Question:

Hi Scott I love Coulter’s book, too.  It’s hard enough to be mentally challenging, yet when too difficult he in a friendly way says "turn the page!" but, do try to come back again to the difficult parts when it’s important to learn the information in them.  Of course I’ve read what he’s said about knee problems in the book. However, my experience is different than what he describes when he writes about the bow pose.  He says it puts a tremendous amount of pressure on the knee joint and should be done cautiously when you have knee trouble. However, I did this pose for two years in Bikram classes without much trouble.  The bend of the knee at 90 degrees was just fine for my knees. Strong ligaments perhaps, allowed this.  It was at the beginning of the pose when reaching back for the feet when the knees are bent practically double (similar angle to Child’s Pose and Hero Pose, shins touching thighs) that I had more difficulty.  But because my weight was on my belly and front, not sitting on my thighs and shins, this discomfort was minor and it went away once I flexed into the bow.  If my knee was inflamed, however, I didn’t do the pose. Coulter says that for minor knee problems, what can be done is a series of standing posed where the kneecaps are lifted, thighs tight, while arms do various shoulder openers, stretches, etc and the torso bends back and side to side.  This strengthens the quadriceps which support the knee joint.  I do these, but not daily for 15 minutes as he recommends. I believe my thighs and hamstrings are strong, and my troubles are mostly with chondramalacia (a form of osteoarthritis)  in the back of the patellae. Pressure on the kneecap as it rubs against the femur or tibia REALLY can get them inflamed. As for those forms of therapy you mentioned, though I have an open mind, I’m not sure if that’s practical now.  I don’t know how they can help the damaged bone cartilage.  I’m reading "Strong Women and Men Beat Arthritis" by the researchers at Tufts University, hoping to get some insight into how to live with this problem millions of people share. Amy See Coulter’s Webpage here:  Body and Breath

– Hide quoted text — Show quoted text – Amy, Have you considered trying bodywork (such as Rolfing, Hellerwork or Thai Massage)? It might help. I have ‘bad knees’ too, and much of the secret in relieving pain is in increasing your own knowledge of the mechanics of yoga practice. You might find that your alignment in certain poses is causing your pain in others. I can _thoroughly_ recommend David Coulter’s book, "The Anatomy of Hatha Yoga". A sound investment! I was forcing my lotus poses at one point under the misapprehension that it would help me progress. All it did was increase the twist in my knees, not the stretch in my hips, and cause me knee pain in Janu Shirshasana. I thought that JS was the problem pose, but once I stopped forcing the lotus poses I found the pain disappeared in JS. What type of pain are you feeling BTW? Could it just be your former injuries ‘opening up’ or is it a definite injury-type pain? Only you can tell the difference, but remember that as yoga opens up the connective tissues over time it can be uncomfortable. If in doubt, however, ease off. It’s better to be safe and stiff than injured and sorry. Cheers, Scott Hi Stu Thanks for replying to my post.  You helped me feel better.  It’s great to do standing poses. They are a mainstay of our classes.  They don’t stress the knee joints at all.  They strengthen the muscles which support the joints.  Standing poses are wonderful!  It’s interesting you say that the washcloths behind the knee stress the patella.  I noticed it didn’t help prevent my pain but everything I’ve read said it was supposed to alleviate knee pain.  I didn’t know why my case was an exception.  During the past few weeks of yoga I’ve tried the poses presented by my teacher such as Virasana, Siddhasana, and Child’s Pose.  By the time we did Supta Baddha Konasana near the end of class one day I couldn’t enjoy it.  (I normally CAN sit in Sukasana and do Baddha Konasana, but not if my knee is inflamed.) My knee hurt from this 30-45 degree bend with no weight on it.   My leg needed to be straight again.  Three weeks in a row of experimenting, trying, seeing how far I’ve come, but it was just too much.  My teacher won’t mind me opting out of the more than 90 degree poses with weight on them for a while.  I can tell her in a nice way. Amy

Response:

Amy, Have you considered trying bodywork (such as Rolfing, Hellerwork or Thai Massage)? It might help. I have ‘bad knees’ too, and much of the secret in relieving pain is in increasing your own knowledge of the mechanics of yoga practice. You might find that your alignment in certain poses is causing your pain in others. I can _thoroughly_ recommend David Coulter’s book, "The Anatomy of Hatha Yoga". A sound investment! I was forcing my lotus poses at one point under the misapprehension that it would help me progress. All it did was increase the twist in my knees, not the stretch in my hips, and cause me knee pain in Janu Shirshasana. I thought that JS was the problem pose, but once I stopped forcing the lotus poses I found the pain disappeared in JS. What type of pain are you feeling BTW? Could it just be your former injuries ‘opening up’ or is it a definite injury-type pain? Only you can tell the difference, but remember that as yoga opens up the connective tissues over time it can be uncomfortable. If in doubt, however, ease off. It’s better to be safe and stiff than injured and sorry. Cheers, Scott

– Hide quoted text — Show quoted text – Hi Stu Thanks for replying to my post.  You helped me feel better.  It’s great to do standing poses. They are a mainstay of our classes.  They don’t stress the knee joints at all.  They strengthen the muscles which support the joints.  Standing poses are wonderful!  It’s interesting you say that the washcloths behind the knee stress the patella.  I noticed it didn’t help prevent my pain but everything I’ve read said it was supposed to alleviate knee pain.  I didn’t know why my case was an exception.  During the past few weeks of yoga I’ve tried the poses presented by my teacher such as Virasana, Siddhasana, and Child’s Pose.  By the time we did Supta Baddha Konasana near the end of class one day I couldn’t enjoy it.  (I normally CAN sit in Sukasana and do Baddha Konasana, but not if my knee is inflamed.) My knee hurt from this 30-45 degree bend with no weight on it.   My leg needed to be straight again.  Three weeks in a row of experimenting, trying, seeing how far I’ve come, but it was just too much.  My teacher won’t mind me opting out of the more than 90 degree poses with weight on them for a while.  I can tell her in a nice way. Amy

Response:

That link didn’t post right.  It’s here: http://www.bodyandbreath.com

– Hide quoted text — Show quoted text – Hi Scott I love Coulter’s book, too.  It’s hard enough to be mentally challenging, yet when too difficult he in a friendly way says "turn the page!" but, do try to come back again to the difficult parts when it’s important to learn the information in them.  Of course I’ve read what he’s said about knee problems in the book. However, my experience is different than what he describes when he writes about the bow pose.  He says it puts a tremendous amount of pressure on the knee joint and should be done cautiously when you have knee trouble. However, I did this pose for two years in Bikram classes without much trouble.  The bend of the knee at 90 degrees was just fine for my knees. Strong ligaments perhaps, allowed this.  It was at the beginning of the pose when reaching back for the feet when the knees are bent practically double (similar angle to Child’s Pose and Hero Pose, shins touching thighs) that I had more difficulty.  But because my weight was on my belly and front, not sitting on my thighs and shins, this discomfort was minor and it went away once I flexed into the bow.  If my knee was inflamed, however, I didn’t do the pose. Coulter says that for minor knee problems, what can be done is a series of standing posed where the kneecaps are lifted, thighs tight, while arms do various shoulder openers, stretches, etc and the torso bends back and side to side.  This strengthens the quadriceps which support the knee joint.  I do these, but not daily for 15 minutes as he recommends. I believe my thighs and hamstrings are strong, and my troubles are mostly with chondramalacia (a form of osteoarthritis)  in the back of the patellae. Pressure on the kneecap as it rubs against the femur or tibia REALLY can get them inflamed. As for those forms of therapy you mentioned, though I have an open mind, I’m not sure if that’s practical now.  I don’t know how they can help the damaged bone cartilage.  I’m reading "Strong Women and Men Beat Arthritis" by the researchers at Tufts University, hoping to get some insight into how to live with this problem millions of people share. Amy See Coulter’s Webpage here:  Body and Breath Amy, Have you considered trying bodywork (such as Rolfing, Hellerwork or Thai Massage)? It might help. I have ‘bad knees’ too, and much of the secret in relieving pain is in increasing your own knowledge of the mechanics of yoga practice. You might find that your alignment in certain poses is causing your pain in others. I can _thoroughly_ recommend David Coulter’s book, "The Anatomy of Hatha Yoga". A sound investment! I was forcing my lotus poses at one point under the misapprehension that it would help me progress. All it did was increase the twist in my knees, not the stretch in my hips, and cause me knee pain in Janu Shirshasana. I thought that JS was the problem pose, but once I stopped forcing the lotus poses I found the pain disappeared in JS. What type of pain are you feeling BTW? Could it just be your former injuries ‘opening up’ or is it a definite injury-type pain? Only you can tell the difference, but remember that as yoga opens up the connective tissues over time it can be uncomfortable. If in doubt, however, ease off. It’s better to be safe and stiff than injured and sorry. Cheers, Scott Hi Stu Thanks for replying to my post.  You helped me feel better.  It’s great to do standing poses. They are a mainstay of our classes.  They don’t stress the knee joints at all.  They strengthen the muscles which support the joints.  Standing poses are wonderful!  It’s interesting you say that the washcloths behind the knee stress the patella.  I noticed it didn’t help prevent my pain but everything I’ve read said it was supposed to alleviate knee pain.  I didn’t know why my case was an exception.  During the past few weeks of yoga I’ve tried the poses presented by my teacher such as Virasana, Siddhasana, and Child’s Pose.  By the time we did Supta Baddha Konasana near the end of class one day I couldn’t enjoy it.  (I normally CAN sit in Sukasana and do Baddha Konasana, but not if my knee is inflamed.) My knee hurt from this 30-45 degree bend with no weight on it.   My leg needed to be straight again.  Three weeks in a row of experimenting, trying, seeing how far I’ve come, but it was just too much.  My teacher won’t mind me opting out of the more than 90 degree poses with weight on them for a while. I can tell her in a nice way. Amy

Response:

Hi Stu Thanks for replying to my post.  You helped me feel better.

My pleasure.  It’s great to do standing poses. They are a mainstay of our classes.  They don’t stress the knee joints at all.  They strengthen the muscles which support the joints.  Standing poses are wonderful!

Standing poses rock. It’s interesting you say that the washcloths behind the knee stress the patella.  I noticed it didn’t help prevent my pain but everything I’ve read said it was supposed to alleviate knee pain.

The washcloth works as a fulcrum.  As you bend the knee it gives a little extra space to stretch the tendon directly beneath the petella.  Ordinarily bending the knee stretches the quads as well, the washcloth gives a slight priority to the knee muscles. For most knee injuries this extra stretch helps open the knee muscles more efficiently.  However for you I would think it may put too much stress on the muscle attachments (ligaments and fascia).  My guess is that the attachments are the problem.  They take a while to heal.  And as you get older they become less elastic.  I didn’t know why my case was an exception.  During the past few weeks of yoga I’ve tried the poses presented by my teacher such as Virasana, Siddhasana, and Child’s Pose.  By the time we did Supta Baddha Konasana near the end of class one day I couldn’t enjoy it.  (I normally CAN sit in Sukasana and do Baddha Konasana, but not if my knee is inflamed.) My knee hurt from this 30-45 degree bend with no weight on it.   My leg needed to be straight again.

Sukasana would be a strain.  How about a modified half lotus.  The foot rests on the opposite knee.  Keep the knees at 90 degrees.  Use plenty of blankets to get support and keep the hips level. Supta Baddha Konasana should not be a problem if you allow the heals to be a little further away from body than normal, and add a few blankets under the knees to support them.  Three weeks in a row of experimenting, trying, seeing how far I’ve come, but it was just too much.  My teacher won’t mind me opting out of the more than 90 degree poses with weight on them for a while.  I can tell her in a nice way. Amy

Sounds like your doing well.  And working smart.  Many people just power through and end up doing more damage.  After this is all over your body will be better for the learning experience. — ~Stu

Response:

Hi Stu Thanks for replying to my post.  You helped me feel better.  It’s great to do standing poses. They are a mainstay of our classes.  They don’t stress the knee joints at all.  They strengthen the muscles which support the joints.  Standing poses are wonderful!  It’s interesting you say that the washcloths behind the knee stress the patella.  I noticed it didn’t help prevent my pain but everything I’ve read said it was supposed to alleviate knee pain.  I didn’t know why my case was an exception.  During the past few weeks of yoga I’ve tried the poses presented by my teacher such as Virasana, Siddhasana, and Child’s Pose.  By the time we did Supta Baddha Konasana near the end of class one day I couldn’t enjoy it.  (I normally CAN sit in Sukasana and do Baddha Konasana, but not if my knee is inflamed.) My knee hurt from this 30-45 degree bend with no weight on it.   My leg needed to be straight again.  Three weeks in a row of experimenting, trying, seeing how far I’ve come, but it was just too much.  My teacher won’t mind me opting out of the more than 90 degree poses with weight on them for a while.  I can tell her in a nice way. Amy

Response:

Hi Amy!  I think you are on the right track here. I usually get knee pain from hero pose and child’s pose.

In both these poses the leg is bent farther than 90 degrees.  My guess is that is too much for you.  You may want to avoid any poses that put you in this position for a while.  (the knees easily torque at this angle.)  I feel it hours later and throughout the next couple days.  I’ve tried putting blankets between my buttocks and heels, and also putting washcloths or small towels behind the knees.

The washcloths behind the knees will increase the strain on the patella. This is a good adjustment for those that need to bring some life to this area.  For you though it appears your knee unhappy with so much attention.  These usually don’t prevent the pain.  It’s possible they make the pain lesser than it would have been without them, but it’s impossible to tell.

Most likely in this case it is exacerbating the problem.  However, one day, when you are over this problem, the washcloths will be of help to get a stretch deep inside the knee.  I have history of arthritis and prior knee surgeries. It’s scary for me because I get pain so often but I don’t feel it right away.   It’s also frustrating and it’s sad when I can’t do these simple things.

Let go of the frustration and sadness.  Allow yourself to heal.  This is not a race.  Sometimes my teacher wants me to try the poses anyway, modified.

I am luck to have a teacher that has no problem allowing injuries to heal, and will take people with shoulder problems or whatever over to the side and give them something totally different to work on then the rest of the class. However, the majority of teachers will want to help by throwing ideas out there and seeing what works.  They mean well.  You have to tell them how far you are willing to go. Do I need to resist her instructions and say "no"? Yes.  How do I do that politely?

Say, "Please No, its my body.  I want to give my knees a break for 5 weeks, then we can try some things and see if they work."  I want to be willing to try things, seeing if time has healed my old injuries because sometimes problems get better as time goes by.  (In fact, I am riding my bicycle again after a long layoff without much difficulty.)  I also don’t want to get into an argument with the teacher.  I think she means well, but has no idea how my knees feel.

Exactly.  You give yourself the best advice.   I take ibuprophen and ice to numb the pain in the knees. It could be worse, right?

The ice (and moist heat) are excellent therapy.  Try to do it regularly (as many times a day as possible) and lay off anything that makes it worse for 5 or 6 weeks. Do the standing poses hurt?  If not these poses do wonders in strengthening the muscles surrounding the knee.  Bicycling and swimming sound good too.  I could need prescription anti-inflammatories which I don’t need and haven’t taken since 12 years ago when all of this began.

I think your going to get through this and by November this is going to be ancient history.  Take care, — ~Stu

Response:

Hi Noah

The knee is a very complicated joint, including three ligament sets that control laterla displacement, etc. when the knee is bent.  You should consult your knee surgeon/doctor about which of these is the one that needs care.  Knee rehab is about strengthening certain muscles to take the load that weak ligaments can’t support.  So you may be stressing your injury in these poses.

Ligaments are okay and the musculature is good.  The main problem is with roughened cartilage (an osteoarthritis)in the patella and on the tibial plateau . (A secondary problem is with bursitis on one knee, however yoga generally doesn’t bring this problem on.)  Yoga with knees bent and weight on them brings back the pain inside the joint relating to the arthritic cartilage. The surgeries 11 years ago "shaved" the cartilage down to be more smooth. Now we read in the newspaper this procedure doesn’t help any, and ortho surgeons are advised to desist from doing it.  I do know people with ligament problems, but in my case the ligaments are healthy and all intact. Next, you need to analyze your own body type/shape.  As another poster mentioned, it may be that you stress the joint with excess weight in these poses.  In child’s pose, you can put your arms out front to carry a little weight, some weight can be on your forehead, and of course, you can use a bolster to decrease the angle of bend in the knee (this is particularly helpful if you have large thighs/hamstrings).

These are good specific suggestions.  Just to paint a picture here, all my excess weight is in my belly and some in my torso.  Below my belly my body is firm.  I am shaped as an "apple, not a pear".  My legs and buttocks are muscular from 30 years of activities like bicycle riding, jogging, squats, lunges, walking, and Bikram yoga.  My upper body isn’t as strong as I want it to be and I’m working on that.  I swim a little, and a year ago I started doing weight training for the upper body and abdominals and lower back. One thing I wonder about is whether practicing Child’s pose modified can help my knees get better eventually.  Is it worth the risk in the beginning? Because as I experiment I inadvertently overdo and end up with pain later until I find just how far I can go.  Will I get conditioned to the action and the pain goes away, or is it just necessary to avoid it altogether because this is something that no amount of practice can alleviate, and I am better off with other poses entirely?  Are there benefits to hero pose, child’s pose, etc, that I’m missing out on if I don’t do them.  And if so, what about doing other ones instead? Thanks for everyone’s comments who replied. Amy Lastly, don’t forget breathing, as oxygen will help the blood flowing through the joint and helping it to "expand".  Again, I would suggest asking the teacher (assuming yours is good) to help you analyze what you ARE doing, and then (with the information you’ve gathered from above) helping to modify the pose to give you greater benefit. NoaH

Ah, breathing, thanks for reminding me! : I think my teacher is good, yes. Just not very experienced with bad knees. – Hide quoted text — Show quoted text – I usually get knee pain from hero pose and child’s pose.  I feel it hours later and throughout the next couple days.  I’ve tried putting blankets between my buttocks and heels, and also putting washcloths or small towels behind the knees.  These usually don’t prevent the pain.  It’s possible they make the pain lesser than it would have been without them, but it’s impossible to tell.  I have history of arthritis and prior knee surgeries. It’s scary for me because I get pain so often but I don’t feel it right away.   It’s also frustrating and it’s sad when I can’t do these simple things.  Sometimes my teacher wants me to try the poses anyway, modified. Do I need to resist her instructions and say "no"?  How do I do that politely?  I want to be willing to try things, seeing if time has healed my old injuries because sometimes problems get better as time goes by.  (In fact, I am riding my bicycle again after a long layoff without much difficulty.)  I also don’t want to get into an argument with the teacher. I think she means well, but has no idea how my knees feel.   I take ibuprophen and ice to numb the pain in the knees. It could be worse, right?  I could need prescription anti-inflammatories which I don’t need and haven’t taken since 12 years ago when all of this began.

Response:

The knee is a very complicated joint, including three ligament sets that control laterla displacement, etc. when the knee is bent.  You should consult your knee surgeon/doctor about which of these is the one that needs care.  Knee rehab is about strengthening certain muscles to take the load that weak ligaments can’t support.  So you may be stressing your injury in these poses. Next, you need to analyze your own body type/shape.  As another poster mentioned, it may be that you stress the joint with excess weight in these poses.  In child’s pose, you can put your arms out front to carry a little weight, some weight can be on your forehead, and of course, you can use a bolster to decrease the angle of bend in the knee (this is particularly helpful if you have large thighs/hamstrings). Lastly, don’t forget breathing, as oxygen will help the blood flowing through the joint and helping it to "expand".  Again, I would suggest asking the teacher (assuming yours is good) to help you analyze what you ARE doing, and then (with the information you’ve gathered from above) helping to modify the pose to give you greater benefit. NoaH

– Hide quoted text — Show quoted text – I usually get knee pain from hero pose and child’s pose.  I feel it hours later and throughout the next couple days.  I’ve tried putting blankets between my buttocks and heels, and also putting washcloths or small towels behind the knees.  These usually don’t prevent the pain.  It’s possible they make the pain lesser than it would have been without them, but it’s impossible to tell.  I have history of arthritis and prior knee surgeries. It’s scary for me because I get pain so often but I don’t feel it right away.   It’s also frustrating and it’s sad when I can’t do these simple things.  Sometimes my teacher wants me to try the poses anyway, modified. Do I need to resist her instructions and say "no"?  How do I do that politely?  I want to be willing to try things, seeing if time has healed my old injuries because sometimes problems get better as time goes by.  (In fact, I am riding my bicycle again after a long layoff without much difficulty.)  I also don’t want to get into an argument with the teacher. I think she means well, but has no idea how my knees feel.   I take ibuprophen and ice to numb the pain in the knees. It could be worse, right?  I could need prescription anti-inflammatories which I don’t need and haven’t taken since 12 years ago when all of this began.

Response:

There is no reason to take chances. Just tell your teacher you have knee problems. Do another posture while everyone else is doing that one. Not everyone – in fact from what I have seen – most can not stand on their head either. Nor sit in lotus. While they are doing kneeling – why not try just doing it for shorter time or try not sitting on your knees and calves but just kneeling and see what happens. I just experiment but I would not hurt myself no matter what. Mike Dubbeld

– Hide quoted text — Show quoted text – I usually get knee pain from hero pose and child’s pose.  I feel it hours later and throughout the next couple days.  I’ve tried putting blankets between my buttocks and heels, and also putting washcloths or small towels behind the knees.  These usually don’t prevent the pain.  It’s possible they make the pain lesser than it would have been without them, but it’s impossible to tell.  I have history of arthritis and prior knee surgeries. It’s scary for me because I get pain so often but I don’t feel it right away.   It’s also frustrating and it’s sad when I can’t do these simple things.  Sometimes my teacher wants me to try the poses anyway, modified. Do I need to resist her instructions and say "no"?  How do I do that politely?  I want to be willing to try things, seeing if time has healed my old injuries because sometimes problems get better as time goes by.  (In fact, I am riding my bicycle again after a long layoff without much difficulty.)  I also don’t want to get into an argument with the teacher. I think she means well, but has no idea how my knees feel.   I take ibuprophen and ice to numb the pain in the knees. It could be worse, right?  I could need prescription anti-inflammatories which I don’t need and haven’t taken since 12 years ago when all of this began.

Response:

I usually get knee pain from hero pose and child’s pose.  I feel it hours later and throughout the next couple days.  I’ve tried putting blankets between my buttocks and heels, and also putting washcloths or small towels behind the knees.  These usually don’t prevent the pain.  It’s possible they make the pain lesser than it would have been without them, but it’s impossible to tell.  I have history of arthritis and prior knee surgeries. It’s scary for me because I get pain so often but I don’t feel it right away.   It’s also frustrating and it’s sad when I can’t do these simple things.  Sometimes my teacher wants me to try the poses anyway, modified. Do I need to resist her instructions and say "no"?  How do I do that politely?  I want to be willing to try things, seeing if time has healed my old injuries because sometimes problems get better as time goes by.  (In fact, I am riding my bicycle again after a long layoff without much difficulty.)  I also don’t want to get into an argument with the teacher.  I think she means well, but has no idea how my knees feel.   I take ibuprophen and ice to numb the pain in the knees. It could be worse, right?  I could need prescription anti-inflammatories which I don’t need and haven’t taken since 12 years ago when all of this began.

Response:

- Hide quoted text — Show quoted text – I usually get knee pain from hero pose and child’s pose.  I feel it hours later and throughout the next couple days.  I’ve tried putting blankets between my buttocks and heels, and also putting washcloths or small towels behind the knees.  These usually don’t prevent the pain.  It’s possible they make the pain lesser than it would have been without them, but it’s impossible to tell.  I have history of arthritis and prior knee surgeries. It’s scary for me because I get pain so often but I don’t feel it right away.   It’s also frustrating and it’s sad when I can’t do these simple things.  Sometimes my teacher wants me to try the poses anyway, modified. Do I need to resist her instructions and say "no"?  How do I do that politely?  I want to be willing to try things, seeing if time has healed my old injuries because sometimes problems get better as time goes by.  (In fact, I am riding my bicycle again after a long layoff without much difficulty.)  I also don’t want to get into an argument with the teacher.  I think she means well, but has no idea how my knees feel.   I take ibuprophen and ice to numb the pain in the knees. It could be worse, right?  I could need prescription anti-inflammatories which I don’t need and haven’t taken since 12 years ago when all of this began.

One thing that you need to do in yoga is listen to your body. The fact that the pain is delayed does not make it any less pain. –Don

Response:

dear amy pain is a sygnal to stop, not something to endure there are other exercises which help knees, no need to insist on these 2

Response:

I usually get knee pain from hero pose and child’s pose.

I too got knee pain after child pose. The trick I adopt was to place my pot belly, between wider bent knees. That seem to have fixed my pain.

Response:

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