A Yin Yoga sequence for knee problems

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Posts: 1212
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

A Yin Yoga sequence for knee problems

Post by Bernie »

I recently received the following questions
  • Hi Bernie

    Firstly, I would like to thank you for your incredibly helpful website and books. They have added to my growing yin knowledge immensely. I have recently completed my first 50 hours of Yin Yoga teacher training.

    I have a teenage son who damaged his meniscus through a rugby injury. It has now been three weeks since his operation, where they trimmed some of the torn tissue. He already has great motion available in the joint and I want to introduce some Yin into his rehabilitation - in consultation with his physiotherapist and surgeon. If you have time would you be able to answer a question for me?

    Would you recommend I only use the seiza pose (with props) or should I create a fuller series of poses for him? I know it is important to also make sure we work on his hips but I'm hesitant to load too much tension onto the lower body. Any guidance you could send our way would be very much appreciated.

Hi Jaimee

Thanks for your question. I am glad you are getting value from Yin Yoga!

Regarding your son: it is difficult to recommend a program for him without knowing more about his situation: I don't know his biography or biology. If I knew what caused his knee issue, it would help. Without that knowledge, I can only offer you what I did in my case. Maybe you can extrapolate to him?

In my situation (which I describe in detail in this posting and this posting), I crushed my menisci by doing Lotus Pose too soon. My hips were very tight. I ignored the burning in my knees and didn't stop until the pain prevented me from doing the pose. After that lesson in "listen to your body!" I sought relief through a variety of yoga practices, but ultimately I had to have the surgery, as your son has had. My surgeon warned me that, without the full menisci, I would get arthritis in my knees. He practically guaranteed me that I would get arthritis, but I was determined to repair the damage as much as I could.

My healing involved a number of modality and techniques. Yes, Seiza pose (Vajrasana) was an important part (see my article on Yin Yoga for the Knees), but I also worked on opening my hips, by which I mean, getting to my full range of external rotation and abduction. If your son also has tight hips, he would probably benefit from a Yin Yoga sequence as follows:
  • Opening Meditation
    Shoelace (can add upper body twists and sidebends)
    Winged Dragon
    Reclining Twisted Roots
This may be too much for him right now. Let his knee heal from the operation so that there is no more swelling and he has his normal range of motion back. Then start to work towards this sequence. This sequence will first work on abduction with a little external rotation, but then it will really work into external rotation deeply. Of course, there are options if these are too much: do Half-Shoelace; skip Winged Dragon for the first few months; shorten the times to 3 minutes at first but work up to 5 minute holds. You can find all these postures explained in the Asana section of the website. If tight hips contributed to your son's knee problems, hopefully this sequence can help him avoid future problems.

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Joined: Fri Jan 18, 2013 6:49 am
Location: Bridgewater, Maine

Yin for knee osteoarthritis from overuse

Post by @marzipanj »

Hi Bernie,
I really appreciate your incredibly useful insights into knee damage and yin yoga. I'm an avid yogini who is struggling with arthritis in my knee joints. My doctor actually forbade yoga involving deep knee bends, and although I argued from clinical evidence available on the benefits of yoga for knee osteoarthritis, he still recommended low-impact aerobic exercise instead. So I've taken a break from yoga to allow my knees to heal, but I'm ready to get back to the mat.

My problem is that for one thing, my knees are in almost constant pain now. The ideal of "no pain, no pain" is confusing for me, because I've been using it to keep me from the mat, but I'm also aware that I may have constant pain from the arthritis now, and I don't know how to deal with that. Should I only do yoga on good days when there is absolutely no pain? Or only do it after taking anti-inflammatories?

I also know that they encourage arthritic people to remain active despite pain, and I've noticed that even when I experience pain during exercise, the pain is relieved afterwards. Many articles say that it's crucial to continue to use the joints, in order to relieve pain, even though using them may be painful. I'd like to begin to do your virasana variation in order to provide minor stress to the joint, but I wondered if you believe that's advisable.

I'm also curious if you can recommend a source for the specific props used in your article. I've experimented with books and blocks, but both seem too stiff, and your two-inch cushions look ideal, but I've been unable to find a source for them online. Doweling is less difficult to find elsewhere, but I still wouldn't mind buying some designed for this purpose.

Thanks so much again for the great resource of your site.

Posts: 1212
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

No pain/no pain?

Post by Bernie »

Hi Melissa

First, let me answer your easy question: you can get the props I use from Halfmoon Yoga. Most studios up here in Canada use these kinds of props, but I am always surprised how unknown they are in the USA. Dowling is available at any hardware store that has wood products (or Home Depot.)

Now, about those knees…yes, “no pain/no pain” is great advice for healthy people, but if you are already in chronic pain, that adage is not very helpful. I am sorry to hear about your situation, but you are correct, despite your discomfort, you do need to move! Or, more accurately, you do need to stress the knee joint to some degree. How much? Only you can tell, and you tell from experimentation. It would be best if you had a physical therapist or yoga therapist to work with so you can modify, observe, change, try again, and over time, work out what is best for you. On your own it is much more difficult, but not impossible.

At the risk of seeming self-serving, I would suggest you get my latest book Your Body, Your Yoga and read a couple of key sections: first the section on Antifragility (page 29), then the section on the knees (beginning on page 157.) If you never stress your knees, they will become more and more fragile. But, of course, any stress now is painful: how much pain you can tolerate and how much is good for you is something you have to discover. I certainly can’t tell you: I’m not a doctor or a therapist and I don’t know you or your body. To help with your inflammation and swelling, long term use of antinflammatory like Ibuprofen is not good. (Check out this web page listing the dangers and contraindications.) Have you tried earthing though? (Check out this article that I wrote a while back.) Or, try curcumin. Reading the section in my book on the knee joint will educate you so you can determine what is working and not working in your knees. It may even help you in your discussion with your doctor.

For example: if your problem is with arthritis of the kneecap and patellar pain, did you know that the “high” version of Chair Pose (Utkatasana) is harder on your knee caps than the “low” version (page 177)? The highest levels of pressure on the kneecap come at around 90 degrees of flexion, and deeper knee bends are actually less stressful! (However, the high version of Chair Pose is less stressful on the lower back, while the low version is more stressful—you have to decide which to stress more or less; the lower back or the knees.)

Well, I am not sure if all this will help. Let us know how it goes.
Good luck.
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