New member seeking help- Vajrasana, childs pose - seated knee pain

Greetings everyone. I joined in hopes to assist my healing progression with my left leg, glute, and hip. I cannot sit back onto my knees (Vajrasana or childs pose). I am currently seeing a PT guy who uses myofascial release on my it band along with deep tissue massage on my TFL, quads, calf and glutes.

I lead a very active lifestyle with swimming usually MWF and strength T, TH,Sat. To loosen up I must perform a hip focused warmup daily prior to my workouts.

Things that exacerbate my problem- bent over activities like mopping and sweeping shoveling and such. I think I have a movement pattern that forces my psoas to be overactive which tightens my gluteal muscles and quads causing a hip impingement.

The last time I saw my PT guy I had him focus a little bit on my psoas and I felt really good for about two days. I would like to ask you all if a chronic tight psoas can cause my issues and what muscles may be inhibited that I can try strengthening. I recently just started stregthening excercises on my psoas by performing banded knee raises while laying on back. I have only been doing this about a week and a half.

I have had this problem for many years but only recently have I started focused muscle imbalance targets. I found out about 6 months ago That my left glute was shut down and I would say it is still about 25% weaker than my right glute but it is getting stronger with my hip and glute routine. Please help I am desperate to get back into yoga and life. Chris

Hi Chris.

Mind sharing your background? You’re using terms in much the same way a personal trainer might and I’m wondering where the vernacular is coming from. I ask because there’s a level of anatomy requisite for a yoga teacher - less so for a student. And that level I’ll call “applied anatomy”. I’m very thoroughly trained and I’ve never once told a student “your glute isn’t firing” simply because it’s generally an approach of other modalities (Pilates, Strength, P/T …).

Since you are opting to use Vajrasana as your model can you expound on the issues there? You state “cannot” but you’ve not even alluded to what feels bound or obstructed or painful in so doing. You’ve also mentioned some inhibited activities which fall into the “bending over” category. What can you tell us about your hamstring opening in the context of your asana practice? What does Supta Padangusthasana look/feel like to you?

Good Morning and thank you for your time. I have no training whatsoever in the medical field. I am an auto parts manufacturer. My language, or terminology, comes from years of on/off phys therapy, and online study of my issues.

I discovered my glute was inhibited thru other injuries that surfaced when I ramped up training for a triathlon. My left quads and other muscles were compensating which caused my IT band, quads and such to become chronically tight (and still is a bit), and the whole issue gave me problems in my left knee when running.

Vajrasana- This is what I have the most problem with since it involves such deep flexion of the hip and knee. I can almost sit completely back on a good day, when I am properly warmed up, and I perform it slowly by rolling up a towel and my yoga mat, and placing it between my calves and sit bones to allow me to relax into position. If just out of bed, forget about it, it begins hurting the moment I start flexing backwards.

Supta Padangusthasana- This is something I kinda forgot about recently. My phys therapist mentioned this may cause pressure on my nerves (sciatic maybe, don’t remember) with my leg straight, so I started leaving this out of my practice. I did however do it this morning for you after I was slightly warmed up, and I could only extend left leg approx 70 deg while right leg about 80deg. I gained about 5 degrees per side during the stretch. It felt tight/ tender where hamstring meets the glute and basically tight along entire back of leg. It did however feel a bit better after, so I may start trying to incorporate this back into my daily routine.

Ardha matsyendrasana- I do this often and it feels good, I really feel the pull in left hip and glute, sometimes difficult bending left leg in front.

This note may also be of importance. When attempting pigeon pose, right leg in front, I can barely extend left leg backward (probably only about 50% back). Performed with opposing leg however, I can almost get right leg all the way back straight, probably about 80%

I hope this helps, Chris

Okay Chris thanks for the additional information. I’m going to run through your reply top to bottom so I am following your logic (not mine) :-).

When you say “I discovered” does that mean you have felt the compensation of muscles? I ask because it (again) sounds like you’re being diagnosed as such by a P/T. If it is you and sensing, fine. If it is a P/T the issue becomes one of modalities and accurate assessment. And yet in what you say later about pigeon it does sound like there’s additional obstruction in the left quads.

Vajrasana requires less hip flexion than Dandasana. So please sit in Dandasana and let’s see if hip flexion is really at issue. My guess is we’re heading to chronically tight quads on the left side and since the Rectus Femoris crosses two joints (pelvis and knee) it may be the offender. There is also the possibility of the Sartorius as an offender or contributor.

Again in this section you say “begins hurting” but are not specific. Where does it hurt? Is the pain in a joint? Is the pain sharp or dull? Is the pain constant or intermittent. Please and thank you. For the moment please sit instead in Virasana with as much height under your sitting bones as necessary for comfort. The pads or blocks should run left to right rather than front to back. In this way the SITTING bones (there are no sit bones because sitting is an adjective) are supported and not collapsing.

Supta Padangusthasana is performed in a supine position (lying down on the back). In this way it is stabilizing for the low back and the sacrum. As long as the three requisite actions are being performed there’s no risk of impingement to the sciatic nerve whatsoever. Assuming you are doing it correctly as per instruction by a sound teacher, please do 12 breaths on the left, 3 on the right for 6 weeks.

Ardha Matseyndrasana is a closed twist and it is inappropriate for beginning students. But it is up to each person what they do in their practice as they are the one who will hash out the consequences of their choices. Feeling good may be one indicator but it is not the only.

Pigeon pose (eka pada rajakapotasana) [I]requires[/I] hip opening in the front leg (external rotation and abduction) and in the back leg (hip extension and internal rotation). As such, the preparation for such a pose is a 60-90 minute session targeting the above. To do the pose when the required opening is not available is to place the hip joint and sacrum/SI joint at risk. Again, do as you like but I assure you this is sound information based on decades of study.

I would add a pose to your practice and that pose is eka pada supta virasana. Please sit on a block or bolster such that the shin bone of the leg folded under is on the floor. Note that the inner knee and the arch of the opposite foot touch one another at the mid line of the body (mid sagital plane). ( breaths on the left, 3 on the right:-)

gordon

[QUOTE=InnerAthlete;87363]Okay Chris thanks for the additional information. I’m going to run through your reply top to bottom so I am following your logic (not mine) :-).

When you say “I discovered” does that mean you have felt the compensation of muscles? I ask because it (again) sounds like you’re being diagnosed as such by a P/T. If it is you and sensing, fine. If it is a P/T the issue becomes one of modalities and accurate assessment. And yet in what you say later about pigeon it does sound like there’s additional obstruction in the left quads.
[/QUOTE]

Since this is going to be a long response on my part let me preface this by saying thank you. I don’t quite understand how one has the time to donate their knowledge in such a selfless way. Don’t think your generosity is taken for granted.

Let me begin- I was getting a sore knee from running due to IT band syndrome. I concluded this by researching my symptoms via the internet. I chose to visit a local PT who offered a runners clinic. He ask me to perform some quick strength tests like standing on one leg then videoed my running on treadmill. He determined my left hip and gluteal muscles were weak and my IT band was tight from the overworked TFL and hip flexor region that was compensating. He put on a regimen of side steps with mini bands, hip hikes on step or block, clams with band, TFL stretch… This regimen was helping and I was beginning to run again, but I also continued research on my own pertaining the glutes. I realized one day while standing at my work computer I had difficulty flexing /engaging my left glutes. I could engage my right glutes and feel them tighten. My left glutes- hardly anything. This was a couple months after I started my hip strengthening routine. At that point I incorporated some form of glute focused excercise into my workout regimen. I now do a 20-25 minute morning warmup routine that includes some things like bridge pose, reverse leg raises…and more, I can post the routine if you’d like. On my off swimming days I try to do a glute focused workout that includes squats and such.

Vajrasana requires less hip flexion than Dandasana. So please sit in Dandasana and let’s see if hip flexion is really at issue. My guess is we’re heading to chronically tight quads on the left side and since the Rectus Femoris crosses two joints (pelvis and knee) it may be the offender. There is also the possibility of the Sartorius as an offender or contributor.

Dandasana is no problem whatsoever

Again in this section you say “begins hurting” but are not specific. Where does it hurt? Is the pain in a joint? Is the pain sharp or dull? Is the pain constant or intermittent. Please and thank you. For the moment please sit instead in Virasana with as much height under your sitting bones as necessary for comfort. The pads or blocks should run left to right rather than front to back. In this way the SITTING bones (there are no sit bones because sitting is an adjective) are supported and not collapsing.

I attempted Vajrasana earlier (to try and help describe my pain) and the pain seems to begin or centralize at the front lower part of the knee. I say “seems” because it is very difficult for me to differentiate where the pain is. It hurts (sharp pain) in the knee but feels like it radiates up into the hip. When I lay on my back however and pull my leg into my chest there is no pain in my hip, until i flex my knee, then it hurts in front lower knee with minor pain in hip.

Virasana was possible with block upright longways under sit bones with some pain.

Supta Padangusthasana is performed in a supine position (lying down on the back). In this way it is stabilizing for the low back and the sacrum. As long as the three requisite actions are being performed there’s no risk of impingement to the sciatic nerve whatsoever. Assuming you are doing it correctly as per instruction by a sound teacher, please do 12 breaths on the left, 3 on the right for 6 weeks.

okay

Ardha Matseyndrasana is a closed twist and it is inappropriate for beginning students. But it is up to each person what they do in their practice as they are the one who will hash out the consequences of their choices. Feeling good may be one indicator but it is not the only.

Okay, I will perform with caution, thanks

Pigeon pose (eka pada rajakapotasana) requires hip opening in the front leg (external rotation and abduction) and in the back leg (hip extension and internal rotation). As such, the preparation for such a pose is a 60-90 minute session targeting the above. To do the pose when the required opening is not available is to place the hip joint and sacrum/SI joint at risk. Again, do as you like but I assure you this is sound information based on decades of study.

So it sounds like I should avoid pigeon altogether. I consider myself very beginner.

I would add a pose to your practice and that pose is eka pada supta virasana. Please sit on a block or bolster such that the shin bone of the leg folded under is on the floor. Note that the inner knee and the arch of the opposite foot touch one another at the mid line of the body (mid sagital plane). ( breaths on the left, 3 on the right

This hurts me just looking at it. My leg will not flex like that. I looked it up, and tried it, and could not get into position w/o the aforementioned knee, leg, hip pain. The sequencing mentioned to revert back to low lunge if there was pain in the knee, which I did, but probably not long enough to make a difference. I will need to attempt this when I have more time to warm up into it and spend more time stretching in low lunge. Note*- low lunge exhibited a strong pull along front of quads up to outer hip so your brief mention of tight rectus femoris may be on target. I’ve also come to realize what I thought was hip pain I believe is mostly from my knee.

Hope this helps.
Thank you, Chris

Yoga teachers who are impassioned for their work give selflessly all day long. But your point is well taken and I’m often better served dedicating my time to contact-hour students here. That said, I don’t like mixing modalities and I surely don’t like getting all mucked up in P/T stuff. We don’t do the same things, look at the world in the same way, or treat the body similarly - even though it appears “the same”.

There should be no SHARP pain in a joint in asana, ever. Period. Dull pain is okay. Sharp in the joint is not. Do whatever is necessary to avoid sharp pain in the joint.

Here’s what I have in mind for you in Eka Pada Supta Virasana.

This is Olympic Track and Field star Norris Frederick.

You also need to focus on everything in your day to day life that has caused this issue.

Once you get problem in any part of your body, brain tries to find out other alternative paths to achieve center of gravity and movement patterns.

Even in case if your therapy is working on you, you may observe same or new problem again because old patterns which may still be interfering.

So you need to train your mind (in addition to therapy) to function correctly and keep avoiding anything that is exacerbating it.

[QUOTE=InnerAthlete;87365]Yoga teachers who are impassioned for their work give selflessly all day long. But your point is well taken and I’m often better served dedicating my time to contact-hour students here. That said, I don’t like mixing modalities and I surely don’t like getting all mucked up in P/T stuff. We don’t do the same things, look at the world in the same way, or treat the body similarly - even though it appears “the same”.

There should be no SHARP pain in a joint in asana, ever. Period. Dull pain is okay. Sharp in the joint is not. Do whatever is necessary to avoid sharp pain in the joint.

This is Olympic Track and Field star Norris Frederick.[/QUOTE]

Gordon, thank you for your response. I understand it must be frustrating when clients come to you asking for you guidance while describing there problems through a physical therapy modality, as you put it. Please understand this is the only channel in which I have to describe my issues, but that I do now seek my healing through yoga.

That being said. I warmed up this morning and tried Eka Pada Supta Virasana as in the photo. It was a bit painful even with a small stool and my yoga block on top, but I stayed with it and after a few minutes I felt the quad loosen a bit and ease up on the knee pain, at which time I took out the block and added two books, then one book, then no book and just the stool.

I have to say I felt very good afterwards and I am eager to start working on this. Can I do this twice a day if I have them time? Again thank you.

[QUOTE=SohamYogaStudio;87366]You also need to focus on everything in your day to day life that has caused this issue.

Once you get problem in any part of your body, brain tries to find out other alternative paths to achieve center of gravity and movement patterns.

Even in case if your therapy is working on you, you may observe same or new problem again because old patterns which may still be interfering.

So you need to train your mind (in addition to therapy) to function correctly and keep avoiding anything that is exacerbating it.[/QUOTE]

I agree that I do have a faulty trained muscle memory somewhere that causes these problems to come back and stick with me, it is difficult to determine what movements, but I feel it is becoming easier for me to pinpoint as I strengthen my weak areas. Thank you for the reminder!!!

First is that I completely agree with what Umesh has shared. At the same time this is a much bigger truth for most of us to hear and in my opinion such concepts are shared after a trust relationship is built between teacher and student. In other words, I don’t “go there” with beginners because they can’t hear it, aren’t ready for it, and it can push them away rather than draw them in. But I respect other approaches. This just happens to be mine.

It is not so much a matter of frustration for me with clients and these other modalities when they SEE me because I have an intake. I get to assess them in real time and I can hear about their stuff and move on. Over the internet it is not like that. So I bring it up with you Chris because I cannot mix the water of yoga with the oil of P/T and have either of us expect a blending.

As for the posture itself, it is crucial to experience some physical relief. Otherwise despair and frustration sets in and not much happens in such a pond. So I’m glad this was possible for you. You may do it twice a day but it is far more important that you do it regularly with discipline than it is that you do it many times. So pick something you can keep to.

Additionally, it matters very little what your expression of the pose is as long as you are mindfully moving toward rather than away from the full expression. So whatever height works, works. No aggression in the doing whatsoever.

Now to this posture add two actions: the pressing of the thigh bone into the knee joint and the drawing of the bottom of the belly on that side up toward the ear. Direct your breath into the discomfort using your mind/awareness. See if you can actually use the breathing mechanism to pacify the discomfort.

gk

Thank you for your input! I’ll work on this.