The Hot Yoga Doctor – Free Bikram and Hot Yoga Resources › Hot Yoga Doctor Forum › Injuries, Restrictions, Ailments, Pose Modifications › Injuries › Knee pain below kneecap
The Hot Yoga Doctor – Free Bikram and Hot Yoga Resources › Hot Yoga Doctor Forum › Injuries, Restrictions, Ailments, Pose Modifications › Injuries › Knee pain below kneecap
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Hi,
I’ve been practicing power vinyasa for about 3 years and am just starting to get into Bikram… I’ve been going about 3x a week for a few months. In general, I am strong, but tight – especially around my hips and knees. A few days ago, during practice, I noticed that an area of attachment around the inside of my left knee felt tweeked – maybe just after standing half moon pose. I didn’t think too much of it and continued to practice – mindful of my knees, and without pain. But after class, I took a taxi, and when I got out, my knee hurt and felt like it could buckle. Two days later, it is still bothering me and I have more trouble kneeling and going down stairs. It is not super painful, but a bit tender and tight – and is bothering me on the right side too. Any ideas what I might be doing wrong and how not to do it again?Thank you!!!
LizHi Liz
Knees are curious creatures aren’t they?
Without more info or without seeing what you are actually doing, or asking what else may be a contributing factor it is difficult to know where to start…
You may have some issues with how you align your feet, ankles, knees and hips. It is possible there is some stress in those areas because of pronation. Or you may have damaged your knees at some stage in or out of class.
A good place to start would be to work out what exactly is bothering you – which structure. You say it is on the inside of your knee. You are also having difficulty kneeling. Can you tell me what position you can get to? Are you able to kneel in the regular fashion: Knees, heels and toes together? What about the first part of Supta vajrasana (Fixed Firm)? To what point are you able to move into that type of kneel?
If you place a small towel like a face washer just behind the knee when it is bent (say in Tree pose or when kneeling) does that cause further pain or does that bring relief? This will help us work out (possibly anyway) if it is perhaps a medial or cruciate ligament problem if at all.
How does your knee or how do your knees feel in other poses? Have you seen the video Great Posture From The Ground Up because it could start a self-diagnosing process – recognizing patterns in your posture and your poses generally.
It would be great to get your thoughts
Namaste
Gabrielle 🙂Hi Gabrielle,
Thank you so much for your response and for the video. Â I do tend to roll in toward the arches of my feet slightly and have trouble lifting up on my arches. Â This may be the root of the problem. Â Also, when I go to stand on my toes, my ankles want to roll out.
I tore my ACL & had surgery to repair it about 10 years ago. Â I am still not as straight in my left leg as my right. Â My hips have been out of alignment since my early teens (I am 31yrs now) – Left hip is higher than the right, both are tilted forward and I’ve been told my femurs are forward in the sockets. Â I’ve begun to have some arthritis / bone spurs in my right hip. Â I know this might sound like a lot – but I’m basically in good shape and am very active. Â I teach yoga and live in NYC – so lots of walking and stairs.
More to your questions – I have never (even as a child) been able to sit in supta vajarasana with my hips touching the floor.  I had – just recently since having ACL surgery – gotten to a point where I could  kneel with my hips touching my heels.  When I 1st started doing yoga, childs pose was uncomfortable because of tightness in my knees, but putting a towel inbetween calves & thighs helped – and it would help with this new tightness too.
The poses that bother me now are:
1) standing deep breathing – it feels as though I draw up too strongly on the knee cap.
2) standing half moon – I feels like I am using the muscles on the insides of my knees to keep my feet on the floor and this hurts.
3) eagle – no problem
4) standing separate leg head to knee – it doesn’t hurt my knee, but I suspect my alignment is off
5) standing bow – same as above
6) balancing stick – no pain
7) separate leg – sometimes feels funny on inner back part of knee – but not current problem.
8) triangle – bothers knee now
9) head to knee – no problem
10) tree – very difficult because of tightness in hips and knees, but not particularly painful with this recent problem
And for the rest… All the backbends and spine strengthening stuff is fine – all the kneeling stuff bothers the inside of my knees a little bit – it feels tight along the inside.Could this be tendonitis? And if so, what should I be doing differently?
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If you don’t have time to reply, I totally understand and will continue to think about my feet!
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Thank you so much!
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Best,
LizHi Liz
Thanks for the detail! It does lead me to me to ask you about what body work or physiotherapy you have undergone or more importantly, currently undergo, that may be addressing your hip issues.
If your hips are tilted and if as you say there could be a femur locating issue in your sockets then there would be flow on effects in your legs down to the ground (affecting knees of course). And although you haven’t mentioned it, there could be some issues in your spine (for example more of a pronounced lumbar curvature and maybe even limitations in deep forward bends). It basically means that there is an imbalance that could be playing out in your difficulty in getting postural alignment and therefore optimum function in your body!
Sometimes that kind of help would involve some manipulation and some specific exercises aimed to address the imbalance.
Would you be willing to tell me what you did or do now?
Namaste
Gabrielle 🙂Dear Gabrielle,
I haven’t been doing any physical therapy, but over the last two or three years I have seen a few doctors, a chiropractor and a rolfer… The doctors seem to think I will eventually need a hip replacement based on x-rays which were consistant with femoral acetabellular impingement syndrome (the socket is bumping into the head of the femur) – which I never want to do. The chiropractor felt too rough, and I don’t remember much of what he said. The rolfer was the one who said the femurs were forward in the sockets, and also that I am losing the curve in my thorasic spine. I think everyone has commented that my left hip is higher than the right and tipped forward. None have given me any special exercises, though I have asked. One doctor said not to do frog pose. I agree that manual manipulation to increase space in my hips would help, but I can’t afford to go more than about once a month.
Thank you so much for your concern! Any advice would be much appreciated!! And…
Happy New Year!Hi Liz
I am surprised that you haven’t been given exercises to practise with a monthly check up and possible manipulation. Isn’t anyone willing to do that?
How does it feel now with some increased focus on your feet and legs?
You mentioned that you thought your quads were too tight in Pranayama so I wondered what could be going on… My next thoughts were about what your PT says about your hamstrings, quadriceps, hip flexors and muscles of lower back? Is there an imbalance between the different groups? The imbalance could definitely have been occurring for many years (as a result of some postural habits when you were young) and could have caused the tilt in your hips/pelvis. The positioning of your femurs could be, for example, due to over strong quads. It’s just a theory. If it is of muscular cause and this is a viable enquiry then some targeted exercises, at gym or at home could start to address this.
Namaste
Gabrielle 🙂 -
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