Knee Pain When Running - Check Your Yoga

If your knee pain from running isn't getting better with fixing bad gait, physical therapy, and medical care, check your yoga. Several poses directly twist, overstretch, or pinch knee cartilage. Over time, injury builds that does not show much in people who do yoga and little else, until their knees encounter resisted motion for running and sports, or from a trip or fall.

Not long ago, people in yoga or sports did not intersect much. Now, the previously more sedentary yoga populations try running, aerobics, and sports. Athletes are being told that yoga will give them magic benefits. Knee injuries bloom when they go back to sports, making the staunch yoga camps claim sports are the culprit, when it was the knee damaging motions in yoga and other stretches.

The knee is a primarily a hinge joint, like the hinge on a door that only can open and close. The door swings toward you and away. If you lift up on the door, it twists the hinge and eventually loosens it. The door begins to creak and rub and make noise.

Think of sitting cross-legged (tailor style). Your knees are out to the side and your lower legs bend toward you. All is fine at that point. Now picture, as with lifting upward on a door, you lift the foot and lower leg to rest it on your thigh in Lotus position or lifting it in some pigeon poses as in the photo, at right. Unless you outwardly rotate the upper leg fully at the hip, the knee twists, overstretching the lateral (outside) ligament and pinching the medial meniscus and soft tissue.

Often people bend the ankle upwards too, also pictured at right, a separate problem - see Unhealthy Yoga Ankles.

How to picture rotation at the hip? Think of a stapler. Like the door just mentioned, the stapler has a hinge or knee joining two sections, like your upper and lower leg. It opens and closes on the hinge. If you pull the upper or lower part sideways, it twists or shears the hinge. To turn to staple sideways, you need to rotate the whole thing.

Hero pose, (Supta Virasana) begins sitting on bent knees, meditation style (left-hand photo below), which often is fine. The knee hinge closes, like closing a door, normal bending. Then the pose continues by pulling the feet outside of the upper legs, like pulling upward on the door hinge. If you do not inwardly rotate both upper legs at the hip fully, your knee twists at the hinge, overstretching the medial (inside- facing the other knee) ligament, pinching the lateral (outer) meniscus and soft tissue. Lying back, as in the right-hand photo adds prying of the joint to the rotation damage (often people overarch the lower spine too instead of stretch the muscles, an additonal problem). In "W" sitting, both feet face outward. Not a problem for the knee unless the hips do not fully rotate (whether relentless W sitting is eventually is too much at the hip is a separate question). Runner's hurdler stretch is the same issue, one leg at a time.

Even though yoga may call for "doing both sides" and following each motion in one direction with one in the other, twisting both the medial and lateral sides of the knee cartilage by doing both Lotus and Hero will not cancel each other, but can overstretch and degenerate both sides.


Warrior poses 1 and 2 are like a lunge. Check your front knee:
- Is it inside the line of your foot?
- Do your foot and knee face the same direction?

Sagging inward unequally loads the knee and when the foot and knee face differently, the knee twists under body weight (blue center model, photo at right).

Keep your knee above your foot, both facing directly forward.



Mighty Chair pose - watch for, and change overly-stylized artificial position, not valuable for any functional motion (photo right and lower drawing left).

For chair pose, use outer thigh muscles to hold straight and prevent knees from sinking inward. Use neutral spine instead of overly-arched to practice movement the way it is needed all day for real life. Right-hand drawing below shows fixing.

Make yoga something that benefits your real life movement habits, not trains artificial, damaging, motion you don't even need.

Check that you don't crane the neck while raising arms, impinging rotator cuff and shearing neck vertebrae and greatly overarch (hyperlordose) the lower spine, see Prevent Back Surgery.

For a functional exercise, instead of straining in chair pose a few moments a week, use healthy half squats (right figure on drawing at left) for daily bending and get hundreds of healthy bends - Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending.


Hindu squats and one-legged heel-up deep bends may not twist the knee as much as pry it. Picture a tool to crack nuts - two handles joined at a hinge, like your upper and lower leg joined at the knee. Imagine putting an object (for example, a soccer ball) between the upper and lower leg and try to close the heel toward the upper leg - if the ball does not compress, the hinge (knee) pries open. That happens with low squats on the toes (heels up) if you have large or heavy legs. If you have slender legs, the heels can come closely, like bending your elbow so that your lower arm rests along your upper arm. Slender legs do this, while muscular athletes may destabilize their knees, leaving them venerable to future injury.

The beginning of one of the pigeon poses is pictured at right. The person pictured is sitting to the side, instead of keeping the back knee and leg rotated to face straight downward. Sitting to the side greatly reduces the stretch, especially to the rear hip's front muscles that need the stretch, but usually no big problem to the knee. When the pose continues to lift the back foot for King Pigeon, if you lift the foot up without facing the knee downward, you twist the knee joint. By turning the whole leg downward, you get a better anterior hip stretch, and when you lift the foot, the knee can bend like a hinge, not twist.

One Legged King Pigeon kneels on the rear knee with that knee bent so only the kneecap bears your weight. To reduce compression, and get a better stretch for your hip, move your back leg further back so that your weight rests on the thigh, not kneecap.

I have taken several yoga teacher certifications. Each gives different, plausible-sounding rationale why knee twist poses help, but the anatomy is just off enough to come to wrong conclusions. In one, they taught to deliberately twist the lower leg on the upper "to protect the meniscus." Twisting does not protect, but twist in a damaging way. There are two bones in the lower leg, allowing some rotation, but twisting injures other structures. Another teacher training stressed extreme knee twisting as a stretch in itself, stating that any increase in motion is beneficial, especially from joints. Knee laxity results. Without much muscle and positioning training, you predispose yourself to instability when giving the knee challenge, like going back to sports, or from a fall or blow. Another certification teacher training taught that knee twisting is beneficial since it allows great range of motion in case you fall down with your knee twisted backward. Sounds plausible for that one fall (unless you fall differently), but for every other day in your life, so much extra space can result that the joint 'rattles' and wears prematurely. In another class we were made to sit in Lotus, then, still folded in Lotus, rise to knees and swivel from knee to knee to waddle around the room, compounding damage with body weight on the twisted strained joints.

In each yoga teacher training and class I take, I hear teachers tell about their knee pain and surgeries. They don't know why. They think they need more yoga and do more injurious poses, getting relief or distraction for the moment, then pain comes back. Movement in general often relieves pain for the moment. No need to repeatedly add injury to get temporary relief. Stop the causes and the pain stops.

There are assertions that many people do these stretches and not everyone gets knee pain, so they must be fine. Smoking and unsafe sex also do not have a one-to-one association with immediately bad consequences every time. Some stretches and movements twist the knee and overstretch cartilage. If you do these stretches and have pain, or just sit or stand with your knees hyper-extended (locked back) even if you think it is unrelated, it is one place to think about.

There is more. For another time.

Related Fun Fitness Fixer:

• Kneecap Tracking - Don't Miss These Reasons It Doesn't Get Better
• Hamstring to Quadriceps Ratios Not the Answer in Knee Injury
• Surgery for Knee Arthritis, Meniscus, Unnecessary
• Free Exercise and Free Back and Knee Pain Prevention - Healthy Bending
• Fixing Leg Numbness, Back Pain, Flank Pain, Knee Pain, Nerve Pain, Three Unhealthy Surgeries, Part II
• Prevent Knee Pain When Rowing
• Strengthen Legs Without Knee Pain - Standing Lunge
• Daughter's Love Saves Parent's Knees
• See all Fitness Fixer articles about yoga by clicking the label yoga, below
  

Random Fun Fitness Fixer:

• Trainers Don't Exercise Enough?

Labels: fix pain, injury, knee, running, stretch, walking, yoga

Permalink | Email Post