As a former wrestler, I suffered many knee injuries and underwent three knee surgeries. After I retired from the sport, my knees felt so worn out that I could no longer run, bike or lift weights without feeling knee pain. But six months after starting yoga, my knee pain subsided. Over time, yoga seemed to reverse my injuries and I became confident enough to return to regular exercise without experiencing discomfort in my knees.
Knee Pain Treatment
Dr. Ferdinand Chan, orthopedic surgeon at Montefiore Health System in the Bronx, New York, estimates about 40% of his patients suffer from knee pain of different severities. Pain ranges from chronic knee pain, which can be helped by yoga and physical therapy, to injuries from an accident or sudden trauma to the knee that may require a medical intervention.
[Read: At-Home Exercises for Knee Pain.]
“Yoga is good because it’s low-impact,” Chan says. “It involves stretching and strengthening, it’s very low-risk to do. It’s easy to get into and you can always make modifications.” He says that most people could avoid even having to see a doctor with proper strengthening and stretching.
According to Chan, about 98% of his patients do not need surgery, and their knee pain is caused by tightness and imbalance. Both physical therapy and yoga are beneficial to preventing and alleviating knee pain if done with proper technique. For his patients experiencing knee pain, he recommends that they try yoga for two to four weeks before seeking out professional help.
How to Protect Your Knees During Yoga
Due to my knee injuries, I have to be particularly cautious with how I approach my yoga practice. I follow the simple guideline that if it hurts, I don’t do it. While everyone is unique, here are some things that help me protect my knees while practicing yoga:
— Healthy knee alignment.
— Knee biomechanics.
— Weight-bearing on your knees.
[READ: 7 Best Yoga Poses for Strength Training.]
Healthy knee alignment
When starting yoga, physical therapy or any other exercises, it’s particularly important to consider the position of your knees and make sure they’re aligned properly.
Set your foundation while standing at the top of your mat. Make sure your feet and toes are pointed straight forward and your feet are inner-hips-width apart, about one fist width apart.
Point your knees the same direction as your feet. For asymmetrical standing poses like high lunge or some warrior poses, make sure that when you bend your knee, your front thigh is parallel with the floor. Be careful that your knee does not bend beyond your ankle.
In seated postures where your legs are straight, aim your feet and knees straight up, and straighten your legs completely without your heels lifting off the floor to avoid hyperextension. If your hamstrings are tight and your knees bend while seated, place your hands behind you on the floor and root your legs down. While moving into your poses, go slowly and intentionally with your breath to avoid misalignment.
Knee biomechanics
In general, flex your foot to protect your knee. For poses like pigeon, where your bent knee creates an angle for your shin, point your foot and flick your toes to take any bend out of your ankle.
Any time your feet are flat on the floor, shift your weight to balance it evenly between the front and back of your feet. This will ensure that your hips, knees and heels are stacked on top of each other. It will also allow you to straighten your legs completely and stretch and strengthen the belly of your leg muscles rather than locking your knees.
Weight-bearing on your knees
If you have trouble putting weight on your knees, there are adjustments you can make to reduce pain:
— Any time you lower your knees to the floor, make sure you move slowly.
— Pad your knees with a towel, blanket or fold up the side of your mat.
— In any pose where your knee lands on the floor, shift weight forward on your knee so you’re putting more weight on your thigh, rather than the knee cap.
Pigeon pose is one of the most common poses that needs to be modified if you are recovering from knee surgery or if you have knee pain. Instead of practicing it upright, lie on your back for a non-weight bearing pigeon. You practice this variation supine with your knees bent, ankles underneath your knees and your feet hips-width apart. Rest your right ankle across your left thigh, flex your right foot and allow your knee to gently move away from you.
[READ: Yoga After Knee Surgery: Does It Help?]
Best Yoga Poses for Your Knees
In general, good alignment in all of your poses will be beneficial for your knees. However, there are certain poses that stretch the areas around your knees that will help avoid imbalances and tightness that can lead to knee pain and risk injury. These types of yoga poses can help you avoid knee pain and injury:
— Hip-opener poses.
— Hamstring stretches.
— Balancing poses.
Hip-opener poses
Lizard lunge, pigeon and twists will help you avoid tightness down the outer-seam of your leg at your hip and IT band. If this area gets extremely tight, it will create more torque at your knee joints in all movements.
Lizard lunge:
1. From down dog, step your right foot forward to the outside of your right hand and lower your back knee gently to the floor. Aim your right foot and knee at a diagonal to the right.
2. As long as your front knee stays aligned over your foot and your weight is centered on your back knee, start to bend your elbows and eventually lower your forearms to the floor.
3. Without moving your back knee, pull it forward on the floor to feel your left thigh plug into its hip-socket. Without moving your front foot, draw it back towards the wall behind you to isometrically set your right hip back for the most effective hip-opener.
4. Hold for ten breaths and repeat on the second side
Pigeon:
1. Start in down dog and set your right knee behind your right wrist at the right edge of your mat.
2. Allow your right shin to angle across your mat at an angle to the left and at a steep enough angle your hips stay square.
3. Lower your back knee to the floor gently. As your hips open, slide your back leg and hips further back, and make your right shin more parallel to the front edge of your mat, as long as your hips do not sway to the side.
4. Hold for ten breaths and switch to the left side.
Twists:
In all twists, especially asymmetrical twists such as a twisted triangle pose, focus on getting a stretch in the outer-hip and outer-seam of the leg or it-band.
1. In a twisted triangle pose, set up by standing at the top of your mat and stepping your left foot back about three feet — just short enough in your stance that your left heel roots down. Point your left foot towards the upper left corner of your mat.
2. With both legs straight and your hips square to the front edge of your mat, bow over your right leg and set your hands on either side of your right foot on the floor. If you can’t touch the floor with straight legs, use blocks.
3. For twisted triangle pose, place your left hand to the outside of your right foot to the floor or on a block.
Hamstring stretches
Hamstring stretches and straightening your legs completely will also be beneficial for mobility in the muscles around your knees and will help to maintain a healthy range of motion in your legs.
Pyramid:
1. From the top of your mat, shift weight into your right foot and step your left foot back about three feet. Straighten both legs and align your left foot to the front left corner of your mat.
2. Pause, set your left inner-seam of your left leg back and square your hips to the front of your mat.
3. Lengthen your back as you fold over your front leg and place your hands on either side of your right foot to the floor or up onto blocks. Churn your low-belly right and center your chest to aim over your right thigh as you bow over your right leg.
4. Hold for 10 breaths and repeat on the left side.
Half-split
:
1. Start in low lunge with your right foot forward, and continue to move your right foot forward so when you straighten your right leg for half split, you’re long enough in your stance that your left knee is slightly behind your hip.
2. Flex your right foot so that your toes aim straight up towards the ceiling and your right knee is in line with your foot. Place your hands on either side of your right shin on the floor. If you can’t touch the floor without bending your right knee, place blocks under your hands.
3. Keep your hips square and twist your upper-body over your front leg until the center of your chest aims over the center of your right thigh.
4. Without moving your front heel, draw it back. Lengthen your low-back and create an even rate of round quality in your upper and mid-back as you bow.
5. Hold for ten breaths and switch sides.
Standing forward fold:
1. Stand with your feet inner hips-width, one fist-width apart and straight.
2. Bend your knees enough to bow forward and touch the floor in front of you. Keep your weight evenly distributed in the front of your heels as much as the tops of your feet. If your feet turn out, your knees knock out or your low back rounds, widen your stance to keep your feet and knees pointing straight forward and a release out of your pelvis in your low-back.
3. Once you’ve touched the floor, over the course of several breaths, start to straighten your legs as much as you maintain good form.
4. Relax your neck, and hold for 10-15 breaths while stretching your hamstrings.
Balancing poses
poses like tree pose demand you recruit the muscles on all sides of your knee to become more stable and develop strength to support your knees.
Tree pose:
1. Stand with your feet inner hips-width apart and straight forward. Shift weight onto your right foot and place your left sole of foot above or below your right knee.
2. Swing your left knee as far left as it will go, without your hips turning left.
3. Press your left foot against your right leg and your leg against your foot to straighten your right leg.
4. Bring your hands together in front of your chest. For a challenge, reach your arms up overhead.
Standing figure four:
1. Start standing with your feet hips-width apart. Shift weight into your right foot and rest your left ankle across your right thigh.
2. Bend your right knee a lot to create a shelf for your left ankle to rest on. Place your right hand on the left sole of your foot.
3. Press your foot and hand together and flex your left foot. Set your left hand on your inner left knee.
4. Lift your inner knee up towards your palm to engage the muscles around your knee and to set your left inner thigh down.
5. Sit deeply, hold for five breaths and repeat on the left side.
Standing quad stretch:
1. While standing with your feet hips-width apart and straight forward, shift weight into your right foot, bend your left knee and swing your left hand behind you to hold the outer-edge of your left foot for a quad stretch.
2. First, aim your left knee straight down towards the floor with your right hand on your hip. As you balance, swing your left knee forward an inch towards the wall your facing. This plugs the root of your left thigh deeply in its hip-socket and stretches the belly of your quad muscle.
3. Pull your left heel towards your hip and flick your left toes against your hand. Keep your right leg straight and stand tall.
4. Hold for five breaths and move onto the second side.
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Best Yoga Poses for Knee Pain originally appeared on usnews.com
