Monday, February 8, 2010

All you "knee-d" to know about keeping your knees in working order for years and years of painless practice



Your knees are precious. Whether you are a casual, drop-in yogi or a lifetime practitioner, you'll want to keep your joints operational for many years. Knee replacement surgery isn't pleasant and although the procedure has added to the quality of life for thousands, artificial joints just can never be a good as the originals. So, how can you ensure proper alignment and protect your knees?

As a rule, most instructors give lots and lots of "cues," or verbal instructions to help students achieve an asana with correct alignment. If you aren't entirely sure about your alignment, ask the instructor for help and clarification. The mirrors in the Group X room can help you "check out" if your body is properly aligned. Some of us just don't process verbal instructions well, we need to see what needs to be done; others need to experience what an asana "feels like" and then rely on muscle memory. We are all different and respond to different teaching cues, particularly for something as important as correct alignment. Never be afraid to ask the instructor for any help--Group X instructors are there to make your class experience positive, safe, and successful. 

When you are in asanas that require a bent knee (Warrior One, Warrior Two, and various lunges), make sure that your bent knee is directly over your ankle. Think about drawing a vertical line from the outside of your knee to your ankle bone. If your knee goes past your toe, you are asking too much from the joint and, over time, the stress will cause pain under the kneecap or worse. When you check your alignment, check that your knee is tracking on a straight axis: look to see your big toe and the inner edge of your front foot. If you want to make a lunging posture deeper, you have two choices: move the foot of your straight (or back) leg further back from your front leg, thus creating a wider stance; or, deepen your lunge by dropping your tailbone down closer to the floor.

When you perform any squatting asanas, such as Chair, your buttocks should never drop lower than your knees. Keep your weight in your heels, and as mentioned above, don't let your knees drift past your toes. While there are some poses such as prayer squat which require your body to go lower, the focus of the asana is always to keep the back straight and use the quadriceps, the strongest muscles in your thighs.

Regarding knee alignment, the easiest rule to remember is this: use your quadriceps (all four of them, thus the name quadricep), not your knee to perform the pose. If you focus on leg strength, you not only save your knee joints, you make them stronger because you engage and thus build up the muscles and ligaments that support your knees.

Is it possible to have too much flexibility in the knee joints? Absolutely! Some of us have knees that can "lock" and hyperextend. In standing poses, it's okay to practice with straight legs, but if you force your knees back too far, it's possible to pull the knee out of alignment with the ankle and hip joints. In standing poses, use your muscles to keep your balance, never a "locked" knee. When you do floor stretches, work with a slightly bent knee. Not only will you avoid knee injuries, but your hamstrings and quadriceps will get the stretch that they need. And of course, if you feel more than a gentle pull behind the knee joint--STOP! your body's let you know that it has reached its limit for the day.

And now, even more than you might "kneed" to know from the site Hatha Yoga Tips: here's the anatomical, muscular, physiological reasons for good knee alignment (don't worry, there's no quiz after reading):

"Two main alignment issues should always be addressed when attempting Yoga poses that place the forward leg into a deep knee bend over the foot: 1) Hyper flexion of the Knee Joint Our muscle fibers contain microfilaments that crossover and generate contraction or shortening of the muscle. To help visual these microfilaments, think of Velcro! When you completely line up a section of Velcro, it is very strong in maintaining its’ grip. If you line up only half of the Velcro, it starts to lose its’ ability to hold together. Lining up only a small fraction of the two pieces of Velcro leaves the Velcro very weak.
"Our microfilaments act in a similar way. As a muscle is stretched longer and longer, the microfilaments crossover less and less, and they have reduced ability to contract or sustain the endurance when the muscle is loaded. This is quite evident for the knee joint. When going into Warrior poses, the knee is place over the heel and knee bends to about 95 degrees. The quadriceps (thigh) muscle is elongated while also contracting (this can be considered an eccentric contraction). The microfilaments are still at a sufficient crossover placement to allow one to hold the pose with ample endurance. When one bends the knee below 90 degrees (thigh bone is moving below the level of the knee), the microfilaments have very little crossover and the muscle begins to loose its’ ability to sustain the contraction.
"Since the muscle cannot sustain the contraction sufficiently, stressing energies move down the thigh into the quadricep tendons and into the knee joint. The pose moves from control into struggle and negative feedback signals are transmitted back to the nervous system.
"A similar alignment error in lunging Yoga poses is to have the knee traveling far forward over the toes as the knee bends. From a side view, one can clearly see that the knee is over flexed (hyper flexed) well below the 90 degree point. Even though kneeling lunging poses do not have the same energetic loading as Warrior Poses, the quadriceps muscle is still required to contract to maintain knee stability. With the knee traveling too far forward and hyper flexing, stressing energies also move into the quadricep tendons and knee structures.
"2) Lateral Tracking of the Knee Very common in Warrior Yoga poses is to see participants have the forward knee slightly or excessively falling inwards in relation to the forward heel. This places an imbalanced energy in the quadricep muscles and can send a chronic or acute injury into the knee.
"We have four muscles making up the quadriceps - an interior line (vastus medialis), an exterior line (vastus lateralis), a superficial middle line (rectus fermorus), and a deep middle line (vastus intermedius). These muscles join together into one tendon that inserts into the top of the knee cap (Patella). This connective line continues from the bottom of the knee cap into the patellar ligament to the top of the leg bone (tibial tuberosity).
"Think of these muscles like four ropes pulling on the knee cap when contracting. If you pull harder on one rope than the others, the knee cap will be pulled more in that direction. This brings us to Warrior Pose. When the knee is placed slightly falling inwards, the outer quadricep line (vastus lateralis) acts more energetically than the inner line (vastus medialis). The biomechanical line of this imbalanced energy creates an outwards pulling motion on the knee cap. Some individuals can be prone to having the knee completely shift or dislocate outwards (lateral or patellar tracking).
"To avoid this imbalance and type of injury to the knee, insure that the knee does not fall inwards or towards the big toe in Warrior Pose. When you look briefly down to check your alignment, a good guide for knee placement is that you are able to see the big toe and inner edge of the foot. As you maintain the pose, accessory muscles help maintain this knee line: outer shin muscles (peroneal muscles) help ground the outer edge of the forward foot and draw the shine bone (tibia) outwards / outer hip muscles (abductors and lateral rotators) help move the thigh bone outwards as well.
"The benefit of this knee placement is the quadricep muscles maintain balanced support and energy on the knee cap and knee joint, and the outwards motion of the thigh bone places a more effective stretch into the groin muscles."
Now you know lots more about the hows and whys of proper knee alignment. You may have a better understanding as to why I never turn the light off completely in the Group X room during our practice (the better to see your knees, my dears) and why I circulate through the room (to demonstrate alignment techniques). Remember, we want you to enjoy yoga for many, many years--and that goes for your knees as well!
Namaste,
Nancy

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