The Hot Yoga Doctor – Free Bikram and Hot Yoga Resources › Hot Yoga Doctor Forum › The Hot Yoga Poses › Utkatasana › arthritic knees – form questions
The Hot Yoga Doctor – Free Bikram and Hot Yoga Resources › Hot Yoga Doctor Forum › The Hot Yoga Poses › Utkatasana › arthritic knees – form questions
-
AuthorPosts
-
I explained some of my knee problems in a thread about fixed firm pose, but now have a few questions about awkward pose. (To recap, I’ve had a number of knee surgeries, both ACLs reconstructed 5-10 years ago, meniscus damage and now arthritis – moreso in my left knee.)
Fixed firm pose and half tortise are going really well – and I don’t even need the towel prop in half tortise pose anymore, so that’s great news!
For awkward pose, I’ve just been squatting down far enough to keep form and not cause knee pain and particularly for the 3rd one, I’m not dropping my hips down much at all as a result. My instructor suggested that (as someone who has had knee issues in the past himself) that I would get more out of the pose if I cold get all the way down, even if it meant breaking form to get there and to get back out of the pose at the end for the time being. Basically, I have good muscle tone in my legs, but there several positions where the arthritis pain cancels out the strength.
I’ve been trying this at home with a mirror and chairs/walls to hang on to to see what happens. And basically, I can get down into the final pose, but not without placing my hands on the ground momentarily to get through the point where my knees hurt trying to drop down in the posture (basically the middle third of the movement is where I’m most affected by arthritis.) I think I can see how just trying to maintain that final posture is helpful, regardless of how I got there, but I was curious if you had any thoughts on this.
Thanks again!
hmmm, well I am definitely a doctor or an expert, but I would avoid anything that causes that much pain unless you have a doctor familiar with your individual injury tell you it is ok to do. I did follow one instructor’s advice about pushing through some neck pain while I was on the mend from an injury, and after that class it took another 1.5 months just to get back to where I was before that class! So I am pretty skeptical about “pushing through pain” now!
Hmmm… I must not have conveyed this very clearly because I’m not pushing through any joint pain (nor was he recommending that I do so). Just avoiding pain by momentarily breaking form to get through the part where I normally stop because it would hurt to push it at that point. I guess that is hard to explain. But what he was recommending was not to push harder, but to avoid the pain and get into the final pose an alternate way (which doesn’t hurt at all – it’s getting there properly that hurts). Maintaining the final pose where you are nearly sitting on your heels does seem to be doing my knees good. I just can’t get into or out of it without my hands touching the ground for a moment. (Though it seems to be improving…)
Though FWIW – the years I’ve spent in physical therapy for my knees could be easily defined as “pushing through pain” with a combination of serious painkillers and then forcing things until you are in tears. Not really my favorite solution.
This is an email message I sent to Bikram and Rajashree about the 3rd awkward pose:
I am 46 years old and has been very athletic all my life.
for the past 25 years I have undergone three left knee surgeries (ACLS tear with reconstruction from tennis, meniscus tear and femoral condyle fracture from racquetbal. the most recent about one year ago for bucket handle meniscus tear which I think its from the awkward pose #3). I also have an extensive medical background.I want to ask you to clarify this posture with your bikram teachers.
First of all, I am somewhat frustrated by the “push until it hurts” repeated by the teacher. students can easily hurts themselves without understanding their limits. One can get meniscus tear from improper axial loading, facet arthropathy from overtwisting of the spine etc.
Don’t get me wrong. Thanks to Bikram yoga. I am discovering the various aspect of yoga. I am still doing Bikram about 2-3 x a week and have started to explore ashtanga yoga.
The reason for this email is to have you consider evaluating the awkward pose #3.
I have done a lot of research on this after my last surgery. Both my orthopedist surgeon and my physical therapist told me NOT to do this valgus move. The loading on the valgus (bow leg) knee can easily damage the meniscus. Even when I started Bikram, I can do this posture easily without any problem. Thinking to myself that I am building the quadricep muscle which it’s true. about a couple years into it, i slowly notice my knee was aching. however I continue to do this posture (have been told that there is a lot of scientific background behind each move). Eventually I was having sharp pain like a catching feeling with this pose. Had an MRi done and showed a bucket handle tear to my meniscus. my surgery is over a year ago now….
Almost every class I have to remind the teacher that I do NOT do this valgus move. Instead I modify it by putting my feet back together instead of 6″ apart….
As you know the least strain on the knee on any flexion movement is the knee over the foot. This valgus awkward move puts a lots of strain on the knee.
So please consider evaluating the physiologic appropriateness of the awkward pose #3.
It scares me when I see new students trying to do this (just like students in the standing head to knee pose: instead of contracting the quadricep on the standing leg, they are hyperextending the leg like a bow. That is also very bad on the knee joint)….
So that is basically what my instructor was telling me to do – bring my knees together at the top and bottom of the movement (where it feels just fine) but while I’m moving up and down, go back to knees over ankles/feet. Thereby avoiding the part of the movement that would be potentially causing pain.
And I don’t know if they are all adding something, but every one if the instructors I’ve had have all emphasized that the “push until it hurts” dialogue is specifically excluded from anything involving your knees. Any pain in your knees = back out of the posture immediately.
Hi Lily
So I am interested to know the response from Bikram. What happened?
Connie, it’s great you have sorted out the pose for you so that you get the benefits and without experiencing any pain.
Namaste
Gabrielle 🙂 -
AuthorPosts
- You must be logged in to reply to this topic.