The Hot Yoga Doctor – Free Bikram and Hot Yoga Resources › Hot Yoga Doctor Forum › Injuries, Restrictions, Ailments, Pose Modifications › Knees, legs and ankles › Knee Pain from Hot Yoga!
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Hi,
I’ve read post from others that describe knee pain in certain postures. I don’t know if my problem really matches the other problems. I’m a biker and my knees are definitely inflamed, and although I thought yoga would help, it has actually worsened the problem. My knees ache during almost every pose (even the spine -strengthening exercises are painful), or if the poses don’t feel painful during….they feel terrible afterward. It confuses me because I see yoga as low-impact, and hot yoga used to always be so soothing to all my ailments. I haven’t been to a class in two weeks now, as I’m still in a great deal of pain. Doctors have told me that surgery isn’t necessary, but I’m off all cardio except swimming. I really want to get back into my Bikram yoga routine but I think it’s actually exacerbating my knee inflammation.Hi Chris
Can you please clarify for me if your knees were hurting before you started yoga? Or did they become painful with yoga?
I guess I should assume you’re riding a pushbike right? Not a motor bike. Do you also run? What other activities bother you?
Namaste
Gabrielle 🙂Hi Gabrielle
I ride a mountain bike but I’m not a runner at all. Using the elliptical machine and biking have become very painful. Walking is now very bothersome too. I don’t believe that yoga caused the knee problems however, the majority of the poses are really difficult to do. I’ve had this pain in the past, but it comes and goes. This is the third big “flare up” in five years. So you could say I’ve had the pain prior to doing yoga…but it is only now that the pain has come back to me since 2008.
~Christina
Hi Christina
It could be that your connection with the ground during yoga has highlighted an alignment issue that gets exacerbated when you’re standing (when your hips, knees and feet are all weight bearing). It concerns me (as it would you) that you have difficulty walking. Can you tell me if you walk with your feet pointing forward? Or to what degree do your feet point out to the sides? What about pronation? Do your arches fall when you stand? When one rides a bike, the power is through the toes isn’t it? So it could be masking an issue that becomes evident when you weight bear through your feet.
What else can you tell me that answers those questions or is a thought prompted by my questions?
Namaste
Gabrielle 🙂you said too ‘the doctors say surgery is not needed’ ….. what do THEY say is the problem then ? and what was the original injury. what about akward and fixed firm … do these poses bother you and…. where are you in the depth of them? just curious …..
The problem, specifically is called chondromalacia patella, which is essentially just pain due to muscle imbalances in the leg. The culprit could be the quads, hamstrings, abductors, adductors….or any combination of those. Normally, I’d do ALL OF the yoga poses with ease (including fixed firm). The only one that was ever iffy was completely locking out during standing head to knee (locking out on the raised leg that is) and the third part of awkward pose. Everything else was always flawless I had never felt pain before. I was always verrryy adamant about keeping my entire foot planted on the floor during all the standing poses. When the instructor reminded the class to “press the big toe into the floor” mine was already firmly in place. I do have flat feet and wear orthotics to correct this. Sometimes I wonder if keeping my foot flat to the floor was a bad idea, because, as a one doctor pointed out to me, when my foot is flat to the floor, my knees point inward as opposed to straight out. When I allow the inner portion of each foot to rise slightly off the floor (creating the arch that I need) my knees straighten up.
When I walk, my feet are straight. There is not inward or outward pointing, or pronation. I’m dying to get back to yoga, but bending AS WELL AS, locking out the leg is very painful. I’ve learned that when I contract my quad (to straighten the leg as much as possible) the pain is intense. So I feel like I can’t do any of the poses that require perfectly straight legs. Even the spine strengthening poses that require a straight leg cause me pain!
Will I be able to resume my practice again someday?
Chris
Hi Chris
Thanks for the missing info! 😉 It’s as I thought really (in my last post). If you check out the video Great Posture From The Ground Up you will see a demonstration of lifting up through the arch and the ankle. You’ll also see why your bike riding is not directly causing the issue but is still probably creating the muscular imbalances in your legs that gets highlighted in yoga. (You may have your big toe down there, but your arch is down there too!)
As a bike rider you probably have very strong quads. Do you feel they cramp up when you try to stand and lock out the leg?
Now here’s a BIG question, are you able or willing even for a time to stop the bike riding and just focus on yoga? I am just wondering if it’s worth doing yoga and trying to sort out the issue and not have the conflicting inputs.
Tell me what you think would work for you and we can start looking at modifications.
Namaste
Gabrielle 🙂Thank you for the link to the video and thank you for looking into the issue further with me. I’m not sure if I understand the video clip as I was supposed to, but I think the overall lesson was that, during the standing poses although the big toe should be firmly pressed into the floor, the arch of the foot ought not be flattened. I am not sure if I will be successful and pressing the toe down without pressing the entire inner portion of the foot. I guess this whole time I thought the entire foot was meant to be completely, and totally, flat. I would focus on yoga for a while IF I knew that it wouldn’t cause any further distress. I DO NOT feel cramping when I lock my legs, I just feel a lot of pressure and discomfort (and pain if I don’t stop) in the knees. However, this discomfort is new- I never really experience cramping OR pain during the yoga classes before.
I’ve seen orthopedists, physical therapists, and now, a podiatrist. I think I will discuss your video segment with him at our next appointment so he can better help me to understand how my feet are contributing to my knee pain.
In the meantime, maybe I can practice some yoga poses at home before going back to 90 minute class; at the studio where I go, students are not permitted to leave the room until the end of class, but I fear that if my pain becomes too much, I’ll be too upset to remain in the room (as the pain is such a distressing issue for me to deal with, emotionally and physically, at this time).
Hi Chris
This is clearly a problem that has to be solved. You need some peace!
I think, however, we’re on the right track. If you could slightly change your focus from big toe to ball of big toe I think you’ll feel a shift which allows that easier lift in your arch and ankle.
Practicing at home sounds like a good way to go to perhaps build up some equilibrated strength without experiencing that pain. This will lead to increased stamina.
If you decide to go to a 90 minute class there is absolutely no reason why you couldn’t start with 15 second bursts for all 60 and 30 second poses. You can either choose to do several bursts of effort or one only and then stay still and meditate and let your body experience the effects of stillness in Savasana.
Come to think of it you could try this: Stand upright, don’t lift your ‘other’ leg; lock the ‘standing leg’ as strongly as your quadriceps will allow and focus on your leg alignment. With both feet on the ground you won’t complicate anything by diverting your attention to the business of one legged balancing.
Balance will have your ankle wobbling around so rather than jumping in and trying to do the whole pose, start with little steps that will create the foundation for a solid stance. In a short time you should be able to lift the heel off and then the foot of the floor. Your alignment of your locked standing leg is what I would like you to work on. Developing that balance of the USE of your muscles where your ankle, knee and hip are stacked over each other. This means that regardless of what the ‘other leg’ is doing, foot lifted or on the floor, both hips are even.
I feel confident that you could take that approach at home OR in the studio. You decide what you’ll feel most comfortable with. Please don’t ever say that you “would be a distraction to others” as the reason to practice at home. It’s just not relevant. 😉
Over to you!
Namaste
Gabrielle 🙂 -
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