How to Avoid Knee Pain in Your Yoga Practice

Many yoga practitioners experience knee pain during their practice. Barring any actual medical conditions, the good news is that you can take steps to avoid it! In this article, we’ll explore tips and modifications to help you practice safely and enjoyably.

Is yoga good or bad for your knees?

Yoga as a practice improves stability, balance and strengthens the muscles around the knee articulation with low impact movement. Most importantly, yoga should teach you to listen to your body so you know when to stop if a pose or a stretch becomes too intense.

Practicing yoga can be a blessing for the knees, as it can improve posture and support in distributing body weight correctly across the joints. This, in turn, can reduce knee pain and improve the overall health of the joints.

This said, some asanas can be really challenging for yogis with sensitive knees! Before we dig into the why and the how, if you suffer from chronic knee pain, always seek advice from your medical provider and discuss what form of practice is appropriate for your unique body.

Some poses can be hard on the knee joint.

We can divide the asanas that are most likely to strain the knees into three main categories:

• Poses with deep knee flexion (e.g., Vajrasana, Thunderbolt Pose):
  The quadriceps muscle group attaches to the kneecap via a tendon. When we have a deep bending of the knee in a pose where the knee is also bearing the weight of our body, that tendon can stretch more than it should if our quadriceps are tight, causing pain.
• Poses that stretch and engage the quadriceps at the same time (e.g., Ustrasana, Urdhva Dhanurasana):
  In backbends like Ustrasana (Camel Pose) or Urdhva Dhanurasana (Wheel Pose) we lengthen the front body but also engage it to avoid falling back! If we rely solely on the quadriceps strength, the muscles will once again play tug of war with the knee tendon, often with the same outcome: knee pain.
• Hip openers that put the shin bone and the thigh bone on different levels (e.g., Lotus, Pigeon Pose):
  The knee joint is primarily designed for bending (flexion) and has only a small amount of rotational movement. If you find it challenging to open your hips, practicing poses like Lotus or Pigeon can cause misalignment between your shin and thigh bones, which may lead to torsion (a sort of twisting) in the knee joint.

Side note: Much of knee pain in yoga can be attributed to tight hips. Since everything is connected, a restriction in the hip joint can be experienced as a pain in the knee when the muscles and fascia that connect the hip to the knee are tense. As your hips open, tension on the knees is reduced.

How to keep the knees safe in yoga.

As a general rule, if you feel anything more than a stretch that feels uncomfortable or painful, listen up! Listening to your body is the first way to keep it safe and happy.

In terms of knees, we should not feel a stretch in our knees (there are no muscles in the knee joint - only ligaments and tendons). Any pain or sensation in the knee joint is an invitation to adjust your pose or practice.

You may already know that tight quadriceps can cause knee pain. The good news is, you can prepare your body by lengthening those muscles BEFORE you attempt a pose by performing Myofascial Release (a technique to release muscle tension).

Myofascial release for the quadriceps.
Place a foam roller or a myofascial release ball on the floor and lay the top of your thigh over the roller or ball, ensuring to the best of your ability that your body is as relaxed as possible (as shown below). Then, slowly, gently rock your body back and forth so that the ball or roller is in continuous contact with your quadriceps. If it feels okay for you, stopping the swaying and breathing into those areas where you feel the most sensation and tightness can also help to alleviate tightness.

Using Props to Reduce Knee Strain.
If, despite preparing your body as best as possible, you’re still struggling in poses like Vajrasana (Thunderbolt pose) or Pigeon Pose with the impact on the knees, consider props as your friends! You can reduce the degree of knee flexion by sitting on one or more blocks.

In active backbends like camel or wheel, you can alleviate the quads work by recruiting the glutes! As you get ready to push your hips forward (camel) or up (wheel), take the feet slightly wider than the hips to help engage your butt! The glutes will reduce the workload on your quadriceps (and from the knees) by stretching the hip flexors.

If pigeon pose makes you wish you ditched your yoga class, flip the pose and practice figure-4 on your back: taking the body weight away from the knee joint will reduce the impact of the pose and you’ll still achieve the same piriformis stretch that’s targeted in pigeon pose!

Want to dive deeper into safe yoga practices? Check out Yogi Flight School's No Bullshit Yoga Pose Library, with more than 90 yoga poses explained step by step, including modifications for beginners and injuries!