Knee pain in seated position and hip opening poses only


#1

So I have been taking these online classes from Youtube/BohoBeautiful and the classes are great I am seeing improvement in most if not all areas. One of my main problems has been while in seated position I have been getting pain in the lower outside part of my left knee, just below the head of the fibula (trying to be as specific as possible). It’s a bout a 2 inch targeted section that consistently gives me trouble. I thought it was strictly due to my limited flexibility because as I trained it became progressively easier to completed the seated pose.

Today i was trying to complete the following pose during a hip opening routine

Please don’t be distracted by the extremely attractive instructor this is serious lol.
During the pose my same troubled left knee Cracked / popped right in the target pain area that I thought was getting better. I know from my old bio-mechanics and pathology classes that cracking / popping can be either an adjustment, breaking up scar tissue, which tho can cause soreness is ultimately helpful, OR some type of structural damage. I am not sure of which of the 2 this was, hence my problem. My immediate plan is to take it easy for a couple days to see if it goes away. This only happened 3 hours ago. I’m hoping I don’t have to waste days going to the Dr. for eval and it winds up being nothing.

Any advice will be appreciated.

AJ


#2

Hi AJ, how are you doing? How is the knee?

I had a similar situation with my knee, and this is what I learned. I am not much of an anatomy expert, but it may be of use to you.

In the seated hip openers, like agnistambhasana, what should be happening is that the femur should be rotating externally in the hip socket. When this happens sufficiently, the legs rest easily on top of each other. The problem I experienced (for me, in pigeon pose) was that the femur was not rotating that much. By “going deeper” into the pose, I was creating flexion at the knee joint, which stretched the outside of the knee, eventually creating pain like you described. I also experienced the poses becoming easier and eventually had a similar popping sensation. Preceding the eventually problematic pop, there were some very minor pops that seemed to not cause much harm as far as I could tell at the time and which I largely ignored (not the best decision). I experienced a similar pain sensation around that area near the knee in seated postures like sukhasana, which also require a good amount of hip rotation. For me, it really all seemed OK (or at least I could believe that) until it really wasn’t OK at all. At that point, it took a few months to heal and get back to a place where I felt more comfortable with the knee again, especially in hip openers.

The pictures you posted show the knee being pushed down. As someone having had this experience, I do not see how this would create the desired rotation of the femur without also creating flexion at the knee joint, particularly expansion at the outside of the knee joint that would stretch the ligament there (though some may have sturdier knees than me). Stretching the ligaments around the knee is not desirable to do even if it may produce a stretching sensation in the hip. Ligaments are not very stretchy and heal much more slowly than muscles.

In my case, after the pop, I had to back way off of hip openers, pretty much doing no hip openers for some time, then only very gentle eye of the needle with support of a wall, then advancing to more poses with caution. I paid very close attention to any sensation around the knee during hip openers and other seated postures and backed off if there was any (which was of course was what my teachers had always advised). At the same time, I focused on making sure the knee was aligned in all poses, activating and strengthening the quads (particularly the vastus medialis) to help stabilize the area, and stretching the IT bands (which were tight on me and also creating tension around the knee). Your body may have different issues. Probably needless to say, my hips lost a lot of flexibility during this recovery time as there were few ways to stretch them without creating pain/injury around the knee. The flexibility in the hips is coming back.

I am now more careful with pain on the outside of the knee and more careful to distinguish in general between pain and soreness from stretching or strength work. I feel that had I backed off and resolved the issue earlier, the recovery would have been quicker and I would have made more real progress over that time period. Pushing onward was not worth it at all. As it was, I learned something about recognizing sensations in the body, respecting the body (especially the knees!), ahimsa, non-forcing, patience, caring/compassion, gratitude and other things. These were great lessons, but I think maybe it is better to learn them without injury if possible. Yoga has a great ability to heal when practiced mindfully, but is perhaps equally powerful when practiced unmindfully.

Best wishes and happy practicing! Namaste.

M


#3

HI AJ,
I agree with the many things M said. I am a physiotherapist and spend a lot of time treating people with this issue. It sounds to me like possible damage to your meniscus. On my trainings I have a golden rule. “There should be no pain in the joints when practicing asana.” There are many subtleties to this rule, but the essence is that the structures in the joints generally shouldn’t be stretched eg, ligaments, cartilage or menisci.
Your issue is most likely limited hip external rotation which you are compensating at the knee.
I made an attempt at a youtube video that illustrates this issue when looking at padmasana.
You can check it out here.


#4

Thanks a lot. Sucks I cant be aggressive on my progress but this seem like sound advice. Thanks for your kind words and professionalism.


#5

man… this stinks. should I see a physician in the interim?


#6

I would go to a physiotherapist. They will be able to diagnose you


#7

@Need2Stretch You diagnosed the problem correctly. You suggested the best remedy also. In my view too, it will be progressively easier and eventually will go off. Don’t get rid of your routines. Don’t add-on anything or don’t overdo until this will get over.

Hope it will be ok soon. Have a nice time.


#8

Sorry about you pain. In fact, the pose you refer to is hard and is a quite advanced pose. I really do not know why all most pop-yoga classes start in seated position, since they are advanced poses.

The golden rule is - knee pain comes from hip tightness. May not be your case, though. Hard to tell without seeing… Post pictures or video, if you do not want to do that then PM me I can tell you more. Consider practicing sitting poses on the elevation (blanket) and read on Ahimsa is asana.

Good luck and keep us posted.