Knee Pain and Yoga

“Listen to your body.” Yoga students hear this phrase time and time again. I tell my student to back off if they feel discomfort. It’s apparent to do this when one has a sore, achy low back, hips or shoulders. However, sometimes the body part speaking the loudest is not the spine and hips, it’s the knees. These knobby appendages are prone to discomfort. Many yoga practitioners find that certain yoga poses are not friendly to the knees. Why is this? The answer to this question is not simple. The knee seems like a simple joint….it bends, it extends, and has a slight amount of rotation……what could possibly go wrong?

In fact, the knee gets more than its share of misfortune. Positioned in the middle of the leg it absorbs weight from the hips and upper body, bears the brunt of postural misalignment, suffer when the feet become unstable or quickly change direction. Plus knees are prone to many sports injuries.

So, what’s a yogi to do? First of all, if knee pain is a persistent problem visit your doctor or physical therapist for an evaluation. Barring any injury to the knee joint, I can offer you the following recommendations:

First, watch your alignment in standing and kneeling postures. Take a look down at your front foot. You should be able to see your big toe, and part or all of the second toe. This will prevent the knee going too far past the ankle or in toward the mid-line of the the body.

Next, Strengthen ALL the hip muscles. This includes the quadriceps (front of thigh), hamstrings (back of thigh), inner thigh (adductor group) and outer thigh (abductor) muscles. There are several yoga poses that can help you achieve this. I suggest to try holding these poses. Start by holding for 5 breaths, then progress to hold for 10-15 breaths. If there’s any soreness release and re-align. A few poses to try are:

Utkatasana (Chair Pose)
Strengthens the quadriceps, hamstrings, adductors & abductors.
Take care to place weight more in the heels than the front of the foot, and also avoid allowing the knees to flare out the the sides. Sometimes tight lats (a muscle on your back that connects to your upper arm) can make it difficult to raise the arms while coming into this squatting position. Try this pose first by keeping the arms in a cactus, or goal post position, then progress to extended arms.

Virabhadrasana I (Warrior I)

More hamstring and quadricep strengthening in this pose.
You can get a nice stretch on the front hip crease if you slightly tuck your tailbone under. Don’t forget to keep an eye out to make sure your knee doesn’t go past the ankle. For additional stability consider widening your stance.

Trikonasana (Triangle Pose)

Be careful not to hyperextend your front knee. Instead try to engage the hamstrings by having a soft bend in the knee. With the weight of your body forward over your knee, you can easily over-stress the knee joint leading to pain and injury.

Vrksasana (Tree Pose)

Standing balance poses such as this one help strengthen those outer hip muscles, which are so important for the health of our knees. In addition, Vrksasana strengthens the external rotators, and the glut max (the tushie muscle). Try to press the raised foot into the standing thigh while pressing the thigh into the foot. This will help with balance, and strengthens the inner thigh.

Last, but absolutely not least, strengthen your core abdominal muscles. If these muscles are strong, they allow us to move our limbs with strength and stability, thus avoiding possible pain and injury. For more info on how to do this, see my previous post Awakening the Sleeping Giant.

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