Written by Lucy Alves
The Key To Healthy Knees
What does our knees look like on the inside and why is proper alignment so important in a multitude of movements? Especially weight bearing, and I mean more than your body-weight, although that can be a problem for some people too.
The shinbone (Tibia) meets the thighbone (Femur) and is shielded at the front by the kneecap (Patella). Two crescent shaped pads of cartilage (meniscus) absorb shocks during movements and a set of ligaments (cruciate crisscrossing behind the patella and collaterals running along the outside of the kneecap) to hold the bones in place. There are also extensive leg muscles to help these ligaments to keep the bones in their right place.
Enough of the dry stuff now, let’s see what Yoga can do for you to help you get a better alignment in your knee and reduce the wear and tear on the cartilage in your knees.
First thing we want is equal co-contraction on both sides of the knee to prevent the knee from rotating as it bends, pulling the kneecap towards the side of the stronger muscle. For the simple reason that this will wear down one of the meniscus faster than the other and over time the bone that the cartilage protects.
The Yoga postures that follow will help you create that equal co-contraction and precise alignment on your road to a healthy knee.
First things first. The feet! Yes, if you mis-align your feet, it later affects what happens in your knee.
If you turn your feet out, the knee rotates out of alignment and will suffer when you move and bend the knee.
Place your feet straight and forward, not too wide and try to spread your toes and press evenly down into the ground with the four corners of both feet.
Make sure you never lock the knee out by pressing the knee back and hyperextending the leg. Hold on to a micro-bend in the joint. If you suffer from hyper-mobility this will feel as if you have your legs bent and takes quite some practice and awareness to learn how not to fall into that bad habit again. But that is a topic for another time.
The knee is a relatively small joint. To help work the knee healthily we first need to open the bigger joint directly above it. Open those hips before deep knee work!
Let’s return to a good hip-opener, Baddha Konasana.
Place the soles of your feet together and release your hips open. Take your feet into your hands but don’t pull them up, instead push your feet through your hands into the floor while you keep your spine straight! Hinge forward slightly, from the hips and place your elbows on the inside of your thighs, don’t push your legs out! Instead keep them in place while you try to close your legs. Hold this contraction for a good 8 breaths and then on a long exhale sit up and let your legs fall open. Repeat three times.
**If you suffer from tight hips you might want this to be a daily stretch**
The first real knee/leg strengthening exercise is Utkatasana.
We are going to start by using the wall. Place your feet as wide as your hips. Not the outside of your flesh, but where the femur enters the pelvis, so where the hip joint actually is in the skeleton. Remember we want that straight alignment for the healthy knee. Stand far enough away from the wall to be able to bend the knee into a 90 degree angle with the back against the wall.
Then lift your arms as high as you can manage without arching the ribcage forward. (remember how we lowered our ribcage in the previous Core exercises?) If you can bring the straight arms high enough up so that the wrists are aligned with your ankles.
Most important though is having your knees aligned with the second/third toe making sure the knees do not move toward each other nor flare out. To achieve that try to drag your feet apart while holding Utkatasana.
Now you know how to stand, release the hips and keep the patella aligned you should also know how to train the body to do all of this on reflex. The best exercises for this are balances on one leg such as Vrksasana or Tree Pose
But also Garudasana or Eagle pose, which not only gives you the balance but also lots of quadriceps strengthening and at the same time hamstring release. Remember how reciprical inhibition works? When engaging one half of of a pair of synergists the other half releases, so in engaging your quads you automatically release the hamstring. It might not be an active stretch but it does the job for now.
How does this balancing work to help the knees? Balancing while bending, moving through the knee (bending it) is a dynamic balance and not only strengthens the knee but trains the functional alignment as what happens when we walk? Every step is even for the smallest of moments a dynamic balance in which the knee automatically has to align into the right position. Practicing for example Garudasana helps the mind/muscle connection to grow and the functional alignment become an automated response.
How do you get into Garudasana? Let’s focus on just the legs for now. Shift your weight on one leg and cross the thighs. Either put the toes of the top leg to the floor on the outside of the foot of the standing leg while you bend that leg, keeping the upperbody in Utkatasana position, or wrap the foot around the calf of the standing leg. Hold your seated position for 5 breaths and then gently release the top leg to change side.
“Rule number one! Listen to your body, there is no gain in pain!”