Knee Deep in Yoga

Yoga can be a source of knee pain or the ideal therapy. Here's a primer on keeping the joint healthy on and off the mat.

By Catherine Guthrie

The chorus of pops emanating from Kyle Ray's knee was his first clue that his body wasn't happy in Padmasana (Lotus Pose). It was the end of a relaxing yoga class in Louisville, Kentucky, and the teacher had instructed everyone to assume a seated position for some chanting. Sure, Ray's knees had acted up on occasion, but he'd gotten himself into Lotus before and was confident he could do it again. He slowly nestled his left ankle into the crook of his hip. Then, grabbing his right calf, he used his arm strength to muscle the top leg into position.

"The noise was awful," says Ray, 31. A second later, a quick, sharp pain shot through his knee. He gingerly unfolded his legs. After class, it was all he could do to hobble home and place an ice pack on the swelling joint. It took six months for him to be able to walk without pain. Although his knee pain did subside, Ray still frets about the stability of his knees and generally avoids knee-taxing postures like Virasana (Hero Pose).

There's no doubt that yoga asks much of the knees. Done properly, asana practice can shore them up to prevent injuries and slow the progression of some musculoskeletal diseases, but practiced without mindfulness, it spells disaster for these joints. Clearly, there are just as many people who credit yoga with rehabilitating weak knees as there are determined yogis like Ray, who will themselves into complex poses and pay a big price for overdoing it. But in poses like Supta Virasana (Reclining Hero Pose), in which the knees can feel pushed to the edge, it's sometimes hard to know if you're helping or hurting them. So what's a yoga practitioner who's concerned about protecting the knees to do? Nothing can replace the guidance of an experienced teacher, but certain principles can guide you into a safe, beneficial practice.

Weak in the Knees

The knee marks the meeting place of three bones: the shinbone (tibia), the thighbone (femur), and the kneecap (patella). Two crescent-shaped pads of cartilage, each called a meniscus, sit between the shinbone and the thighbone and act as cushions between the bones and shock absorbers during movement. Two sets of ligaments—the cruciates and the collaterals—strap all three bones in place. The cruciates crisscross below the kneecap; the collaterals run alongside the outside of the kneecap. The leg's substantial muscles help these ligaments keep the bones properly aligned.

Unfortunately, the knee's mechanics are better suited to chasing animals for dinner than to sliding into second base, says Stephen Messier, professor of health and exercise science at Wake Forest University in Winston-Salem, North Carolina. "We weren't designed to do the things we do with our bodies nowadays," he explains. "The knee's engineering isn't the greatest."

And it shows: Every year, nearly 11 million Americans complain to doctors about knee pain. Orthopedic surgeons operate more often on the knees than on any other body part; they performed more than 1.2 million such surgeries in 1996 alone (the latest year for which figures were kept).

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