The Girl From Ipanema’s Follow-up

The Girl From Ipanema’s Follow-up 

An Introduction

Girl from Ipanema: Dr. Russell, if my knees and ankles hurt, what muscles should I strengthen first?

Me: Girl – if I may call you that

GfI: Sure, if I can call you Pookie.

Me: –  what a surprising question! (Well, maybe not so surprising since I wrote the question and you are fictional… but I digress.) And I think my answer will be as surprising as the question.

In my reasonably humble opinion, the muscles that help the knees and ankles the most are neither knee or ankle muscles.

GfI: OMG, Pookie, color me intrigued! Discuss.

Me: Glad to.

The gluteal muscles, aka your butt, are comprised of the gluteus maximus, gluteus medius, and gluteus minimus.

GfI: uh-huh…?

You may recall that your songwriting admirers experienced your glutes primarily in aesthetic terms.

GFI: Well, yeah.

Me: But I examined your gait as you walked to the sea, and while my analysis substantiates their findings, my other findings are more troubling. I see that your hips swing excessively from side to side, and that is a sign of weak side glutes.

GFI: !

Me: the glutes are active in almost all movement, so their weakness is putting you in danger of injury and pain.

The three leg joints – hip, knee and ankle – work together in just about every real-life leg movement. Of these, the hip is the biggest joint, with the biggest and most powerful muscles. In fact, your glut max is the largest muscle in your body.

GfI: Are you calling me fat?

Me: The fibers of the various glutes can move the hip in almost every direction. Beyond that, they stabilize and balance all movements of the hips, and that in turn stabilizes the joints below.

The more active the glutes are, the less work and strain for the joints below.

GfI: Now that you mention it, each eve as I walk back from the sea, my inner knees and arches hurt.

Me: The outside glutes help prevent knock knees and fallen arches. They draw the lower end of your thigh away from the center, putting more of your weight on the outside of the leg. That makes your long, tan, young, lovely legs straighter, de-stressing the inside of the leg and ankle for ease and efficiency.

Your weak outer glutes have made you a tragic beauty. As happens, you please onlookers, but that power comes with a price tag.

GfI: Yeah, Antonio [Carlos Jobim] was frightfully annoyed that I wouldn’t look at him every damned time he whistled, but if I turned my head it was hard to keep my balance so I had to, as he put it, “look straight ahead, not at he”. And I notice it’s hard to swim as fast as I used to. I’m not sure if I told you this, but I’m also developing bunions, inner knee pain, hip joint clicking, meniscus problems, patello-femoral tracking syndrome, ACL strain, plantar fasciitis and low back pain.

However, as has been noted, I look great on the beach.

Me: That’s a long list of problems!

GfI: Well, y’know, Pookie, you wrote it, not me. I don’t even know what half of that stuff is.

Is there any hope for me, Pookie?

Me: Yes.

Six weeks later:

Girl: Doctor –

Me: Please, call me Pookie.

GfI: I performed the exercises in the video below religiously for 6 weeks, and all my symptoms are better! I’m balanced, integrated, comfortable and strong, and I can kick an awful lot of sand effortlessly into the faces of my more obnoxious admirers.

Me: Score!