Happy Knees in Yoga

bodhisattvas knees copyOur most basic pranic flows are laid down in the early days of our gestation. In the very first few weeks of life, our limb buds grew outward from our tiny bodies. The direction of their flow was clear and simple. There were no complications or great articulations at this point—just simple presence and potential—and this initial flow of life force is still present and underlies the healthy movement of all of our limbs. The underlying pranic flows in the body are always present within, and are supportive of healthy movement. Even when we have injured ourselves, torn and shredded structures, the healthy flow remains—as if dormant—underneath the injured tissues. In Embodyoga®, as in Body-Mind-Centering® we explore these initial movements of life force to understand, embody, and maintain health in all the body tissues. (We study embryological growth, and its importance in embodiment and yoga practice, in our training programs and workshops.)

Maintaining the continuity of the embryological spirals is organizing and supportive of the knee joints. The underlying spiral of the lower limb supports the knee and provides simplicity of flow through the limb that is balancing and healing to knee issues. All of the articulations that we go through in the knee, foreleg, ankle, and foot in our yoga postures are much later developments. By returning to the simplicity of the embryological spiral we allow the prana to flow as it naturally wants to, without laying on all sorts of ideas about what we think is right. Once prana is flowing, it will be much easier to address specific imbalances.

Front view of knee joint anatomy

Knee Anatomy
Understanding healthy rotations at the musculoskeletal level in the hip, foreleg, ankle, and foot are also critical for maintaining knee health. Improper rotations put excessive stress on the knee joint. The knee joints are unstable, true, but they are beautifully articulable when used wholesomely. When any of the joints above or below the knee are restricted (or hyper mobile) the knee will suffer. The knee needs an environment of good support without restriction. Because it is so mobile, if joints on either side are compromised the knee is very likely to take a major amount of stress.

In yoga practice we do many postures that require a lot of “knee rotation”. This requires integration and wholesome movement through the entire lower limb. What that means, is we need to figure out how to have rotational forces going through the knee without torqueing it and disturbing its delicate balance. It is never safe to allow forces to get caught in the knee joints. Forces must flow seamlessly through the knees at all times. Most people practice rotational movements without the benefit of understanding what needs to take place here and how to honor one’s own healthy range of motion.

Knee Rotations—Rotation is perhaps the trickiest of the knee’s articulations. Anatomists still often refer to the knee as a “hinge joint”. It is far from being a hinge. Rotations in the knee along with those of the foot and the foreleg provide the structural possibilities for so many different movements, making it possible to even walk comfortably on uneven surfaces. Our rotational abilities give a sense of freedom and ease in the knees. The menisci—one on each side of the tibial plateau— are responsible for assuring that these rotations move through the joints and feel good and free. They shouldn’t be painful, as is so often the case, especially in yoga practice.

 

KNEE ROTATIONS (Dr. Dibyendunarayan Bid, PT)
 The Sarvajaik College of Physiotherapy, Rampura, Surat

Both internal and external rotations of the knees rotate around the center of the medial condyle. The medial meniscus is required to distort and move with the rotations to maintain the integrity of force flow through the knee and to avoid harming the meniscus. Of course, when the rotation is more like a torquing of the knee, the menisci cannot healthfully accommodate the movement. It may become overly compressed or even torn by the action of the rotation.

Healthy rotational movement is limited, and is maximized at about ninety degrees of knee flexion. Importantly, this does not mean that one should freeze the knee joint at ninety degrees and then rotate. That kind of movement would be ill advised, as well. As we know, any action in a joint, needs to be moving longitudinally or vertically through the joint as well, otherwise it WILL irritate it.

front-acl-anterior-cruciate-posterior-ligament-medial-lateral-collateral-jfar-orf-lcl-lateral-meniscus-knee-meniscus-anatomy-normal-view

A good look at the medial and lateral menisci and the anterior and posterior cruciate ligaments of the knee.

Both sides of the knee joint—or joints—function independently and together. The menisci rotate and distort to accommodate forward and backward flexion and extension, lateral flexion and extension, rotational movement and all combinations of the above.

The cruciate ligaments keep the femur from sliding off the tibial plateau. Their crossed shape directs balancing forces through the knee joints and supports rotational movements.

The surrounding joints affect all knee movement. The movements of the feet, ankles and forelegs can easily be restricted and put pressure into the knees. Tightness in the region of the hips also dramatically affects our knees. Since the knees are so highly mobile, restrictions in the joints around them will often destabilize them causing many of the problems that we see in yoga practitioners. We also see hardening and tightness in the knees. This can be caused by direct trauma, sports injuries, or simply a long-time pattern of restricting and bracing in a conscious or unconscious attempt to stabilize them. In looking deeply at knee structures and their options for movement, it further clarifies how important the templates of embryological development are for maintaining healthy movement as adults. The initial continuity of prana flow must be under these structures or they will suffer. When that is present we can move on to looking at all of the various articulations, as well.

Many simply do not have the available range of motion to be able to the do big rotations through the hip, knee, foreleg, ankle, and foot without adverse effects. As yoga teachers, we need to learn to observe and honor how many people, for one reason or another, will never be able to healthfully practice large rotational movements like padmasana (lotus posture). They may never put their legs behind their heads. For some, even releasing their knees to the floor in a seated posture will not be useful. Attaining these positions has little to do with “opening hips”.  As teachers, we need to be diligent about letting our students know that “opening” hips does not mean that they need to attain any particular postural shape. Opening hips is about the freeing the flow of life force, and life force is not necessarily restricted by position. Hyper mobility is no better than restriction.

No matter what the degree of range of movement the practitioner may have, many things need to be looked at before moving into some of the deeper rotations that are involved in some postures. The movement must happen all the way through the feet and into and through the pelvic halves for postures like padmasana or virasana, to name just two. Padmasana and virasana are perfect examples of deep external and internal rotations in the lower limbs. Many postures make use of these same rotations, but in most cases, they are not so extreme.

Good stability (not rigidity) and healthy mobility (not hyper-mobility) of the many joints involved in the lower limb need to be discovered for approaching any deep rotation that affects the knee. Incorporation of embryological spirals and the developmental movements and spirals of the first year of life, are important. It is amazing how many of the yoga postures follow these spirals when we learn to move into them skillfully. As we learn to feel them, we can begin to allow them to direct the movement. The shapes of the postures are there in part to teach us the spirals and to feel life-force flow more continuously along these pathways. When we break things apart and fragment the body excessively we undermine our own ability to feel the pranic flow.

Life force always needs to flow seamlessly through the knees, no matter what shape the knee is taking in form. In padmasana, as in tadasana, forces must flow thorough the knee without any deviating lines of force laterally

knee-tendons-ligaments

Tendons and Ligaments of the Knee

or diagonally across it. In an extreme rotation such as padmasana, there definitely needs to be adequate movement in all of the surrounding joints. The foot bones, the ankle bones, the tibia and the fibula, need to be able to move freely so that excessive force isn’t put into the knee joints. Of course, if the rotation in the hip socket is limited, no amount of freedom in the lower leg will make for a safe padmasana. Padmasana is the classic posture for causing knee injuries in yoga because almost everyone allows the forces to shear right across the knee joint. Few people can execute padmasana well.  But that doesn’t mean that it can’t be done. Certainly, for most people it is much better to just leave padmasana out of their repertoire.

Watch Out for These Common Issues for Knees in Asana

  • Allowing the knee joint to be torqued in any posture. It will put pressure and often seriously pinch and eventually shred or tear completely one or more of the menisci. Torqueing is also harmful for the central ligaments in the knee.
  • Hyperextension of the knee that pushes forces into the back of the joint and also runs the risk of pinching the menisci in the front.
  • Generally pushing any flow of force across the knee joint, forward through the center, or shearing through the medial or lateral menisci.
  • Lack of good spiraling action through the bones of the foot, the talus, the tibia, and the fibula.
  • Any time the prana flow is moving against a critical structure in the knee it is endangering it. Forces in the knee need to flow from femur to tibia and tibia to femur without any shearing forces…No matter how extreme the posture may be.

The Solutions

  • Understanding the anatomy of the knee, foreleg, ankle and foot—assisting balanced stability and mobility through all of the joints.
  • Shifting one’s own paradigm of thinking from one that sees a hinge joint to one that perceives the tensegritous support of the knee, by and through the surrounding tissues and into the rest of the body.
  • A joint is space. Bones and soft tissues support the space and bones shouldn’t touch. If you can see it you can teach it.
  • Understanding how the rotation of the foreleg and the movement of the talus affects knee stability and range. And understanding the movement of the menisci in rotation, flexion, and extension. (Embodyoga®200-Hr. Teacher Training Manual).
  • Offering ways to attain better stability and mobility in the bones of the ankle and the foot.
  • Understanding healthy anatomical range of motion in the hip joints and honoring that— not allowing torquing in the knee to try to make up for less range in the hips.
  • Learn to see the continuity of prana flow, and how and where it is interrupted.
  • Embodying how prana flows through these joints unimpeded so that you can also see it in your students and help them more effectively.
  • Honoring anatomical structures of each individual and providing supports and alternatives to postures and positions that are unhealthy for some.

 

2 thoughts on “Happy Knees in Yoga

  1. Hi Patty~ Coincidentally, tonight I thought about my knees while walking my dogs and did not run a majority of the time like usual. I will look forward to absorbing this info. I appreciate this blog and was excited to see this new info today! I love the Embodyoga philosophy so much 🙂 Karen Miscall-Bannon is the greatest teacher ever and is missed now while she teaches in Thailand~ Namaste’ from Lori in Northern California near Placerville p.s. I love that photo of you on this blog. You have that radiant glow like Karen has! I hope to shine that bright one day also 🙂

    Liked by 1 person

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