The Bee’s Knees

Yoga, when practiced with careful attention to alignment, can keep your knees healthy. In this post, Dr. Baxter Bell explains how.
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You’ve probably heard the quirky phrase "bee's knees" at some point or another. It means “excellent, or the finest quality.” The function of your knee joints is imperative to daily life, so it's vitally important to keep them in "bee’s knees" condition. Unfortunately, life tends to take its toll on this oh-so-important joint in our legs. Luckily, practicing yoga with careful attention to alignment, can help keep your knees healthy. But, before I get more into that, let's talk about how the knees work when they are in good functioning order.

The knee joint connects the large upper leg bone, the femur, with one of the two lower leg bones, the larger tibia. The patella, commonly referred to as the knee cap, is a shield-like bone at the front. Where these three bones intersect is surrounded by a sleeve of strong, yet slightly moveable, connective tissue called the joint capsule, and is reinforced with a number of interior and exterior ligaments that go bone-to-bone to keep everything in close contact. Inside the sleeve is a closed off space that contains fluid that acts to a keep a bit of space between the bones and provide lubrication for when the bones move past each other, like when you bend the knee to climb a set of stairs. The ends of the bones have a coating of cartilage that is slick and acts as a cushion when healthy, but can wear out over time from improper movement patterns, injury, or disease. The thicker cushions on the top of the tibia, called menisci, can also wear out.

Since humans became upright so many eons ago, the knees have been taking on more and more responsibility for our movement and standing ability. A lot of weight drops down through the joint, so it has to deal with the effects of gravity more than other parts of the body (with the exception of the ankles and feet). The knees' overall function is influenced by the joints above and below. All the activities we have been engaged in over the course of our lives have left their mark, like the football played as a kid, or the ballet lessons we took for years. Genetics also play a part. In my family, for example, we have a history of arthritis in the big joints, so my mom had to have both her knees replaced a few years back because walking was so painful.

Yoga, especially styles that pay close attention to good joint alignment, tend to support the health of the knee joint. We know from research that the cartilage of the joints gets positive stimulation from moving the joint through a full range of motion, like when moving into poses where the knees are deeply folded, such as Child’s Pose. In addition, flowing sequences, like Sun Salutations, if done with attention to the knees bending and straightening without a lot of side-to-side sway, could have the same beneficial effect for the knees.

Improving the stability of the knee joint, so we can stand well without pain, happens via many of the straight-legged standing poses. By concentrating on building strength in all the muscle groups around the knee joint (the quads, hamstrings, adductors and IT band), you will help the bones line up in a healthier relationship than they might otherwise. So Mountain, Triangle, Pyramid and other poses in this class would be good to add into the mix.

Also, I like to have students hold a block between their thighs in poses like Mountain to activate and strengthen the vastus medialis, the quad muscles to the inside front of the thighs that tend to be a little weak. When this muscle is of is weak, the kneecap tends to pull to the outside front of the joint and can cause uneven wear on the backside of the bone, which could lead to pain and swelling over time. The block squeeze in Mountain, going into Forward Fold, or down into Chair Pose, can help build that weak muscle into a strong one, keeping your knees healthier for the future.

In general, if you are new to yoga and start at a beginning level and advance slowly and mindfully, you will find the practice is wonderful for the health of your knees. There are exceptions to this, as yoga tools applied improperly can sometimes put the knee at risk for injury. I will take this up next time with recommendations on how to prevent unwanted side effects from the yoga you love.