In America, close to 9,000 people received medical treatment for yoga-related injuries in 2004 and 2005, according to the US Consumer Product Safety Commission. The good news is there are only two yoga injuries reported for every 10,000 times yoga is practiced, according to American Sports Data.
Injuries can actually be great teachers. They invite you to reflect on your own practice, find out what you do wrong and make corrections.

Of course the best way to deal with injuries is to avoid them, but if you already have them, you can learn the proper techniques to incorporate into your practice to help heal the injuries.
For the next three issues, I will focus on the three areas most vulnerable to injuries: the inner knees, hamstring tendons and sacroiliac joints.

These parts are vulnerable to damage and take time to mend.

You can easily adjust your practice to avoid injuries to these areas to help heal them, but you first need to understand what causes the trauma to these areas. This first of three articles on yoga injuries deals with that which affects the inner knee.

Knees  
If you’re new to yoga, have tight hips or have had issues with your knees, and are told by teacher in your class to place both feet on the upper thighs of the opposite legs in padmasana or lotus pose, resist the temptation to get yourself into the full pose, even if everyone around you seems to be able to do it easily.

Forcing your legs into this position might cause a frightening “pop” in the knees, followed by years of pain and limited mobility.

When people hurt their inner knees doing yoga, it’s usually because they’ve tried to force a leg into Lotus or one of its variations.

Sometimes the injury occurs after one or both legs are already in Lotus position and yogis attempt a pose that adds a back-bending movement, such as matsyasana (fish pose) — where they arch their back and place the crown of the head on the floor — or forward bending movement as in ardha badha padma pashcimottanasana (half-bound lotus seated forward bend).

To get into the lotus position safely, your thigh has to rotate outward about 115 degrees. Bone structure or tight muscles and ligaments can inhibit the movement, so for many people this pose is unattainable, especially at the beginning of the practice.

If you keep lifting the shin and foot past the point where your thigh stops rotating, you’ll bend the knee joint sideways. This will pinch the inner-knee bones together — the upper inner end of the shinbone pressing against the lower inner end of the thighbone.

The media meniscus, which is a protective rim of cartilage that pads the knee joint and guides its movement, lies between these bones. If the thighbone doesn’t rotate enough, you’ll apply tremendous pinching pressure to the meniscus. Forcing this lift, even moderately can do serious damage.
Similarly, if you are in lotus and your top knee is not on the floor, pushing that knee downward can apply enormous damaging force to the meniscus.

Preventing and healing
Again, the best thing to do to an injury is to prevent it. Never force your legs into any lotus variations — either by pulling the foot strongly upward, pushing the knee downward or thrusting your body forward or backward.

Don’t let your yoga teacher push or pull you into any of these poses either. Stop going deeper and back off if you feel pressure or pain in the knee.  

As you go deeper, you should feel stretching or releasing sensations around the hip area, the area that needs to loosen up in these poses.

Virasana (hero pose): JP/P.J. Leo

The safest way to practice the lotus and related poses is to strongly rotate your thigh outward at the hip and not go deeper into the pose when you reach the limit of your outward rotation.

Stop lifting your foot when your thigh stops rotating, so you may not get your foot on the opposite thigh. If your knee ends up dangling in midair, support it with a folded blanket so you do not force it downward as you turn the thigh outward.

If you have already injured your inner knee in lotus or a related pose, the first thing to do is leave it alone. You need to rest, ice, elevate and compress it for a few days to reduce swelling and inflammation.
If the injury seems serious, seek medical attention. You should, however, reintroduce some range of motion to the injured area as early as you can by gently flexing and extending the knee to the extent possible.

Have a qualified instructor develop an individualized yoga program for recovery. There will be some modifications to your yoga practice to help protect the injured knee and to heal it.

With basic standing poses like trikonasana (triangle pose) and virabhadrasana II (warrior II), alignment must be precise, and if necessary, support your body with a chair to take weight off the knee.
Increase your range of motion by doing these two seated poses:

• Virasana (hero pose)
Elevate your pelvis as high as is necessary with folded blankets to avoid pain in the knees. Align your heels directly under your outer hips. Keep your knees slightly apart with you thigh bones parallel. Place your feet in line with your shins. Sit in this position for several minutes every day. Gradually lower the props depending on the rate of your recovery.

• Padmasana (lotus pose)
Set up blankets to support your pelvis and bend your knee. Sit in dandasana (staff pose) with both legs extended. Bend one knee and place a washcloth or blanket behind it.  Keeping the knee firmly bent, grip the end of the cloth in one hand and pull toward your body and out to the side to open the inner knee and rotate the thighbone outward.

Continue this rotation as you lift your heel with your other hand and place your foot high atop the opposite thigh, near the hip if possible. Stop you experience knee discomfort.

Eventually, begin to practice rotating movements like baddha konasana (butterfly pose) and supported lotus, but remember to do so gently and always listen to your body, and feel the sensation as you go in and stay in the pose.

Namaste.

— Photos by JP/P.J. Leo


The writer is a yoga practitioner and teacher. “Yoga Connection” is a regular column on all things yoga, appearing every second week in the Body & Soul section. For questions and comments, please email her at dasmaran@indo.net.id.

Popular

No more motorcycles for free meals program, says Purbaya

New justice puts Constitutional Court in spotlight amid TNI Law petitions

Govt insists on growth target as World Bank lowers forecast