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 knee problemsModerators: Moderators Jump to page : 1 Now viewing page 1 [25 messages per page] | View previous thread :: View next thread |
| Yoga -> Ashtanga Yoga | Message format |
bobuboy |
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| kulkarnn |
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| bobuboy |
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| kulkarnn |
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| Nick |
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    Location: London, England | Hi there, Sorry to hear about your knees and the resulting indecision about whether to continue practicing or not-it's a tough one, giving up something that you enjoy, and have put so much effort in to. I've been practicing for about twenty two years now, and have to tell you that in the world of yoga, and this isn't limited to astanga yoga, anatomy and physiology is not taught to any great extent, nor are the effects of postures on the human body understood. I have a degree in chiropractic, and am fairly confident that this is the case. A two year training program does not give a teacher even a basic understanding of human anatomy! Plus, those who do attempt to learn further are frustrated by the inability of teachers and students to change the habits of a lifetime-people don't like to admit that they have been doing things wrong, and resent the implication that they may have harmed others by what they teach-it's all very political. I would have thought that the knees, and the wrists, are two segments of the human body causing the most injuries in astanga yoga. You are going to have to see a specialist to find out what is going on, but the pain you describe is pretty much textbook for "anterior knee pain." This occurs when the kneecap begins to rub against the groove on the front surface of the femur. What is supposed to happen is that the kneecap travels up and down this groove when you extend or flex the knee, respectively. Runners often experience this type of pain as a result of shortened quadriceps muscles which attach to the kneecap itself. As the muscles get tighter, the kneecap can no longer pass smoothly up the groove, but instead the back of the kneecap starts to be pulled in to the groove, creating a greater friction and likelyhood of pain and damage. The above joint is not the knee joint, and you have not described any symptoms describing the knee joint. You have only described symptoms of the patello-femoral joint (patella-kneecap, femoral-thigh bone). It's a common misconception that there is only one joint underneath the surface-there's two distinct joints. Assuming you do have anterior knee pain, and this is where I am going to ask you to seek medical advice from a physio, chiro, or osteo, or someone of that ilk, you have probably been engaging the quadriceps inappropiately. Astanga and other forms of yoga have for years been making the mistake of teaching students to engage the quadiceps and pull the kneecap up the thigh. I shudder as I write this, and the hairs on tha back of my neck have stood up. I got the same reaction the other day when I went to the museum and saw a garrot used by the medieval Spanish for executing prisoners. Just to give you an idea of how stupid this instruction is  . Now there's a problem-if the quads are tight, stretching them by flexing the knee will cause tension in the muscle which may cause more knee pain. This is where one of the above specialists will help out. And should you give up? I nearly did-It took getting a degree to fathom out all the stupid things that are taught in the world of yoga. This option is not available to most. But maybe you have a great teacher who is busy taking apart the teachings of astanga yoga as we write-who knows ? So I can't with any certainty tell you to give up or carry on. If I could get my hands on you, I could probably show you how to navigate your way through these tricky waters, and I'm not touting for business, but it's just that I'm a rehabilitation specialist-this is what I'm trained to do-to help people carry out the activities of their daily lives without pain-which is basically what needs to be taught to yoga teachers. That'a another story, but it's relevant to your questions. Take care, if I can be of any help on this forum, give me a shout. Nick | ||
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| nucleareggset |
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| hnia |
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| bobuboy |
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| Nick |
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Location: London, England | Hi there, Recommending rehabilitation exercises should probably be left to the orthopaedic surgeon or to someone recommended by them. And also, if I give you an exercise and you get it wrong, which you will because at first you will be unskilful and weak at that exercise, then I'd be doing you a big disservice. There's no point giving you exercises you have no trouble performing, or are already strong at-rehabilitation identifies areas of weakness and then targets those areas of weakness. Having said that ( ), something I can thoroughly recommend is walking, especially over uneven terrain-obviously not so uneven that you twist an ankle. If you look at most books on knee rehab, what you will see is dozens of exercises which basically imitate the walking pattern, but often add resistance in some form-standing at the base of the stairs putting one foot two steps up, and propelling yourself up on one leg. The various forms of squats all utilize simultaneous movement of the three weight-bearing joints of the leg, just as walking does. So knee rehab is just walking in a controlled environment where the clinician will critique the patient's ability to perform the exercises, and then takes home a big paycheck at the end of each week. Marvellous. At various points, people have attempted to endorse knee rehabilitation exercises which do not conform to the above rule-years ago it started circulating that many knee problems were caused by weakness of the vastus medialis muscle which inserts onto the top medial edge of the patella-so already you can see a mistake-weakness in the vastus medialis causes the patella to not track properly up that groove in my last post, which isn't even the knee joint, so these people set out a form of rehabilitation which usually involved knee extension work, without the hip or ankle being flexed simultaneously-this is called an open kinetic chain, where you sit on a chair, for example, and lift one foot until you can see the vastus medialis contract above the knee. There's now been quite a few papers written on this, so I won't get long-winded, but the upshot is that probably thousands of people will undergo knee surgery which would not have been necessary if they had recieved better exercises-this exercise can not only make an on-going problem worse, but can actually create a problem! So what you have in yoga is this instruction to lift the knee caps-people's knees are being ruined every day in yoga classes, unnecessarily. If you run this by your orthopaedic doctor, if he/she is any good, their mouth should drop open-all their efforts at reconstructive surgery and maintaining an awareness of the knee which allows the population to make lifestyle changes to save their knees, is all being undone by this simple instruction to lift the kneecap by contracting the vastus medialis. My kneecap does lift when I extend my knee, but this is as a result of the muscles that cross the knee joint pulling up. I do this by using bandha, and as many of the mid-section muscles also cross the knee-rectus femoris, hamstrings, sartorius, tensor fascia latae, for example, wil all contract to varying degres in diffenrent postures-so If I have a posture with the knee straight, I'll use my core to feel the knee pull up-done properly, it feels as if you are pulling an imaginary kneecap that is on the back of your knee, as well as one on the front. The result is, obviously that your knee is going to be so much stiffer than if you were attempting to do the whole thing just using the relatively tiny vastus medialis. Then you have an army of volunteers, not a pathetic individual . Anyway, that's my rant for the day, thanks for letting me go on-oh hang on, you couldn't stop me could you? take care Nick | ||
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| browntoes |
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Nick - 2008-06-09 2:26 AM I've been practicing for about twenty two years now, and have to tell you that in the world of yoga, and this isn't limited to astanga yoga, anatomy and physiology is not taught to any great extent, nor are the effects of postures on the human body understood. I have a degree in chiropractic, and am fairly confident that this is the case. A two year training program does not give a teacher even a basic understanding of human anatomy! Plus, those who do attempt to learn further are frustrated by the inability of teachers and students to change the habits of a lifetime-people don't like to admit that they have been doing things wrong, and resent the implication that they may have harmed others by what they teach-it's all very political. Nick HI, I hope that I am not taking away from the original discussion but I found myself intrigued by these statements. I do not disagree with them, however, lately I have been thinking that yoga has become so diluted with anatomy. Bear with me as I am not very articulate. It seems to me that the yoga that was practiced for 4 or 5 thousand years is becoming a distant cousin of the yoga done today. The destination is the same but perhaps the road we travel is different. I am not saying that there is anything wrong with fine tuning things. I remember when I first started studying yoga in India. The instructions were Uttitha Trikonasana, Parsva Trikonasana, etc....names of poses and that was it. The other day I was in a class where the teacher was going in to the minutia of the anatomy and I am certain that other than myself (and perhaps any medically trained students) no one had any idea what she was talking about. In a group of mix level (mostly beginners) it just seemed that the instructions go on and on to the point where those details are lost on the average newbie yogi. Add to that mix that if you go to different studios or study different styles under different teachers - the instructions start to change. Look at one asana - lets say Trikonasana. Some teachers are telling you to rotate the thighs one way and some another. If anatomy is so cut and dried - why isn't there one set of instructions? Why cant we all agree? As a teacher, I am constantly looking things up . I am at the point now where I am thinking about going back to school to do a kinesiology degree because I DO see anatomy as a fundamental necessity for me to teach safely. As a student, I really miss those days long ago before I knew anything about anatomy. Now, I think we spend too much time analyzing every muscle, ligament, tendon, etc in each pose. Something is getting lost there - I am sure of it. Maybe after another 20 years I wont feel that way. I think I am just rambling here but it is something I have been thinking about. Are we improving yoga? Are things getting lost in the process? How did yogis 4000 years ago practice asana without anatomical knowledge? Oh, to bring it back to the original knee discussion - NICK -Hi Nick What instructions do you give for the leg and knee to bring it to the anatomically correct position? I would love to hear what you all think about what I am saying but perhaps I should have moved this somewhere else....sorry if I am taking away from the original discussion. | |||
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| Nick |
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Location: London, England | Hi there, Excellent points-this is something I am also concerned with! It requires some thought however, will get back to you tomorrow-end of a long day Nick | ||
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| Nick |
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Location: London, England | "HI, I hope that I am not taking away from the original discussion but I found myself intrigued by these statements. I do not disagree with them, however, lately I have been thinking that yoga has become so diluted with anatomy. " Believe, me I would think the same thing if I hadn't studied-but the simple fact is, yoga isn't inundated with good anatomy instructions-more than 99% of what I read in the yoga lierature is either mistaken or misleading, and only goes to convince the reader that the author is knowledgeable, which they are not, and reinforces the student's belief in this exercise system. The truth is, if I had taken up yoga after I became reasonably fluent in anatomy, I would not have continued. You wouldn't believe how many world class yoga instructors have given me adjustments and explanations for the methods, not knowing I trained as a chiro, which I know to be untruths. This is why I don't go to classes. Each one usually involves the teacher assaulting my body or my intellect. "I am not saying that there is anything wrong with fine tuning things. I remember when I first started studying yoga in India. The instructions were Uttitha Trikonasana, Parsva Trikonasana, etc....names of poses and that was it. The other day I was in a class where the teacher was going in to the minutia of the anatomy and I am certain that other than myself (and perhaps any medically trained students) no one had any idea what she was talking about. In a group of mix level (mostly beginners) it just seemed that the instructions go on and on to the point where those details are lost on the average newbie yogi. Add to that mix that if you go to different studios or study different styles under different teachers - the instructions start to change. Look at one asana - lets say Trikonasana. Some teachers are telling you to rotate the thighs one way and some another. If anatomy is so cut and dried - why isn't there one set of instructions? Why cant we all agree? " They cannot agree, because, like I said above, they don't know what they are talking about, and are also trying to juggle any knowledge they do have with not wanting to rock the boat-people need to stand up and say that the teachers of the last century were ignorant in their application of yoga to their students. "As a teacher, I am constantly looking things up . I am at the point now where I am thinking about going back to school to do a kinesiology degree because I DO see anatomy as a fundamental necessity for me to teach safely. As a student, I really miss those days long ago before I knew anything about anatomy. Now, I think we spend too much time analyzing every muscle, ligament, tendon, etc in each pose. Something is getting lost there - I am sure of it. Maybe after another 20 years I wont feel that way. " I have felt the same way-but now, I believe I am in the process of melding the physical and spiritual together-when you first learn a language, and try to use it in its country of origin, the sentences you use are halting and simplified-with time, you become fluent. Different aspects of that language form a link so that your understanding is like a web, which when knocked at one end, sends reverberations throughout the web. The problem, like I've said, is that yoga teaching courses just are not long enough, nor involved enough, in the anatomical side of things. So I would say that most teachers in the world are always at that stage of being a beginner-then anatomy isn't useful-in that case, I would agree with you-I experienced the same thing myself. Then, when I went to college, the degree of information is such that it can become a spiritual endevour in itself-vast portions of your brain forming new connections, revelations on the true nature of things, the realization that your yoga teachers are BS artists, not spiritual beings. Sorry, that was a bit much. "I think I am just rambling here but it is something I have been thinking about. Are we improving yoga? Are things getting lost in the process? How did yogis 4000 years ago practice asana without anatomical knowledge?" They may have had a reasonable aantomical knowledge-the yogis hanging around the carnal grounds will have seen animals tearing apart muscles, bones and tendons. The opportunities for watching dissection may have helped form their understanding. Death is on display all over the place in India. The flip side is that there are yogins over there who stand on one leg for twenty years, resulting in hideous deformities-so who cares what they do-idiots. "Oh, to bring it back to the original knee discussion - NICK -Hi Nick What instructions do you give for the leg and knee to bring it to the anatomically correct position? " Well, to cut a long story short, bandha-the contraction of the mid-section muscles pulls on the knee from above. In standing poses, this creates a contraction of the muscles on the soles of the feet, which I call the 'short foot,' which helps to squeeze the foot to the floor and stabilizes the centre of pressure. Because the hamstrings are a core muscle, they are part of the set-up of bandha. So if tighten them, the lumbo-pelvic hip complex is more stable. As the hamstrings contract, they help to stop the knee from hyper-extending. This means that the kneecap is pulled up the thigh without hyper-extension of the knee. An analogy-imagine the leg as a bridge which can be raised to let ships pass underneath- A car passing over the centre of the bridge is going to have an accident if the two spans of the bridge are not perfectly level-the car is the kneecap. So in a sense, you are using the hamstrings to buttress the bridge, so that the patella can track properly. Only using the quads to lift the kneecap up is like driving a lorry which is too heavy for the bridge to withstand-the structure collapses. In stting poses, say a forward bend, performing bandha effectively will again pull on the hamstrings, resulting in a lift of the back of the knee away from the floor, especially if you tend to hyper-extend it. You will also feel a pull on the back of the heel, or that the heel is pressing into the floor. And getting back to the original points, you are now integrating the actions of your body-mind to create an series of forces that are pulled inwards, rather than performing an isolated series of actions of the mind and body which result in you pushing 'energy' away from your self. Take care Nick | ||
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| browntoes |
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Awesome answers from everyone. Thanks! I will be back with a longer response in a few days  | |||
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| Eteraz |
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| bobuboy |
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