Dear Mukunda,
I am worried about a (sporadic) yoga student. She is awakened at night by pain in the lateral part of her right knee. She pointed to the TFL, and when I felt the knee, the gravelly movement is under the patella . She says that when she wakes up and straightens her leg, the knee pops and then pain shoots up all the way to the shoulder and down to the foot.
She originally asked me about a right shoulder injury she got. She wrenched it on a medicine cabinet about three weeks ago and it was very sore. Due to the soreness, I did not evaluate her muscle strength, but just asked her questions. She has a pronounced right thoracic scoliosis and tells me that she had to wear a cast for six months at the age of 15 ( she is in her mid 30s). Her right scapula wings back and she has always had pain in the left hip and knee. However, this new pain is all on the right side. Also, lately she has had trouble breathing. She says her chest feels restricted and she can’t take deep breaths. This is what alarms me. She says she has no neck pain. She is icing both sides of her body each night before bed, and still going to work and riding her bike! The pain that wakes her at night has been happening for the last three nights. She has tried physical therapy in the past with poor results and seems reluctant to do that again. She does not take pain relievers, and she is slim with generally low muscle tone in the upper body. Can I give her some breathing exercises? Should she lay in bed a certain way? Should I send her to a doctor? I did tell her to stop putting ice on her muscles for now.
Thanks for any help you can give me.
Namaste,
A - When you have a concern for student that has not seen a doctor, you must act on that impulse and encourage her to see one. Especially if you feel that what is needed is beyond your skill. I can see her in addition to her seeing a physician when I come there. With a scoliosis there are many regions that can respond to it. If she truly had only a right thoracic curve and not a lumbar then it is unlikely that symptoms to the knee would arise from that. The knee issues sound like need for stretching the IT band with reclining Gomukhasana pose. This may also lessen the tension on the patellar tendon. For pain relief I would recommend that she develop the wave breath of Ujjaye and begin to encourage exhales and sighs. Also she can work with intercostal breath motions to relieve the thoracic and shoulder symptoms. AS far as bed position it is always the most comfortable that she can find. In general I recommend students fall asleep by lying on the right side as this opens the parasympathetic dominated left nostril flow (Swara). Namaste