The Hot Yoga Doctor – Free Bikram and Hot Yoga Resources › Hot Yoga Doctor Forum › Injuries, Restrictions, Ailments, Pose Modifications › Knees, legs and ankles › Pain in knee
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Hello
I have a problem in my right knee – or rather the muscles/tendons on the outside or on the back, I can’t really tell. It is painful when I bend the knee – mostly when going down stairs, and when I am in an extreme bend, like during the third part of awkward pose, I feel it badly – it feels very “thick” behind the knee. It isn’t as bad in the later poses – perhaps because I am more warmed up. However I have never been able to go down in fixed firm.
I have been doing bikram yoga for 5 months and didn’t have any problems until about the last month. So I started doing a lot of reading on different websites including this one to try to find help. I’ve watched the “from the feet up” video and found it very helpful, and the past few weeks I’ve been conscious of ensuring my ankle is not falling inward and keeping the weight distributed across the entire foot. I do think I have a weak right arch – I often have pain in the arch at the end of the day. I also have had previous side of the knee pain due to inflammation from tight IT bands. I am not sure my current problem is related to this or not.
Another culprit of the problem could be that I was confused about the whole “lock the knee” issue. I may have overdone it, not realizing I am slightly hypermobile – I don’t know if I am, I am just guessing, because I also have pain now when I walk. I feel like when I take a step the knee goes too far back now – sort of a strange feeling both in the back of the knee and the front. I talked to my instructors and for the past few weeks I have focused a lot on tightening my thigh and hip/butt area rather than pushing the knee back. But I still am having this pain. I’m not sure to back off, or keep going. Ice takes the pain. Walking at a hard pace makes it much worse. I bike about 8 miles to work each day. I don’t have pain when I bike.
Any ideas or advice is greatly appreciated!
Hello Holly
Thanks for all that detail. I will ask you some more if you don’t mind. 😉
Would you please tell me what stage that you’re at exactly with Fixed Firm. Are you able to sit between the heels? How close are your knees together when you are seated? What pain if any are you feeling and at what stage, and where on the knee? When you are seated are the front of your ankles against the floor?
If bringing your knees together in Part 3 Awkward is painful and difficult then you can actually strengthen the knee and make the pose work for you. You will need to use a soft block between the knees against which you can press your knees. Start with the block at its widest and see how that feels. Over time you can diminish the distance by changing the orientation of the block.
You can do this outside of class (especially if you have teachers who won’t “allow” you to do this) if you have to avoid part 3. Replace part 3 with a second set of part 2 because that will continue to strengthen your feet and knees. You will love the block exercise because you can feel the progress it is creating.
Let me know the answers to above!
Some dedicated gym type exercises with or without machines will help you develop any strength lacking in your hamstrings. Or if you’ve been seeing a physiotherapist they can give you those eccentric exercises. Take a look at the other forum posts about IT bands to see if anything resonates there.
Namaste
Gabrielle 🙂Thank you for your response! I have been traveling over the holidays and haven’t been able to reply until now (nor do any yoga classes).
To answer your questions: In fixed firm before my knee problem I could sit between my heels with my knees spread quite a bit. Now I am unable to go down at all, but haven’t been to a class now for 3 weeks. The pain occurs when I go down stairs and when I bend my knee to squat so I will have a problem with other postures. The pain is mostly on the top and right side of the knee and it feels swollen. When I straighten my leg and put weight on it it feels like my knee pushes back too far, perhaps I overdid it with locking the knee.
I am seeing a physiotherapist who advised me to not exercise for awhile but I have not had any improvement. He suspected a problem with my popliteus muscle or tendon. Miss my hot yoga class terribly but am afraid doing more damage.
I appreciate your advice. Just got your book for Christmas, and enjoying it so far.
Hi there, sorry to hijack your post but I am also suffering from a knee injury if anyone is able to help!.
Basically I have sustained an injury doing yoga. It was my first time trying Bikram (and yoga for that matter), and I hadn’t done any exercise for a few weeks before, so I guess it was then.
Since I was a beginner, I believe I may have put too much pressure on my knees trying to do the stretch where you lower yourself onto one knee slowly down to the floor. There was no immediate pain, but the next day, I could barely walk as I was suffering from a very sharp pain in my right knee and lesser so in my left. Fast forward 6 weeks, and I can’t really walk long distances without feeling a dull achey pain in both knees, and have not been able to do any other form of rigorous exercise bar swimming (not sure if this is helping or hindering) since. I don’t know why it has lasted so long. I’m trying to keep movement to a minimum, but worried that although the pain has decreased a lot, it still persists!
I am male, 24, 6ft and about 76kgs if that helps. Not use to this type of exercise but generally active.Would anyone be able to pinpoint what kind of injury I have?
Thanks, Mike
Hi Holly
Phew! I am so pleased you are resting your leg and more importantly seeing somebody to help you fix the problem.
It is essential you do some exercises to strengthen what could be a weakness in the back of the leg (you say you hyper-extend). It appears you have a damaged muscle – some tearing.
I disagree with those teachers that say you should focus on firm hips and butt to counter the hyper-extension. If you are hyper=extending then you need to strengthen back of leg with gym work or other exercises recommended by physios rather than immobilise your hips. Tightening your bottom would be akin to putting earplugs in if you hear a funny noise in your car engine when you drive. It doesn’t fix the problem. You may also need some massage of the area.
If you check out page 238 in the book, Hot Yoga MasterClass (and thank you for letting me know about your Christmas gift :cheese: ) then you will see an entry and a photograph about a ‘restorative pose for the knees’. This will be what you will do when able to, before you even think of creating distance between the knees. At the first stage you will most likely need quite some space between hips and heels (with a cushion or rolled or folded towel or towels).
First thing is to rid yourself of the acute symptoms. You will be able to go back to yoga. Let me know how you are progressing. It has been a little while since your post so you may have made significant gains already.
Namaste
Gabrielle 🙂Hello Mike
No need for apologies! Mike, I am not clear how many classes you did of Bikram or hot yoga. Can you please tell me? If it was only one and you had that issue then it would be a different circumstance to the one where you would continue going to class. I would need to ask you some questions to get closer to the root of the problem.
So, to get the ball rolling, would you please tell me what your yoga experience is (number per week, when you stopped – if you did stop) and any other details you can offer? Are you getting any professional help too?
See you back here soon
Namaste
Gabrielle 🙂Hi Gabrielle
After 6 weeks break I have returned to the studio. I got the go ahead from my physio and am taking it gently, although the pain has not changed. Physio tells me to work on strengthening the medial quad and glutes, which I am doing. Still have pain when I bend my knee more than 90 degrees or go down stairs. Putting a towel behind the knee for the deep knee bends does help, but it still hurts. I saw an orthopedic today and he warned me to be careful in case I have a tear, that I don’t tear it more. I will be getting an MRI in a few weeks to fully diagnose the problem. In the meantime I continue to practice about 4 times per week because I just can’t stay away! I put a lot of attention on tightening the quad and lifting the knee where I am supposed to, but it is hard to feel the kneecap lift because of this injury. Also I feel like when I tighten the quad that my hamstring tightens as well. Maybe I am doing it wrong. When in doubt I usually check the muscle with my hand to feel if it is tight. I am also careful not to press my knee back in standing separate leg stretch, and the other positions where you are instructed to lock the knee. Do you have any other tips or things to be aware of? Should I maintain a “microbend” while engaging the quad?
Thank you for this very useful forum!
Holly
Hi Holly
So pleased you saw a physio.
What I would like to recommend is for you to read this blog post about bending the legs in certain poses where you have been instructed to keep them straight.
See if you can apply the same technique to all the Paschimottanasana poses and sit up. Check out the book for the appropriate pose.
There is a problem with many Bikram yogis. That is, that they cannot engage quadriceps without firing the hamstrings as well. Well done for noticing that. It comes from the insistence of locking EVERYTHING indiscriminately. Some people then somehow override their ability to selectively engage. Your awareness around this will help enormously.
As in most questions there is not a black and white answer: So regarding quads and hamstrings, it also depends on what you’re doing at the time of quadriceps engagement. If you’re sitting on the ground then it is possible to have quads engaged with relaxation of the hamstrings. However when you’re standing your hamstrings will at least PARTIALLY engage in order to KEEP you standing. They are involved in balance. So, notice whether your hamstrings are solidly engaged or not. 😆 There are some things that are black and white… 😉
Other tips: Avoid excruciating pain in every case. Perhaps see if the twisting action in Tree pose should be avoided too. Methinks don’t go into toe stand.
Namaste
Gabrielle 🙂update: a recent MRI showed a torn meniscus. Having surgery on Tuesday. I’m wondering when it would be safe to return to my practice, and what I need to consider and be careful of both while healing but also in the future to avoid a recurring problem? I currently cannot do fixed firm, toe stand (on right leg), or go down too far in 3rd phase of awkward pose. Should I continue to avoid these poses or do a modification? Thanks for the advice.
Hello Holly
So, you now know you have a torn meniscus. Which side of the knee: Medial or Lateral? Sometimes with issues of the medial meniscus one can still sit in Fixed Firm. You mentioned previously that you could not. Is that the case?
Please do tell me precisely what you are able to do in Fixed Firm so that I can assist you for future milestone recognition (in order to proceed). You are unable to do Toe Stand on the right leg. How about Tree Pose?
Awkward Pose part III: There are couple of things you can do. One is going down keeping a vertical back to the point where you can come back up and where your knees feel secure. Over time your depth of descent will improve. Other ideas we can look at if the one offered is not appropriate.
By avoiding a forward movement of your body you will keep your centre of gravity more central (vertical) and keep undue pressure off the knees.
Please let me know where you’re at
Namaste
Gabrielle 🙂 -
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