Hello Yogis! Today we will take a look at three different mechanisms that can cause potential harm to the knee joint, and some poses that you’ll want to be mindful of your knees in. Plus, I’ll share some good tips and biomechanics to protect your knee joints!
There is a saying in the physical rehab, movement-as-medicine world that states, “Unless there is direct trauma/stress involved, knee pain is always an accessory to hip or ankle joint dysfunction.” If you have knee pain, it’s probably your hip or ankle that is messing it up. Hips and ankles are highly mobile joints compared to your knee that just bends and rotates a tiny bit. When your hip or ankle’s range of motion, ROM, is limited, the knee ends up absorbing more force when you move.
This form of compensation is how a lot of mechanical knee pain occurs. It’s always a good idea to throw a little ankle and hip ROM work into your warm up before you do yoga. Mobility work opens the range of motion and lights up the nervous system to ensure the joint is stable and protected. It will also help take away any unnecessary forces on your knee, since the other joints will be working as they should!
Now it is worth it to mention that in yoga we do some poses that cause extra stress to the knee. A lot of this is through how we load, or put force/stress, into the knee joint. A very common example is end-range loading.
End-range loading is a term used to describe putting force on a joint that is at the end of physiologic range of motion. The joint cannot go further and unnecessary force, especially repetitive, at this range can cause potential harm to the joint.
Where we commonly see end-range loading in yoga is one legged balancing postures, such as Dancer’s Pose, where the knee is extended and locked out. When the knee is extended at its end range, more force is absorbed into the joint and articular surfaces of the bones. The joint surfaces and capsule are absorbing most of the force, rather than the muscles that should be helping to absorb force and stabilize the joint.
In yoga there are also poses where we apply direct pressure to the knee joint. The direct pressure poses are the obvious ones, like Camel Pose or Tabletop, where the knee is in direct contact with the ground. It’s a good practice to cushion your knees whenever it’s possible, even if it’s comfortable to do it without.
It should be noted that the mechanisms of the compensation, extra stress from end-range loading, and direct pressure injuries described above may have no effect initially. These types of injuries occur over time, as the knee is repetitively extended and balanced on. Without proper muscular engagement and stabilization, this can lead to degeneration and arthritic changes of the knee joint.
Now for some tips for strong healthy knees:
- Warm up your hips and ankles with mobility work before you do yoga.
- Cushion your knees when they are on the ground.
- Always, always, always have a bend to your knee when you are balancing.
Strengthen, Mobilize, and Balance your Lower Extremities!
Here’s an exercise called a Star Lunge. It’s great for training dynamic single leg balance, and mobility of the hip-knee-ankle complex of the lower body.
Start: Plant one foot on the ground, keep it there for the first set.
- With your other leg lunge forward, then step back.
- Keep lunging in a Star pattern! (Diagonally in front, directly to the side, diagonally behind you, directly behind you, etc)
- Complete the star by lunging to the side of the stationary foot as shown in the diagram above.
- Once you’re done with that leg, switch sides!
Notes & Movement Refinements:
- Keep the lunges small at first. As you get better, you can begin to lunge further out which will challenge your lower extremities in different vectors.
- Focus on how you land your foot. Try to be light and land without sound.
- If pain/discomfort occurs at any point, modify! This is a great pain-free-range-of-motion exercise. Take a step back and work within a range that is comfortable rather than painful.
- Go slow and focus on the sensation of the movement! This kind of movement is not about speed, it’s about control. Speed Hides Need is an old adage in strength training which means that going fast makes it easy to compensate!
- You can modify by placing a towel/blanket/floor slider under the moving leg to make this more of a sliding exercise.
Protect your knee joints Yogis! After all, you only get two and knee replacements are not a fun process.
In love & light,
Dr. Yogi Gare
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Illustrations by Ksenia Sapunkova.