Ask a Yoga Teacher: What to do with cranky knees when practicing yoga

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People come to yoga for different reasons. Some people come to ease their back pain, others to feel calmer. But what if you have a part of your body, like your knees, that need extra care when you practice?

The beauty of practicing yoga, is that you don’t need to mold your body to fit the practice, the practice adjusts for your body. You just need to know how to do it. Practicing with a skilled teacher can help you modify your practice to best suit your body.

Since your body changes over time, it’s important to understand how to keep your practice going while honoring those changes. You never want to push through pain. Pain is information. Your body communicates through the language of sensation to tell you that something is wrong. Understanding what it’s telling you helps you know what to do.

Have You Ever Wondered What it Means to “Listen to Your Body?”

What’s going on with your knees?

In this post I am focusing specifically on your knees. The knees are a tricky joint, though seemingly simple in design. They mostly flex and extend (bend and straighten), but they do have a small amount of lateral movement (side to side).

In my 20+ years as an acupuncturist, I have come to understand that the majority of knee pain has nothing to do with the knees. What I consider knee pain is arthritis, meniscus issues, ligament issues, etc.

However, about 80% of knee pain has nothing to do with the knee. The knee is the “hapless bystander” between the foot and the hip. I find 80% of the time, pain in the knee is due to dysfunction in the hip, foot, thigh or lower leg. When you treat the knee, it doesn’t help. When you treat those other places the knee pain goes away.

Different types of “pain in the knee” and possible causes

I will refer to this type of pain as “pain in the knee,” based on where you feel the pain. If you feel the pain in the joint itself, this can often be arthritis pain. This pain might feel worse on rainy, humid, hot, or cold days. With that type of pain, moving the knee joint and keeping it mobile and flexible is your best option, as well as strengthening the quads to help stabilize the knee.

Pain in the inner knee that is not a meniscus or MCL issue is often due to a tight inner thigh or a tight outer calf. This pain can also be caused by weak glutes. Pain in the outer knee can be due to a tight IT band (IlioTibial band), or walking toward the outside of your foot. Rolling and/or stretching these various parts can help.

Pain in the kneecap or below the knee at the patellar tendon can be caused by tight quads. For this I would roll the quads first and then stretch, as stretching might not be enough.

What to do with knee pain and yoga modifications

Regardless of why your knees hurt, there may be are certain poses, like Child’s pose and Pigeon pose, that can exacerbate knee pain instead of stretching the lower back or hips the way they are supposed to. The good news is there are plenty of modifications that can help you feel more comfortable, even with cranky knees.

This is a quick tutorial on how to use props generally. Props are your friends, not a crutch. Using them doesn’t mean you are worse at yoga. In fact, more experienced students who have learned to listen to their body, understand the value of using props in their practice.

Padding

Blocks and blankets/towels are definitely your friends if you have cranky knees. Padding under the knees is always a good idea, especially if you practice yoga on a floor or hard surface. You can use a second mat, a blanket or towel, or a gardening pad under your knees for a little cushion if having your knees on the floor hurts.

Support with flexion

Blankets are also helpful if you struggle with full flexion (bending your knees all the way). In a pose like Child’s pose, placing a blanket behind your knees creates some space and support for the knee joint so that you don’t feel compression in the knee joint.

Anytime you can support your body weight will help. If you are sitting and kneeling, place 1-2 blocks under your hips to take the pressure off your knee joints. This higher your hips, the less flexion is required. Find the height and support that you need. If that’s not enough, you can also “stand up” on your knees, with your hips over your knees instead of over your heels.

Creating stability and strength for the knee joint

Regardless of the cause of your pain, strengthening and stabilizing the joint helps. The quads play a big role in stabilizing your knees and keeping them strong will help you through your day. Whether you are walking, playing tennis (which is terrible for aging knees), or getting in and out of a chair, having strong quads will keep your knees acting as they should.

When you practice yoga, keep the center of the knee in line with the center of the foot. There are rare occasions when this doesn’t apply due to anatomical discrepancies, but for the majority of the population, this is good.

In a pose like Warrior 2, if your knee rolls inward, it will eventually cause pain. This usually happens due to weak glutes and tight inner thighs. Look for your big toe on the inside of your knee by pressing your knee outward in the direction of the 5th toe. This will also engage and strengthen the glutes on that side, always a win.

In a pose like Triangle or Tree pose, engage the quads to support the knee. You never want to hyperextend the knee joint. This over stretches the ligaments causing joint instability. Ligaments should be tight to stabilize the joint. If you have lax ligaments, what feels like straight really isn’t. You always want to create a softness in the back of the knee by bending it slightly. It will feel bent, but you will actually move from beyond straight to straight.

With any straight leg, engage the quads to support the knee joint. If you struggle to activate the quads, bend the knee slightly. They don’t really turn on if you are in hyperextension. Move to neutral and they will activate.

Poses for knee strength

The knees are one part of the whole. These poses create functional strength for the knee joints, as well as strength in other parts of the body that affect the knes

Utkatasana with a block: This pose creates strength and stability in the knee joint and is helpful for training yourself to get in and out of a chair. Placing a block between your knees helps you keep the thighs parallel. This pose strengthens the quads, glutes, and inner thighs, as well as your abdominals.

Tree pose: This pose cultivates balance and strengthens the legs, both the standing leg, and the lifted leg. Engaging the quads, glutes, and inner thighs gives stability and support to the knee. Make sure to not only press the footn against the leg, but also the leg against the foot.

Crescent Lunge with knee taps: Going back and forth between Crescent Lunge and tapping the knee to (or toward) the floor strengthens the quads and glutes to support the knee. The lower you can go, the better, but not at the expense of your knees! Listen to your body and only go as low as your body allows. With practice you can hover over the floor or touch your knee to the floor.

Poses for knee mobility

Child’s pose: This pose gently stretches the knees to improve mobility. Feel free to place a blanket behind the knees or 1-2 blocks under your hips for support. You never want to create pain in your knees. Listen to your body and support yourself the way that you need.

Seated Frog pose: This pose stretches the inner thighs which, when tight, can pull on the knee joints. Feel free to lean on your hands instead of your elbows. You can also pad under the knees by placing a blanket or towel under the knees.

Side-Lying Quad Stretch: Grab your foot with your hand and draw the heel toward your buttonck, keeping the knee hip height. If you can’t reach your foot, you can hook a strap or towel around your foot and hold that instead. This pose stretches the quads which, when tight, can pull in the knees.

Ask a Yoga Teacher is a series that comes out on the first Saturday of each month. If you have yoga questions you’d like me to answer, comment below! You can also email me to reach out!

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