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The Hot Yoga Doctor – Free Bikram and Hot Yoga Resources › Hot Yoga Doctor Forum › Injuries, Restrictions, Ailments, Pose Modifications › Injuries › Torn medial minisicis: Practicing Bikram while balancing knee pain, good idea?
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Greetings,
Fantastic forum…..having just started Bikram 8 days ago, I just found this forum as well. I have read several threads relative to miniscis injuries however they don’t quite hit on my specific concern.General Info: 44 yr old, 6’3, 225lbs. Incredibly inflexible(as I NOW know :). Runner (20-30miles wk)…weight training.
2 months ago I was diagnosed (MRI) with a torn medial miniscis (right knee). Initially I was highly symptomatic, and after discussing everything with the Ortho he suggested I wait and see if I will be symptomatic in general and have my lifestyle inhibited…or if I might be mostly pain free.
My initial symptoms subsided within 1.5 weeks and I returned to running and normal exercise. Concurrently about 2 weeks later I discovered Bikram and my knee started acting up. Please note: My knee began acting up several days before starting Bikram.I am currently seeing my Chiro daily for ultrasound/laser/electrostim on the area to try and calm it down.
I AM continuing to practice Bikram. (although not running).
Honestly I feel I will most likely end up getting the knee scoped….however in the interim I really,….really….REALLY want to keep practicing Bikram.
When doing Bikram, nothing really aggravates the knee while practicing. My knee in general is a roller coaster throughout the day…aching/hurting…feeling fine…hurting when I walk…not hurting when I walk..etc. Kind of all over the place.
My question is: As long as the Bikram postures are not specifically causing me discomfort while in class is there any reason I should not practice while having this “flare up” of miniscis pain?
Thanks so much for any insight you might have!
Hi Jeff
So, you want to know if you can keep practising. Well, even though you say that nothing else is bothering you in class, can you please confirm for me if there is any little tiny issue at all with the following?
When you
>> lock the knee in a standing balancing pose
>> are in Fixed Firm (Supta Vajrasana). Actually this one really should NOT bother you if your problem is the medial meniscus, but I am checking anyway
>> bend your leg up to your hip in Tree poseIf there is any pain, niggle, issue or anything that comes to mind, then please let me know what the nature of the pain is, and what pose it occurs in etc.
The other thing I would like to know is, if and when you are feeling pain in your leg with the torn meniscus, what exactly do you do to relieve it? Here are ideas that are possibilities. Feel free to tell me exactly what you do with as much detail as you can. [Ideas: Do you extend your leg straight and massage it? Do you just straighten the leg? Do you keep it bent? Or keep it bent and massage it?]
Over to you! I will flesh out the response when you ‘get back’.
Namaste
Gabrielle 🙂Thanks for the reply Gabrielle,
Note: As I am generally very inflexible, slightly overweight..etc…I do experience little tweaks and such in various joints (including knee)….for this specifics of this discussion I will leave out mention of those.
Locking knee in balancing pose causes no sensations to my knee.
Fixed firm causes no sensation to my knees.
Bending my leg up in tree pose causes no sensation in my kneeThe pain in my knee is random and aggravated by driving and walking long distances..(not in yoga 😉
My current treatment for this “flare up” is going to my therapist daily for ultrasound/laser & elctro-stim treatments…..then I ice at night as well.
This usually calms everything down within 5-8 days….as it is doing this time as well 🙂
Acute relief usually comes from either stopping walking momentarily…or when driving simply shifting the weight/knee/angle ever so slightly….then within 5-10 minutes the discomfort sets back in….repeat shifting..etc.I am trying to avoid the surgery…and If I have 2-3 “flare ups” a year I will endure that….however if the flare ups occur more frequently I will consider surgery.
So being very new to Bikram….it was paramount for me to assess whether I could practice during a flare up of my knee. (whereas running or such is obviously out).
Thanks!
JeffHi Jeff
Thanks! From a yoga point of view and as those particular poses would indicate, you should not be at risk for your medial meniscus. There could be other issues (which I was trying to elicit with the question about what you do to relieve the problem). With that I was asking if you do something yourself (quite apart from going to your therapist) to gain relief when you are driving or walking.
Recently I was at a yoga studio (owned by chiropractors). The head chiropractor wrongly recommended straightening the leg of their student when that student’s meniscus was giving him problems. This is the worst possible thing you could do. By asking you those questions about relief in my response 2 days ago, I was trying to work out what you do when you feel that problem, when you are driving or walking. So, I will just offer this to you. When you feel that problem, it is best to bend the leg to open up the joint and then massage lightly in that area. Your meniscus will have more space to regain its proper position. Opening up the leg closes the joint and you are at risk of squeezing any tags or torn parts of your meniscus and even ripping it. This is why that self-proclaimed yoga-chiropractor guru was wrong and creating problems for his student.
This is also why when you are walking or driving and your leg is outstretched you may like to stop for a moment and bend it!
The other active thing that I can offer you is to sometimes sit in a kneeling position where toes, heels and hips are touching. If you ever watch television then this restorative knee position may help stabilise your joint and create space where you need it.
Keep me posted
Namaste
Gabrielle 🙂Hey Jeff,
Great topic and questions!
I am a physiotherapist with 15 years experience and have been practising Bikram yoga for 5 years!
Meniscal injuries are very common, and often will settle with appropriate hands on treatment, corrective exercise and avoidance of aggravating activities!
The first thing to understand is that the musculoskeletal body functions as a whole! So for example, a problem with your foot, or your lumbo-pelvic-hip region can cause and perpetuate problems in your knee!
A very common finding is that if you lack adequate flexibility in your hip joint, especially external and internal rotation, then often your knee joint will rotate to “make up” or compensate for the lack of movement in your hip! Now knee joints are hinge joints, meaning they straighten and bend, and are not designed to rotate! This over a period of time can lead to break down of the meniscus!
Another common scenario are muscle imbalances – this means some muscles start working more (and usually get tight) as they are compensating for weakness elsewhere . As the saying goes, “the rich get richer, the poor get poorer”, similarly overworking muscles continue overworking and weak muscles get weaker! These muscle imbalances often alter the subtle mechanics of a joint!
I would recommend seeking the assistance of a knowledgeable physiotherapist in your area, to perform a thorough bio-mechanical assessment of your whole lower limbs.
A carefully prescribed corrective exercise program, in conjunction with joint mobilisation and soft tissue release techniques , can rapidly reduce your pain, and most importantly educate you regarding long term management of your knees so you can enjoy the benefits of hot yoga, your running and improving your flexibility!
Great luck!
Mat
Hi Mat
Thank you for your bio-mechanical response! It was very useful, simply and beautifully put. I hope you will be around for some more physio contributions.
Namaste
Gabrielle 🙂 -
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