Knee pain is a common problem in America. Whether or not your pain is from an actual injury or pain caused by misalignment, the issue is the same. You're limited in the activities that you do because of the pain. As you age, you'll tend to do less and less activities because you would rather avoid the pain than suffer through an activity you used to enjoy. Even certain types of yoga can be aggravating and should be avoided. But yoga in general is great for helping those sore knees and in figuring out what may be causing the pain.
Practicing safely in your yoga class will help prevent an injury and help build better alignment so the body can heal. Below are a few tips.
- Avoid hyper-extending: If your knees hyper-extend, that means your ligaments are stretched out, which means poor support for the structure of your knees. To see if you have hyper-extended knees, sit on the ground with your legs stretched out like you're going to do a forward fold. Press your knees into the floor. If your ankles and feet lift up off the floor, you hyper-extend. To protect your knees in your practice you'll want to always have a micro bend in your knees and never lock them. Hyper-extending will feel natural to you, so you'll constantly have to check to make sure you aren't doing it, in and out of your yoga class.
- Check your feet: Your feet are your pedestals. If your base isn't balanced, the rest of your body won't be. Check to see that you have even weight on the feet and that you aren't collapsing in your arches.
- Keep your knees in line: This is so important. When you're knee isn't lined up right, like letting the knee lean inward in warrior two, you're putting a lot of strain on the joint. Also when in poses like Fire Log Pose where you're putting pressure on the ankle and the knee, you'll need to flex the foot to protect the alignment of the knee. This works by activating the muscles in the legs and stabilizes the joint. When you bend the ankle inward it will actually separate the knee joint putting strain on the ligaments.
- Tune into subtle signals: Listen to your body, specifically your joints. How does your knee feel in a pose? If it hurts or you feel a stretch in the knee, you need to come out of the pose. No stretch should ever be felt in the knee joint. Just the belly of the calf and the quads. When you have a knee injury, it's not a good time to test your limits. Moderate your practice and avoid a vigorous flow class where you don't always have time to focus on alignment.
- Build strength by balancing: Often one knee hurts because that leg is the weakest. Build strength in that leg by doing balance poses. Focus on proper alignment of the feet and hips. Use a wall or chair for support if needed. If you aren't aligned correctly in the balance pose, you'll only make the problem worse.
- Be prop friendly: As mentioned above. Love your props. Props help you to get your body in the position it needs to be so that the pose can give you the most benefits. Let go of the ego and do what is best for your body. Give it the support it needs.
- Warm up: In order for all your muscles to work together, they all need to be warm. If you just start working a specific part of the body, but the rest isn't warmed up, you're going to create an imbalance and cause more trouble. Before doing any kind of PT on the body, warm it all up. Not all teachers are good about warming up students before they put them into harder poses. If this is the case, warm up before you go to class.
- Alignment first, then strength and stretch: If you try to strengthen weak quads or hamstrings because you were told they're the culprit to your knee pain, make sure you focus on alignment first. If the knee isn't in correct alignment and you begin to work on strengthening it or stretching it, you'll only cause more damage.
- Avoid prolonged kneeling, squatting or sitting: Basically any position that puts a lot of pressure on the joint.
So how do you know if misalignment is causing your knee pain. Check these things either in a mirror or have a friend take a look:
- Do you have any restricted movement in the feet, ankles or hips?
- Instability in your posture. Do you lean to the side, forward or back?
- How is your walk? Is it uneven?
- Do you have low back pain (usually from either tight hamstrings or quads).
- Do you have a range of motion difference from one leg/hip to the other.
Most knee misalignment's begin in the hips, usually because they are tight and weak. Below are some poses that you can do to help open up the hips and strengthen the muscles that help keep the knees in alignment.
Fire logs or four square (picture to the right)
Supine leg stretch, abduction (drop the leg out to the side away from the body) and adduction (drop the leg across the body to the other side). To work on strength, don't use a strap and lift and drop the leg by engaging your muscles. Make sure not to strain.
Windshield wiper legs: lay on your back with knees bent feet a little bit wider than hip distance apart. Swish the knees to the left as far as they will gently go and then swish to the right. Keep the hips on the ground, if they're tight they'll try to lift up. Continue this motion slowly. Repeat 5-10 times.
Remember to focus on alignment and keeping your feet flexed when necessary, like in the above picture of four square. Notice where you're feeling the stretch and modify if needed. Write down any imbalances that you notice in your practice such as your right legs seems stronger than your left or your left leg seems tighter than your right. Perhaps your hips aren't level when you're standing evenly on both feet. These are all clues to why your knee is hurting. Writing them down allows you to see the pieces of the puzzle and will help you to figure out the cause of your pain. The answers are all in the subtle details.
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