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Knee injuries and yoga

Yoga and knees

Yoga is great for increasing strength and flexibility in knees after an injury, as well as for guarding against future injuries or problems. More and more doctors are recommending yoga to their patients who are rehabilitating after a ligament injury.

Benefits of Yoga and knee injuries

The key with yoga is that it helps to strengthen both the inner and outer quadriceps, which help to keep the kneecap in alignment. Injuries and knee problems are often due to mechanical issues with the kneecap, which then impacts the ligaments and the joints. Much of standard physical therapy focuses on strengthening the muscles surrounding the knee to help support the knee; but most excercises fail to equally develop the inner and outer, upper and lower muscles. Yoga does this. The great thing about yoga is that it strengthens the quadriceps, the hamstrings, the calves and the ankles- all fairly consistently. Strength in these areas all help to support a weak knee.

Another benefit that yoga serves for the knees is the increase in blood flow and nourishment that it sends to the surrounding joints and ligaments. As with most poses in yoga, the action of squeezing a body part, and then releasing it, sends lots of nutrient rich blood to the area that was affected in the posture. Many postures do this for the knees in yoga.

Ways to protect your knee while practicing

However, it is important to practice yoga with caution. Postures that are done incorrectly can actually injure the knee or exacerbate existing injuries. As always in yoga, it is most important to listen carefully to your body. If there is a tugging in the knee or on the sides of the knee in any posture, it is best to back off. No need to wait for acute pain, especially with knees.

Sometimes it helps to practice slower, gentler forms of yoga as you are healing from injuries. It might make sense to stay away from Power Yoga or fast-paced Ashtanga classes until your knee is healed.

Focus on the placement of your feet. It is key to make sure that good alignment starts with your feet. If they are not in the right position, the knees tend to be the first thing to over-compensate. Make sure to push down through all four corner of the feet in most postures, push down through the ball of the foot, and feel as if you can lift the toes off the mat.
Make sure your knees are aligned over your ankles. In lunges and knee bends, it is important to make sure that your knee is aligned over your ankle, not moving out over it. The knee should also be tracking toward to middle toe. Or in some postures, such as Parsvokanasana, the knee should be moving slightly in the direction of the pinky toe. At the same time, make sure to pull up on the arches of the feet, especially in the Prasarita series (Standing extended-leg forward fold.)
Be careful of hyperextending your knees. It is easy to hyperextend the knees in yoga. When parts of the body and hip joints are tight, it is often easier to get deeper into postures through locking the knees. Some types of yoga, such a Bikram yoga, stress 'locking the knees' in certain postures. Knees should never ever be locked in any postures in yoga. It is important to distinguish between the difference in pulling up on your knee caps (this is ok) and between locking the knees (not ok.) If you hyperextend, keep the knees slightly bent in most standing and forward folding poses.
Open the hips early in class. If the hips are not open, the knees will end up taking a lot of the stress of the postures. This can be especially true in Virabadrasana I (Warrior 1) and many of the standing poses.

Yoga poses to practice with caution

Virasana (Hero's pose). This pose, where you sit down between your heels with your knees bent, can pull at the ligaments of the knee. If you have knee problems, practice this with caution and be especially careful of Supta Virasana, Hero's pose with the back on the ground behind you. However, note that this pose can also be tremendously healing for knee injuries, if practiced correctly and cautiously.
Trikonasana (Triangle). It is easy to lock your knees or hyper-extend them in this pose.
Paschimottanasana(Seated forward-fold.) Many rely on the their knees, rather than their hamstrings to take them deeper into a forward fold. It is best to bend the knees slightly to avoid hyperextension.
Child's pose. Even though Child's Pose is a restorative pose, it can hurt some people's knees. If this is the case for you, try putting a blanket between your buttocks and your calves, this should take some strain off the knees.