation. Notice, for example, how it feels to have your feet parallel in Down Dog, then experiment and see how it feels if you point the feet outward. My personal experience may not be the same as yours but, when my feet are parallel and I pull the heels to the ground, I feel more stress in the calves and it feels great, but when my feel are pointed outward, my heels more easily come to the ground and the Aldo Nadi external rotation of the femur allows me to more deeply flex my pelvis, which allows me to relax my upper body closer to the earth. Neither position is right or wrong: I feel no pain or risk of injury either way, but one version definitely works a different area of my body than the other. Also, my transition from Down Dog with feet pointing outward, stepping forward into Warrior, is much smoother: my back foot is already turned out and fully grounded supporting the movement, like an ice skater who turns his back foot out to accelerate forward onto his gliding leg, or a fencer thrusting from the back foot, which is also pointing outward. [Notice the back foot of Aldo Nadi, considered one of the best fencers of all time, and how it is aligned. Would you go up to him and suggest he change the alignment of his back foot?]

The effect of different alignment choices of my feet is something I had to discover about my own body. Your experience, though different from mine, may be likewise just as enlightening. Once you have played around with the alignment of your feet in Down Dog, try the same experiment in other postures. Does a Sun Salutation feel better for you or worse when your feet point in various directions? How about in Chair Pose? How about in wide-legged forward folds? In Wheel or Bridge Pose? Where should your feet point? It depends on your intention. Also, try ignoring the feet as you experiment, and instead feel what is happening at your hip sockets. Allow your body to come to a neutral position there, and note the resulting manifestation of the feet. See if that angle of your feet works for you in a variety poses. Sometimes it will, sometimes it won’t: find out what your body is allowing you to do, rather than forcing the body.

If you intend to regain, maintain or optimize your health, practice functional yoga. The functional approach to yoga focuses on using postures to work specific regions of the body. Aesthetic yoga focuses on looking good. This doesn’t mean you have to drop your normal alignment cues if you are a yoga teacher, but don’t be dogmatic about them and don’t insist that everyone must listen and do exactly what you say. If someone doesn’t do what you say, find out why. What are they feeling when they do it your way and their way? Remember what your intention is in assigning the pose. Determine your intention before coming into a posture and see if that posture is working the intended area. [See the article Suzee Cues & Functional Yoga for more on what Functional Yoga is all about.] If the posture fails to stimulate the targeted area, play around with your alignment and see if you can find a way to get the stress you are seeking. If you still cannot generate the stress you want, come out of the pose and try something different. Yoga is both experimental and experiential. We can learn a lot about ourselves when we pay attention to what the body is telling us. Ignoring our unique anatomical structure and trying to look like everybody else is not functional.

We have seen how a single variation in one bone of the body can have a dramatic affect on our yoga practice. We started this series of articles with the tibia because it is a simple way to introduce you to the concept of skeletal variation, and what it means for your alignment in yoga postures. In future articles we will look at the femur and pelvis, and other ways that our unique anatomy determines how we should safely and effectively practice our yoga.

Footnotes:

  1. — It is my intention to examine the effect of the femur and hip socket on the direction of the feet in later articles.
  2. — Interestingly, the Thieme Atlas of Anatomy implies that a 23% torsion is “normal”. See page 373 of Thieme Atlas of Anatomy, printed by Thieme of Stuttgart, Germany 2010.
  3. — Ibid.

 

Box 1: Who Are You Calling Average?

Imagine this: you are asked to arrange the entertainment for a birthday party. You relish the challenge, ideas start flowing through your head, and then you realize you better ask for the ages of the partiers. You are told that there will be 12 people with an average age of 16. That night you get some great ideas: a multi-player video game for teams of 4. Boys love video games: this will be great! With excitement you plan out the party and arrive for the big day only to be shocked and bemused. You find awaiting your arrival six 4-year-old girls and their 28-year-old mothers. The average age: 16! But not a single person is actually 16 years old: not even close. Your plans to entertain the average person at this party go horribly wrong.

The average tibial torsion of a 4-year old child is around 28%, but it keeps changing as the child ages. For the next 10 years, the twist in the bone increases by about 1 per year, until mid teens. Then the rate of change slows down, but over the next decade as much as 4 more is added. This rate of growth varies considerably between individuals, but by the time we reach adulthood, the average amount of tibial torsion is 38. While this may be the average, the range of variation is large: from 18 to 47. These statistics are from a study that examined 78 children and adults. [4]

But is anyone average? We take a big leap of faith when we plan for an average person. There is no one who is exactly average age, average height, average weight, has an average torsion to their tibia, to their femurs, to their pelvis, spine, shoulders … we could go on an on. There are a few people who do fit the “average” for any one of these criteria, but no one is average in all respects. Trying to teach to an average person runs the great risk of teaching to no one, because no one is average! Do we assume that boys and girls are equivalent creatures? Do so at your own peril! Men and women are anatomically quite different, beyond the obvious. Age also brings significant differences. And there are the differences we were all born with.

Studies are infamous for being inconsistent: while the study cited above found the average tibial torsion to be 38%, another study found the average to be a little less. This study discovered that in females, the average tibial torsion was 31 for the right tibia and 30 for the left. For males, the averages were 32.7 and 35.3 s for the right and left tibias, respectively. [5] Notice the variations by gender and by side of the body – the degree of our asymmetry is another way we are all unique.

1 — See “The normal development of tibial torsion.” Skeletal Radiol. 2001 Sep; 30(9):519-22. Kristiansen LP, Gunderson RB, Steen H, Reikeros O. Source: National Hospital Orthopaedic Center, University of Oslo, Norway.
2 — “Determination of tibial torsion by computed topography” 1994 Mar-Apr;33(2):144-7. Sayli U, Balakbasi S, Atik OS, Gondogdu S. Department of Orthopedic Surgery and Radiology, Gazi University, Medical Facility, Ankara, Turkey.

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Box 2: An Exercise in Empathy

Early in my yoga teaching career I had a student who refused to listen to my alignment cues. I was teaching in a high tech company and literally had rocket scientists as students, but despite one student’s engineering brilliance, he became an idiot as soon as he stepped into my yoga classroom. What he refused to do was – stand at the front of his mat with his feet together and parallel. Could anything be more simple than that? Oh, he would try. At the start of a Sun Salutation his feet would be together, but by the end … his feet were pointing way out to the sides again. He just wouldn’t listen!

Later, when I discovered the truth about skeletal variations, I thought about this bright engineer whose IQ dropped while on a yoga mat. I realized that what he may well have had was a significant amount of tibial rotation. Sure enough, the next time I saw him, I noticed – not his feet – but his knees. When he bent his legs to come into Chair Pose (Utkatasana), and while his feet stayed pointing out to the sides of the room, his knees tracked straight to the front of the room. Now I understood why was he continually going back to having his feet pointing out to the side: because it was really uncomfortable to do a Sun Salutation any other way.

What I was, in effect, asking this poor student to do was to internally rotate his legs to align his feet the way it aesthetically looked right to me. For most people, strongly internally rotating the femur in the hip socket reduces the ability to flex the pelvis and fold forward. We will see why in more detail in a later article, but internal rotation of the femur at the hip socket reduces the range of motion for flexion of the pelvis because the neck of femur may get in the way of the of the ilium or the lip of the acetabulum (depending upon the size, shape and orientation of the hip socket.) To illustrate this: try sitting on the front edge of your chair, spread your legs apart and point your toes outward. Now, fold from the hips and notice how easy this is. Your thighs are externally rotated and abducted making flexion easier. Now bring your knees together, move your feet far apart, toes pointing inward and then fold forward. Do you notice a difference? When the thighs are internally rotated and adducted, flexion is not very easy.

Alize Nation pigeon toed To help us understand what this felt like for my rocket scientist, we can simulate his situation. Stand up in Mountain Pose, feet together and parallel. Now, make your feet pigeon toed by moving your heels far apart, but keep your big toes together. Imitate singer Alize Nation, shown here modeling her pigeon toed stance (why do so many women on the red carpet stand like this? Don’t they ever go to yoga classes?). Notice how internally rotated she is, and you now are. While staying in this artificially produced internal rotation, lift your arms high over your head and fold forward. Try to touch your toes. Doesn’t that feel special? What do you mean that you don’t like it? Return by lifting your arms wide to the side and come up; see how it feels.

If you have an urge to change your feet position, you now know what I was subjecting my unfortunate student to. For him, the proper alignment cue for his feet was to have them pointing out, not parallel as I kept insisting. Once I imitated what I was doing to this guy at the hip sockets in my own practice, I quickly stopped picking on him. He needed alignment cues that focused on his core, not the extremities: function, not aesthetics.

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(Back to Newsletter #17)
Or you can visit the next article in this series:
Skeletal Variations of The Femur And the Concepts of Tension & Compression