Hello Yoga doctor, I am in your office this morning because I want to ask you about the knee pain that I am encountering while in only a few poses. Can you direct me so that I can continue hot yoga without pain. On a pain level from 1-10 it is about a 3. The poses that I am experiencing pain are breath of fire, bent knee lying flat on floor spine twisting pose, and Janushirasana bent knee can not go to groin. I do not experience pain during the day or night so what do you think is going on and what should I do? I use ibuprofen and ice for foot pain at night.
Michael Hulme

Hello Michael
Thanks for coming to me with your problem! It seems that there is some issue with poses that have some kind of twisting component.

I do seek a little more information. You mention final breathing gives you an issue but not fixed firm pose (suptavajrasana). Would you please confirm for me whether you have the pain with fixed firm? The other pose that is often poses a problem for knees is tree pose. Please also let me know.

For starters in final spine twisting pose and Janushirasana you can quite easily avoid the painful position in 2 ways. In the twist, instead of placing your knee down on the floor, simply extend your leg out in front of you at 12 o’clock. For Janushirasana (head to knee) the position of your leg will depend on the severity of the problem. You can either extend your leg out somewhere in front of you (generally from 10-12 o’clock) or you can bend it in to a point where it remains painless.

The knees, although a simple hinge joint, are extremely physiologically complex with a nexus of ligaments and muscles. It is important not to mess around with them and force the issue. If my suspicions are correct then you will benefit from a simple restorative position. But I would like to hear the answer to my question above please.

Cheers!
Gabrielle