Yoga for knee health

Le Bouchier, Écrins, France. Crag approaches with a heavy sack take a toll on the knees.

Climbing and other outdoor activities keep us healthy in many ways.  One exception is the wear and tear our activities inflict on our knees!

Crag approaches are often arduous: steep; on rough ground; and usually carrying a heavy sack of gear.  Climbing moves such as rock-overs and drop-knees also put unusual strains on the knees and supporting soft tissues.  No wonder so many of us suffer from effects of wear and tear in our knees.

Chuffed to have done The Corner, but the descent from the Cromlech is knee hell

Yoga can’t reverse that wear and tear, but regular practice can help our knees stay more resilient by:

  • Maintaining range of motion
  • Strengthening the muscles which support the knee. The knee is a very mobile joint and the muscles play an important role in stabilising it.
  • Building awareness of knee alignment. Exercising barefoot, as we do in yoga, promotes proprioception – awareness of our own body position and movement.

Another cause of knee pain is muscle imbalance. Prolonged deskwork or driving can cause the hip flexor muscles in the front of the hip to tighten, and the gluteal muscles in the side and back of the hips to weaken. Strong glutes are key to holding the knee in correct alignment; if they become weak the knee tends to buckle inwards (especially walking downhill). Unfortunately climbing, with its repeated leg-raises, can reinforce this imbalance. But there are plenty of yoga poses which can help, by releasing the hip flexors and strengthening the glutes.

The first part of this article suggests yoga poses to help maintain knee health. The second part suggests ways to modify your practice if you need to reduce the strain on your knees.

The suggestions given here are not a substitute for medical advice.  If you have a knee injury or a chronic condition such as arthritis of the knee, always seek advice from a qualified health professional such as your family doctor or a physiotherapist about which forms of exercise are suitable for your condition. 

The physical practice of yoga was originally to prepare the body for seated meditation, so many poses involve deep flexion of the knees. Donautal, Germany.

Maintain range of motion

If classic poses such as Easy (cross-legged) (Sukhasana), Hero (Virasana) and Child (Balasana) are available to you, this will help you maintain a full range of motion in your knees. 

If your knees cause you pain or discomfort in these poses, try unweighted poses such as supine Knees to Chest (Apanasana). With a hand on each knee, try taking the knees round in gentle circles.

Strengthen legs and maintain alignment

Standing poses like Warrior 2 (Virabhadrasana 2) and variations such as Side Angle (Parshvakonasana) help strengthen the leg muscles and build awareness of knee alignment. 

Don’t try to bend your front knee deeper than you are comfortable with. Instead, take a gentler bend in the knee and focus on acheiving these poses in a controlled and mindful way. This will help you develop a sense of correct alignment for your knee. Your knee should not be further forward than your ankle, and should not buckle inwards – use the muscles in your outer hip and thigh to keep your knee in line with the baby-toe side of the foot.  Engage your glutes and core to maintain a healthy pelvic tilt – you should feel as though your tailbone is tucking beneath you.

Balance poses such as Tree (Vrksasana) also build strength and stability throughout the leg.  You’ll get maximum benefit from a balance you can maintain without grabbing on to a support, so choose a variation you feel comfortable with.  Don’t worry if you wobble – those subconscious tiny adjustments strengthen legs and core!

Glenbrittle, Skye
Terre Rouge, Briancon, France.

Restoring muscle imbalance between hip flexors and glutes

Low lunges (Anjaneyasana, pictured) are great for releasing tight hip flexors and strengthening the glutes.

Bridge (Setubandha) is another effective pose to work the glutes. To take it further, try a Theraband or strap round the thighs or calves to help engage the outer glutes (gluteus medius).

For more advanced yogis, Camel (Ustrasana), Bow (Dhanurasana) and Wheel (Chakrasana) are powerful poses for restoring the balance between the front and back of the hips.

ADAPTING YOUR PRACTICE TO PROTECT YOUR KNEES

If you are experiencing knee pain during your yoga practice, here are modifications you can make to some common poses to take the strain off your knees. 

STANDING POSES

Adapt Warrior II and variations by taking a narrower stance with a gentler bend in the knee.  Consider holding onto the back of a sturdy chair or using the chair to support the front thigh. All pose illustrations © Tummee.com. Sequences by Vertical Yoga.

A chair or block for your hand reduces the strain in poses such as Triangle (Trikonasana) and Side Angle (Parshvakonasana).

Take extra care with Triangle as the rotation involved can place a lot of strain on the knee!  Again, take a narrower stance, with a micro-bend in the front knee to avoid hyperextension.

SITTING AND KNEELING POSES

Classic yoga seated poses involve deep knee flexion and hip rotation. You can reduce the strain by sitting on blocks or a chair. For a relaxing alternative to Cobbler/Bound Angle (Baddha Konasana), try lying down with your feet resting against the wall.

The full flexion involved in Hero (Virasana) and Cow Face (Gomukhasana) can be very challenging if you have knee problems, and you may want to avoid these completely. Consider the supine variations shown below instead.

CHILD POSE

Child (Balasana) should be restorative – but it’s hard to relax with painful knees. Try a rolled towel behind the knees to reduce the flexion – or just keep your hips raised.

CAT COW (Bitilasana Marjaryasana)

If poses on your hands and knees are uncomfortable, try some extra cushioning under your knees. A fold in your yoga mat under your knees is a quick solution, or treat yourself to a couple of specially designed knee pads.

Or alternatively you can get similar benefits from seated versions of the poses – for example, the seated version of Cat-Cow (Bitilasana Marjaryasana), shown here.