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Left Knee Problem
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   Fitness -> Injuries and rehabMessage format
 
CarsonZi
Posted 2009-05-06 2:35 PM (#115751)
Subject: Left Knee Problem


Namaste All....

This is my first thread so I will give a little bit of background on this injury.

I used to snowboard semi-pro as a teenager and at the age of 17 injured my left knee (compression injury) very badly and basically had the cartiledge replaced due to this. I continued to spend many years after that abusing the knee more with skateboarding, rock climbing, yoga asanas etc etc, but after the surgery at 17 I had very little problems with it. This past weekend I went to a Sahaja Yoga seminar and spent an hour and a half (lost track of time) sitting in full siddhasana with my left foot on my right leg. When exiting the posture and upon standing up, my left leg buckled completely and I basically fell on my face . Since then my knee has been very sore and I have had to be very ginger with my postures in order to not aggravate things at all.

Now that you know a little about my injury and the background leading up to it, I will tell you a bit about my yoga practice. I practice AYP yoga twice daily, as well as Kundalini Yoga and some Buddhist practices mixed in. AYP is an 8 limbed system that doesn't put much focus on postures so my daily rountine is basically 30 minutes of postures, 5 minutes of kriyas, 10 minutes of pranayam, a few minutes of kumbhakas, 20 minutes of internal mantra meditation, 5-10 minutes of samyama, 5 minutes of targetted bastrika pranayam, and 15 minutes of rest twice daily.

Because I am not the most well versed when it comes to asanas, I am not sure exactly how to continue with my practices in order to heal and strengthen my left knee. Do I continue gingerly, not doing anything stressful for the knee until it heals? Do I push forward in hopes of strengthening it? Do I back off completely until it is better? Do I go for surgery again? Any advice would be greatly appreciated. The advice I get from the AYP forums in not the best in the "physical" sense. Perhaps I will get better advice here. Thanks.

Love,
Carson
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Posted 2009-05-06 4:07 PM (#115752 - in reply to #115751)
Subject: Re: Left Knee Problem


it would be best to have lessons from a teacher well versed in the 'physical' sense. we all could certainly suggest poses, but without seeing how you are performing them you could likely do more harm than good.
standing poses held with attention to alignment specifics would likely be the best thing for your knee.
but you would need to learn from a qualified teacher.
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Posted 2009-05-06 5:16 PM (#115754 - in reply to #115751)
Subject: Re: Left Knee Problem


if you're have a previous injury, and are currently experiencing knee pain, that is incorrect alignment?
that's my assumption....
specifically, which postures are giving you pain?
how are you rotating the shin inwards?
look at the balance of the inner and outer edges of the ankle,
the distortion of the toes
and the imbalance between the inner and outer calves.
for conversations sake, the directions inner and outer refer to the lateral and medial borders.
rather than the deep and/or superficial structure.
work from the base of the posture.
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Posted 2009-05-06 6:07 PM (#115756 - in reply to #115751)
Subject: Re: Left Knee Problem


moreso, which postures/movements currently aggravate the pain you currently feel?
knowledge of the physiology of the knee is less important in my mind than internal awareness of the musculature.
it is very easy to read five pages in an anatomy book and understand the knee, but understanding of your own knee as a part of the kinetic chain of your body requires patient dedicated practice.
when i say to work from the base of the pose, i mean to work from the bottom to the top.
in standing poses, that means to work from the sensations of the bottom of the feet and move upwards.
for inverted poses, it would mean to work from the head, arms, hands....
whichever part is in contact with the ground.

....

if you had a serious injury at the age of seventeen, it is very likely your physical body distorted around said injury.
injured areas of the body are unable to support their own weight and pull on the structures connected to them.
everything kind of distorts around the injury and sinks into it.
the longer these injuries are left untreated, the more ingrained they become.
(some) asana practices are well equipped to deal with this by slowly and methodically bringing awareness to deeper and deeper layers of muscle fibers, giving us the awareness to extend control over long dormant tissues.
in this way, the mind is extended into the body, and the body becomes smarter and more balanced
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Posted 2009-05-07 12:19 AM (#115762 - in reply to #115751)
Subject: Re: Left Knee Problem


bikram was a little too hard on my joints as well.
i would recommend iyengar yoga for its painstaking attention to detail
it will help the practitioner to develop a keen internal awareness, as opposed to striving for the external appearance of the pose.
...
it addressed my many injuries and relieved me of severe chronic pain in a fairly short time.
if at all possible, though, it should be learned from an iyengar certified teacher.
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Nick
Posted 2009-05-09 2:37 AM (#115830 - in reply to #115762)
Subject: Re: Left Knee Problem



20005001002525
Location: London, England
Hi Carson,
You mention that yoga postures which rotate the tibia internally produce knee pain. Taking siddhasana as an example, the problem is compounded because the hip is externally rotating, which means that the opposing surfaces of the knee joint are rotating in opposite directions. The answer, obviously, is to rotate the tibia externally as you place the foot on the opposite calf. Most people do not do this-you also see it occur in some of the other poses you mentioned which give you pain, like tree and padmasana.
This happens for different reason, but I guess the main one is because people hold their foot in such a way that the rotation is induced-if you start to rotate the foot in the opposite direction, this is external rotation, now your hip, knee and foot are functioning as a unit, rather than disparate elements.
Once in siddhasana, people then relax the hips and legs so that the foot then becomes wedged into the space between the back of the opposite thigh and calf-this is very wrong, and should be combatted by continuing to externally rotate at both hips-the action pulls the knees away from each other,i.e. away from your centre-line. Previously, you probably created a 'crumple zone' at the knee joint in this asana. With this modification, you have got rid of that crumple zone, got rid of obstacles to your progress towards a more advanced expression of this particular pose.
Maybe try to sit cross-legged, maybe on a block-it's much easier to feel the action, and you may also see that even sitting cross-legged has not been doing the knee any good, by predisposing it towards improper movement and posture.
Hope that helps, knees are a pain.

Nick
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Nick
Posted 2009-05-10 11:48 AM (#115848 - in reply to #115830)
Subject: Re: Left Knee Problem



20005001002525
Location: London, England
CarsonZi - 2009-05-09 4:32 PM

Extremely helpful Nick, I thank you. My hips are not incredibly open and I already am sitting on a rolled up towel in siddhasana for easier leverage. I will try to pay close attention to move the leg as a unit and not isolating each individual section of leg, thigh, shin, foot.... Thank you for taking the time to give me your advice. I am taking it to the mat right now

Love,
Carson

Hi Carson,
Hope it helps! Yoga postures make joint alignment of the legs (and every other joint ( ) very difficult to achieve. because the hip muscles are the biggest in the body, they often present the biggest impediment to good posture, it takes time and patience to learn how to train the hip muscles rather than using the smaller knee, ankle, and foot joints to overcome hip inflexibility.

Nick
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