The knee is a complicated joint and one of the most unstable in the body. It is also one that we often overlook in our yoga practice as we focus on our hips and feet and seem to notice our knees mostly when they hurt. They deserve more than this! Check out the anatomical discussion and asana exploration below to give your knees some more love in life...
One of the reasons the knees are so unstable is that there is no good fit where the bones can lend support like the ball and socket of the hip joint. It is primarily the muscles and ligaments that provide support. So, it is especially important that you have supple and strong muscles around your knee. The menisci are also important in knee function, providing padding to the inner and outer knee and helping the joint to track with the hip. If one of your menisci is damaged, you will need to compensate appropriately with props and muscular strengthening. The kneecap also helps keep the knee tracking with the hip and as it is encapsulated by your quadriceps, focussing on proper quadricep function can be helpful. Misalignment, especially in standing poses can cause inner or outer quads to become stronger than the other, resulting in your kneecap not tracking properly.
When muscles are too tight it can be difficult for them to function properly as nerve signals become impeded and circulation can be easily compromised. Thus we encourage a little stretch and flexibility in yoga poses to open the lines of communication where appropriate. However, if you are hyperflexible, having more than functional range of motion, encouraging more flexibility will have a detrimental effect, so decide appropriately. The knee does flexion and extension and a TINY bit of rotation (this can be explored in the knee release below). The ability to do this rotation is important to healthy knees but having or extorting too much rotation causes problems. Except for a few extreme poses, we always try to track the knee with the hip in yoga, especially when in is under load.
Knee pain can even be caused by excessive internal or external rotation of the hips, this is often an imbalance in the flexibility and strength of the hips, not the knees. The poses below will help you understand this concept.
I cannot help you diagnose what knee problems you might have, only your doctor or physical therapist can do that. But I hope that this down and dirty discussion encourages you to pick up an anatomy book (or look online) and explore your own knees through yoga. The more you know... the better you can feel!
When you practice, NEVER allow for pain in the knees. This is not a situation you can “push though.” And if your knees are already injured, it may require a great deal of patience in helping them to heal. What is most key in helping your knees live a better life is threefold – open your hips in all directions, make space in the knee joint, learn to use your muscles in stabilizing your knees.
Here's a practice to help you explore proper knee alignment and engagement...
Modified Hero Pose – Stand on your knees, with whatever padding you need beneath your ankles for comfort. Ensure that your toes point straight back. Take a rolled blanket and place in across the backs of your knees – the thicker the roll, the more intense this will be. Sit your hips back toward your heels, keeping your back straight. If your hips don't comfortably come to your heels, place a block beneath your bottom. Sit here for at least 2 minutes. This pose helps to gently stretch the quads, intrisic muscles of the knee and tibialis anterior in the lower leg without creating compression in the knee.
Knee release – seated with knee bent, hold one thigh to ensure it will not move. Move your toes to face in and then out, trying to bring as much of the movement from your knee as you can. This helps to release the muscles at the back of the knee and encourage full range of motion. Remember, your knee is not meant to move much except forward and back, so don't push it!
Anjaneyasana/ knee down lunge – keeping hips square and isometrically flexing front foot, inhale hips forward and back, in and out of the lunge, being mindful of the alignment of the front knee. Don't let it wing out or roll in. Then hold in a lunge, hands to floor, keeping knee pointing in same direction as the toes. Remember, taking your knee forward past your ankle creates strain on the knee is loadbearing postures.
Warrior 1 two ways and foot flexion – You may need the help of a partner to find your alignment for this one... Stand in a high lunge with all ten toes pointing straight ahead, back heel off the floor. Point both knees in the same direction. Square your hips. Once you are confident in your alignment in this version of Warrior 1, turn your back toes out a bit and bring your heel to the floor. As you do this, keep your hips as square forward as you can, keep the alignment of BOTH knees pointing in the same direction as your toes. This second version of Warrior 1 can cause torque on your back knee if your alignment is correct, so be extra careful to maintain that.
Triangle – Move into your triangle with more awareness not just of your knees always pointing in the same direction as your toes but with more awareness of NOT hyperextending the knees. Hyperextension means that the knee is locked into its most extreme straight position. This causes a stretching of the ligaments and ligaments have very little ability to “unstretch”. Work your hamstrings (back of the legs) and quads (front of the legs) against one another to keep a stabilizing slight bend in the knees.
Revolved Triangle – This is a great pose for exploring how your hips exert pressure on the knees. Keep the knees always pointing in the same direction as the toes, even as you twist your hips. Keep space in the knees here by pressing the feet into the floor and pulling your thighbones into your hip sockets, this will also help stabilize the low back. Remember not to hyperextend!
Standing Squat – This pose is great for learning to equalize support around your knees. Be sure you can see your toes when you look down so as not to overstress your knees – this means you need to stick your butt out! Having done the previous poses, you know a little more about your assymetries and strengths/weaknesses. See if you can bring your knees into alignment and provide equal muscular support all the way around with this pose.
Bow Pose – This is a great posture for really understanding how your knee alignment affects your low back and vice verse. Take bow pose keeping your knees hip width apart. You will need to be sure to support your low back with your abs. If this challenges either your low back or your knees, you've got some hip opening to work on ;-)
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