know your knees

The knees bring a sense of levity to our practice. When they are functioning well, and without pain, they enable us to become buoyant, easily transferring movement and action from the hips to the feet. In our yoga poses, this buoyancy is translated into the feeling of grounded lightness. If you have felt any type of knee pain while practicing yoga and have recovered from it, you know what I mean. Whether the pain is along the inside of the knee or the outside, under the kneecap, or in back of the knee, knee pain while practicing can feel like being tethered – the rest of your body feels great, but the pain in the knee prevents full enjoyment of the practice. But then it resolves, you overcome it – perhaps the muscles of the hips release, maybe you become more stable, or perhaps the fascia of your foot releases and your walking gait changes. Overall, something has shifted and your knee pain resolves. The tether is no longer holding you back, and your practice opens up, imbued with lightness. You are wiser, having experienced the pain and resolved it. You can feel the difference in your standing poses, whether you have two feet on the ground or just one, or whether your legs are wide apart or close together. You can feel the freedom as you move into your sitting poses – padmasana (Lotus Pose), janu sirsasana (Head to Knee Pose), baddha konasana (Bound Angle Pose) – as well as into the alluring pose of eka pada rajakapotasana (One-Legged King Pigeon Pose). So to honor those who have overcome knee pain, to encourage those with knee pain – this article is for you. We will explore the knee, bring understanding to it and its relationship to a particularly knee-intensive yoga asana: padmasana (Lotus Pose). Anatomy Of The Knee I often point out in classes that the knee is really not a distinct body part at all but rather a coming together of bones – the femur at the top, the tibia on the bottom, and the patella moving along a midline between the two. The reason I make this point is to bring to light the most important concept of the knee in yoga: Two of the three bones that create this joint are responsible for creating two separate joints: the femur creates the hip joint, and the tibia creates the ankle joint. The point here is that whatever is happening at the hip joint and ankle joint is going to influence the functioning of the knee joint as well. Let’s look at a real example – padmasana. I often hear the question “How do I strengthen my knees to get into this pose?” The answer can be tricky for the newcomer to anatomy. Padmasana has little to do with the knee. It has everything to do with how we move at the hips. When the hips are tight, the femurs won’t perform external rotation, abduction, and then adduction. If the hips will not move into even one of these positions, the knees will tend to compensate, and pain, strain, or “heat sensations” will occur. Let’s Look Deeper The knee joint is considered to be a classic “hinge joint.” That is, much like a door swinging on a hinge (not a rotational door hinge, just an open-and-close hinge), the knee moves primarily in two directions. It can move into flexion, which bends the leg at the knee, bringing the heel of your foot to your buttocks; or it can move into extension, which straightens the leg at the knee, taking the heel of your foot away from the buttocks. Your knee also allows some extra movement called rotation. There is not much rotation, but enough that if you land from a jump and then turn your body without turning your feet, your knee will provide you with a little bit of ‘give’ in order to prevent injury. This can also happen in padmasana. If the hip joint doesn’t move fully or safely into external rotation, abduction, then adduction, the yogi will tend to rotate the leg at the knee in order to move into the pose. The yogi will also tend to torque a little extra on the foot and ankle to place the foot into the groin. That torque will apply extra strain to the muscles and fascia that attach between the knee and ankle, placing further strain on the knee joint. Bear in mind that once or twice won’t necessarily bother the knee, but over time, since the knee can only take so much, you will slowly begin to feel strain. I write slowly because the damage being created in the knee is “stealth-like”; oftentimes the cumulative damage occurs just outside of our awareness, and then one day – boom! – the knee is now feeling painful and strained, or a new sensation is now present along the inside, outside, at the back of the knee or around the kneecap. So then, how do you need to move in order to prevent pain at the knee? 1. Nourish Relaxation Relaxation is crucial. I emphasize relaxation because with this state of mind comes incredible strength and release. When yogis become aware of their mind chatter and realize that it is simply thoughts of the future and of the past, and that those thoughts have nothing to do with what is present, then both their bodies and minds move into just that – that which is present, a state free of restlessness. In this state, awareness grows, free of judgment. As awareness grows, release, strength, and healing flows. How does this relate to the knees? It could be a human tendency to force, or it could just be a certain mind frame that forces, but by increasing our tendency to force we reduce our power to perceive. The knees are famous for providing quiet cues that say “ouch,” that signal ‘bad pain.’ When we don’t hear or act on those cues, they get louder – but the loudness comes in the form of real injury such as strains and tears. The only way to hear those quiet sensations is for you to quiet down yourself. And the quieter you become, the more you will hear. 2. Move from the Hip Socket, and Don’t Pull at your Ankle All styles of yoga use the word alignment. We know what it is, and generally how to cultivate it. Sometimes, though, whether as a teacher or a student, we need to hear other words describing how to create alignment in order for us to move from ‘knowing it’ to ‘getting it.’ Let’s explore.  To do this, you will need a strap with a buckle. • Preparation: To get your mind thinking about the knee and hip, try this experiment: while sitting, try to bend your knee without moving your hip. That’s it, keep trying. Hard to do, isn’t it? It is actually impossible in this position, because of the femur’s connection to both the knee and hip. • Let’s get into the exercise. Bend your right knee toward the chest, so that the right heel is close to your butt (as is comfortable). Your right thigh will be close to your body. Take your strap and tie it around the upper and lower leg, so that the knee stays bent. Keep lots of tail on the strap, and hang the tail down the outside of the leg toward the foot. Pull it around the bottom of the foot, toward the inside. • Pull the strap, at its tail end, and feel the movement (or lack of movement) in your hip. Your knee will be stable, your ankle will be stable enabling you to feel the movement that is specific to your hip. That is your true movement. That is what you get to work with. What you have available may surprise you. If there is little movement, it is your cue to spend more time focusing on your hips so that you don’t overdue the work at your knees. 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