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| I recently found out that I have a torn mensicus on my left knee which I received from an overzealous visiting instructor who did a full bind into Marichansana D (my fault I should have voiced up). The pain in the knee had gone away for quite awhile and then came back after I came out of Baddha Konasana a couple of weeks ago. I went to see a specialist, MRI and now the diagnosis of torn meniscus.
So two questions.
1) My right knee is bothering but I am guessing that is due to the weird way of walking i.e. I am totally out of alignment.
2) I am having arthroscopic surgery done since it is painful to walk. Is Ashtanga a good practice to continue with after I have the surger done? I don't want to give up Ashtanga. Is paying close attention to my alignment, easing into moves that place stress on the knees (i.e. marichasana, trikonasana, etc) and breathing enough? Or does Ashtanga as a practice place more stress on the knees than other types of practice.
Thanks for any respones. |
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Expert Yogi
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| Hi SS - I would be cautious about recommending Ashtanga at this point, but I admit an Iyengar bias  The thing with any "flow" yoga is that you move in and out of the poses quickly so there is always more risk that you will not move with good alignment. But you may have a teacher with enough experience to help you rehab safely. Whatever you do, go slowly and do all the stuff you are told to do to recover from the surgery. Take care! |
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| I would also go to a different tradition until I was completely healed.
Ashtanga is a hard, dynamic practice, so your knee would most likely get bent out of shape again (so to speak).
I injured my knee and couldn't bend it for 3 months so I went to a gentle hatha class, and then did my own practice with one straight leg. There was an awful lot that I couldn't do, but I still benefitted from moving the rest of me.
Ashtanga will always be there. Don't fret.
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| I'd like to steer clear of any referral to or from an ashtanga practice. Rather I'd encourage you to research the development of the practice, why it was created, and see if that "why" still suits you.
As for your number one, it's impossible to say why your right knee feels wonky.It could be compensatory. But who knows. I can't see your gate, your body, or your practice so I'd be a careless fool to advise you based on the feedback given thus far.
Question number two depends on how you would like to care for your knees over the next few decades of your life in this body. I can, as a knee surgery recipient, tell you that a "scope" for a meniscal tear is a thousand times more pleasant than a reconstructed ligament. An ACL recovery time would be six to eight months rebuilding the muscle mass of the leg upon which surgery was performed. A scope usually is dealt with in terms of weeks rather than months. Still you're dealing with a part of the body that does not receive much (if any) in the way of blood flow and therefore is quite stingy on the healing process.
If you don't want to give up Ashtanga then don't. The broader question is what is/was your body trying to communicate to you and are you in a mood to listen??? |
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| Thanks for the feedback from everyone. I will meet with my regular teachers who I am thinking would work wiht me on a variation of my practice that will allow me to stay in their studio.
If I may ask what is the difference between a "scope" and a full ACL?
Since I am new to these forums maybe I will keep regular postings on my experience with this problem. I have not found a lot of indepth information onlien about the wholistic process in dealing with the knee (physical, mental, philosophical) and just found it a little odd at the speed with which it came about. I have practiced for 7 years with no problem.
I shall see. As always the practice is ever evolving, guess that is what has kept me interested. |
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Expert Yogi
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| ss - I know extremely little about such things and others may correct me but I would venture to guess that you could have been chipping away at this injury over time and that final adjustment just broke the camel's back, as it were. A lot of things our bodies do appear to happen suddenly, but in fact we have been contributing to the problem for years before it blossoms into something we can feel. |
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| My guess is that you are right.
I will keep the forum posted on further developments. |
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| Keeping in mind I am not a orthopedist...
A scope refers to arthroscopic procedures. These typically use small cameras inserting into the joint through small holes. This allows the surgical team to see what they are doing without slicing open the entire joint. It's a minor procedure according to western medicine. In the meniscus repair the surgeon either cuts or stitchs the meniscus, depending on the nature of the damage.
An ACL reconstruct does use arthroscopy but the ligament is reconstructed. Back in the early 90's there were three types of material used fto recreate the ACL. One was from a cadaver, the other was synthetic and the third was a slice of the patients patellar tendon. This noew ligament was placed under the knee cap and attached in two places. Once it takes it becomes the new ligament.
Does this make sense?
Sorry but I'm unabashedly exhausted and must sleep.
sansoda - 2006-10-01 4:08 PM
Thanks for the feedback from everyone. I will meet with my regular teachers who I am thinking would work wiht me on a variation of my practice that will allow me to stay in their studio.
If I may ask what is the difference between a "scope" and a full ACL?
Since I am new to these forums maybe I will keep regular postings on my experience with this problem. I have not found a lot of indepth information onlien about the wholistic process in dealing with the knee (physical, mental, philosophical) and just found it a little odd at the speed with which it came about. I have practiced for 7 years with no problem.
I shall see. As always the practice is ever evolving, guess that is what has kept me interested.
Edited by purnayoga 2006-10-02 3:00 AM
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Location: London, England | Hi David,
Bad luck. You asked, should you give up astanga? Well, as with everything, it's not what you do, it's how you do it-many times, when people tell me they have had knee injuries, they will also be the ones with the worst knee positions in the class, and it is impossible to say whether this is a result of the injury, or what contributed to the injury.
Unfortunately, in Astanga yoga, people try to adjust themselves to what you might call the norm-and there is no such thing-every skeleton is unique. If you have an exceptional teacher, then they will adjust the practice to suit you-before you get injured, preferably, not afterwards. But in a large class this can be difficult or impossible.
Sometimes people can make it very difficult to spot-I have a woman with sacroiliac joint pain in my class that I took over recently who is extremely flexible and does postures which hurt at the time, and cause massive amounts of pain between classes-but she has been let down by her previous teachers so I am attempting to re-educate her-it breaks my heart to see somone who enjoys their yoga so much, and for them to simply be destroyed by it. I'm fully confident that within a few months she can be pain-free-but not if she keeps on hurting herself.
Unfortunately, in the world of yoga today, the art of rehabilitation is sorely misunderstood, and in the world of astanga, a form of yoga which needs to understand rehab principles perhaps even more than in other forms (that's debateable, I know), so I feel that perhaps you might be better off going for some proper rehab with a sports physio. Then use the principles they teach you to adjust the way you do yoga. This is assuming you find a fantastic physio.
In an ideal world, they would teach you knee alignment, then you could go away and practice some postures by yourself, go back to the physio and show them which ones hurt-they would then show you once again why the alignment principles that they originally taught you are useful in the posture, and how you can adapt the principles of good knee alignment and exercise to your yoga practice. Otherwise, your yoga practice will doom you to a lifetime of knee injuries/surgery.
Having sounded like the voice of doom, it is also possible to end up with fantastic knee as a result of yoga-because you are challenging your knee in a multi-planar, multi-dimensional training environment, theoretically the knee is more functional than a knee which is perhaps only trained in a single plane, such as on a bench doing leg extensions (which are not recommended).
In a sense, pain is the ultimate teacher-if it hurts, you are doing it wrong, or have done it wrong-do not listen to the voice of your teacher, but set up an internal dialogue iwth the nerve receptors in your body which are there to warn you to back off. In an ideal world, there would be a sensor in the yoga room which lit up and let the teacher know as well, just in case you were being too stoical 
Take care, look at the use of glucosamine and chondroitin sulphate just to promote joint health in general.
Nick |
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| Well I've torn a meniscus in each knee, and had alternate therapies. On the left I had the scope surgery. On the right I'm currently in therapy. The scope is not a difficult surgery for most. I was back to normal walking in a week. On the right knee the MRI showed that it was small and said I could either try physical therapy, or have the surgery. I chose therapy, and it's taken 3 months of work to get back to about 75%. See those ligiments take a long time to heal.
The therapist banned me from yoga for about 6 weeks. But I had also sprained my knee as well. I then chose restorative classes first and am now back to the normal Ashtanga practice with some modifications of course.
I informed the teachers of my condition My restorative teacher had a similar injury and said that bicycling and cross country skiing really helped her. She got me using several props. A belt, a wedge, and some blocks.
She also said something that stuck with me. Sometimes a humble practice can be wonderful.
But I honestly believe that for my conditions I get better instructions for my poses from my Anusara studio. But he's been teaching for over 10 years and is aware of many ways to correct injuries. Too bad they're over 45 miles away and in the mountains (snowed already).
How serious is your tear.
Edited by MrD 2006-10-03 5:43 PM
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| Here is the latest in my saga.
The tear in my left knee was described to me like this by a doctor after viewing and MRI scan. Imagine a sandwich bun cut in half and then on the interior there is another tear that flips over on the bottom half. So my guess is medium to bad in its severity. I am going in for surgery on the left side next week the 25th, and will post how my healing proceeds.
Consequenlty with my left side being injured I have been walking weirdly. In general my entire equilibrium is off, and now my right knee hurts to put weight on it because of my weird walking gait. I have still continued my practice, and it greatly helps. I have been working with a visiting instructor in my usual studio.
In general while I am not happy to have torn the meniscus there will be many positive side effects, i.e. a general re-examination of my practice and my motivation for doing it.
more later -d |
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| Just thought I would post what has been going on with my recovery. Just as an aside, the tear that I had was fairly bad (just for others that may be viewing this to compare to their own experiences).
It is now a little over 10 weeks since the surgery, and I have been in Physical Therapy for the last 8 weeks. Timeline of recovery
weeks 1-2 : lots of pain, unable to walk without a cane
weeks 3-6 : started PT, steady improvement
weeks 7-9 : at the beginning of week 7 marked increased in flexibility & motion, towards the end of 9th week almost back to a normal walking rhythm.
In the end I am going to continue with physical therapy and go back to my practice in another couple of weeks. |
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Expert Yogi
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| Thanks for the update. Hope you are 100% soon  |
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| Your Ashtanga practice? |
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| Ashtanga is not the practice for you and your knees. Take a good look at Janu Sirsana C (not to mention D). There are numerous poses in the ashtanga practice that just shouldn't be done by anybody who values the use of their knees.
Of course, these poses are found in all of Hatha yoga, but most practices don't require you to do them as much as ashtanga does.
If you are married to the ashtanga practice, then at least find a teacher that will allow you to skip some of the more dangerous poses.
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| Yes it is a return to an Ashtanga practice. With that said any person practicing any type of yoga, or for that matter any type of physical activity has to take into account their limits. Any good teacher will take that into account as well.
As I originally posted the injury was sustained by being forced into a move, I had never had any problems with my knees before that. I have also reviewed the moves of the practice with my physical therapist who said he does not see any reason that I would not be able to return to a full practice. Again that will only be achieved through a slow and controlled approach to my practice.
Edited by sansoda 2007-01-10 11:46 AM
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Location: London, England | Hi Sansoda,
There are a lot of mis-conceptions about astanga yoga on this board and in the yoga world. Everyone thinks they know all about it from just a few attempts or a few years practice. By all means follow good advice, as I feel you are doing, but you are right, if you get it right, there is no reason why astanga yoga should be bad for your knees. Having said that, if you get it wrong, then any weakness in the body usually surfaces. Try to nip injuries in the bud, come back onto the board, and hopefully we can construct a practice which brings you back to full health.
So basically, every time you feel pain in the knee, regard the pain as a stop sign-you have explored the wrong avenue in learning to move and form posture.
Take care
Nick |
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| They says that the pain protects you!
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Expert Yogi
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| Nick - I don't know if I would say there are misconceptions about ashtanga on the board. We are all speaking from our experiences or knowledge such as it is, for better or worse. Of course, everyone has gaps in their understanding and there are people like me who have not done ashtanga or Bikram or whatever who are clear (I usually try to be clear anyway...) that we are only speaking from what we have heard. And things are different for different people at different times or places - for example, your experience of Iyengar differs highly from mine in some areas, such as the idea that forward pelvic tilt is encouraged (which it is absolutely not, in my experience). Anyway, while we can agree that it is possible for someone with rebuilt knees to practice ashtanga, I think it is safe to say that as general advice to people whose situation we are not perfectly clear about, the advice to look for a slower practice is probably pretty good. |
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Location: London, England | Hi Glenda,
You've got to remember that my means of perceiving astanga yoga has been heavily influenced by my meagre grasp of human anatomy and physiology-to the extent that I would say that it looks like an evolved (and I hope it's for the better) version of astanga yoga. So my comments, to a certain extent dissacociate me from that style of Astanga yoga which is heavy on tradition, and is so renowned for causing injuries, as it attempts to make the human body do what it is not capable of, just because one perosn in India with a lifetime of training can do it, does not mean that the system should not be modified for each individual-I don't want to go to much into this, because I prefer to look at the positive aspects of doing exercise properly, rather than being the harbinger of doom.
So i do accept that your experience of astanga is different from mine. I was lucky enough to encounter it about 16 years ago, when one of the twelve westerners acknowledged ot be masters of the form cmae and gave two week workshops every summer in oxford. The classes were small, and I was keen, so I had all the benefits of practically one-on-one tuition, and we got to hang out-sometimes other yoga freaks would come, Matthew Eppler, Gilli Harouvi-all enthusiasts of practicing astanga yoga in a mindful way-this went very well with my training in Iyengar yoga. I feel i am very fortunate to have had this early experience of astanga yoga, I ahve to say that every other teacher since then has left me cold, and very unimpressed with the philosophy and manner of teaching-I think I would have had your reservations if it had not been for this jump start that I was lucky enough to experience-so I do recognize your reservations about astanga yoga-part of my life purpose is to evolve the system so that astanga yoga compliments the unique design of each human body by recognizing it is unique, and that we are not attempting to churn out a bunch of robots with no variation in performance or design-this would not be possible until we can clone ourselves, so you can do it in star Wars (although some of those clone trooper's outfits need to be modified for padmasana).
Take care
Nick
tourist - 2007-01-11 3:02 PM
Nick - I don't know if I would say there are misconceptions about ashtanga on the board. We are all speaking from our experiences or knowledge such as it is, for better or worse. Of course, everyone has gaps in their understanding and there are people like me who have not done ashtanga or Bikram or whatever who are clear (I usually try to be clear anyway...) that we are only speaking from what we have heard. And things are different for different people at different times or places - for example, your experience of Iyengar differs highly from mine in some areas, such as the idea that forward pelvic tilt is encouraged (which it is absolutely not, in my experience). Anyway, while we can agree that it is possible for someone with rebuilt knees to practice ashtanga, I think it is safe to say that as general advice to people whose situation we are not perfectly clear about, the advice to look for a slower practice is probably pretty good.
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Location: London, England | Hey glenda,
How does our understanding of pelvic tilt differ? Again this may not be Iyengar or Astanga , nut my anatomy training which is guiding me along a different path.
It may be that forward pelvic tilt doesn't get taught much, but the best praticioners will be using it in every forward bend-otherwise the alignment is bad, and no Iyengar yogi person would ever allow bad alignment. Not ever.
Nick
Edited by Nick 2007-01-11 11:16 AM
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Expert Yogi
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| Well, you often say that yogis, dancers etc. "encourage a forward pelvic tilt" and in my experience that is not so. The Iyengar teachers I know encourage a neutral pelvis and have run me ragged working on reducing my excessive lordosis. Extensive bodywork and practice have reduced it significantly. Are there students and teachers with forward tilting pelvises? Yep. But we work on bringing it to neutral all the time. Of course it has to tilt forward in forward bends. |
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Location: London, England | tourist - 2007-01-12 3:40 PM
Well, you often say that yogis, dancers etc. "encourage a forward pelvic tilt" and in my experience that is not so. The Iyengar teachers I know encourage a neutral pelvis and have run me ragged working on reducing my excessive lordosis. Extensive bodywork and practice have reduced it significantly. Are there students and teachers with forward tilting pelvises? Yep. But we work on bringing it to neutral all the time. Of course it has to tilt forward in forward bends.
Hi Glenda,
Sorry, I think I gave you the wrong end of the stick somewhere-what I meant was that you sometimes see dancers with excessive lordosis, and it's clear that their dance training has something to do with the lordosis. But in yoga, you often see the hip extension has been lost in postures where the most is to be gained. Typically, you will often see tight erector spinae working over a hyper-extended lumbar spine in backbends. It's one thing to have contracted back muscles which will pull you into the posture, it's another thing to allow the disintegration of the spinal joints, through having bad posture.
If I might just make another observation, and this is purely personal, and that is that the instruction to keep a neutral spine is in fact counter-productive to a healthy outcome for the lumbar spine in backbends-take cobra, for example-if you pre-brace your postural alignment so that the lumbar spine is held in neutral, you then force your body to hinge around the lumbar spine, rather than around the hips. What is important, I think, is to allow full hip extension to take place-without it, the idea of neutral spine and pelvis is a most unhelpful tool.
Nick |
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Expert Yogi
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| Actually, I think a lot of the lordosis you see on skinny dancers, models and gymnasts is due to the fact that they have no shape and have to make extremem movelments of their bodies to look curvy. Think about swimsuit models - they do these crazy movements with their hips and butts so there will be something interesting for the camera. Forty or fifty years ago, the girls just had to stand in front of the camera (think of Marilyn Monroe or others of her era and earlier) and they had curves
Speaking only for myself, if I wasn't instructed to keep my lumbar long and pelvis closer to neutral, I would do all my backbending in my low back. If the psoas area is tight, you don't get much backbend from the front hips. Sorry I can't go with the anatomically correct words today. Brain freeze. It has been, in the words of a co-worker, a "DAY."   |
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| Interesting to see that this post has started to generate a lot of discussion (hopefully it will be useful for other users in the future). I should have added that I have been continuing with physical therapy the entire and will do so up through mid-February. All told I will have been in physical therapy for 15 weeks by the time I finish. Interestingly enough many of the exercises I do in physical therapy are similar to the ones I do in practice, and there like practice if my form is off it hurts.
So far slow and steady does it, still continuing with only the standing poses. My instructor has noticed a mark improvement in my form she has said, and as she has said, "It is not the number of Asanas you do, it is how you do them". Our plan now is for me to continue only with standing poses for the next 2-3 months, and as I gain greater motion in my knee add other elements of the first series to my practice. |
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Torn meniscus in Ashtanga
