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Aaptiv “Easy Ways to Modify Yoga with a Knee Injury”

Aaptiv
Easy Ways to Modify Yoga with a Knee Injury

By Julia Dellitt

Experts weigh in on various modifications you can make to support injuries big and small.

Whether a tiny twinge from overexercising or a serious injury, such as a torn ligament, troublesome knees can derail your workout plan. This leads many to yoga as a low-impact exercise trade-off. Research indicates yoga may improve overall leg strength, which can benefit your knees. But certain postures might actually put extra stress on your knees, as well. Check out these expert tips for modifying yoga with a knee injury, so you can make it onto your mat without discomfort or pain.

Is it safe to practice yoga if you have knee issues?

“Generally speaking, yes—it is safe to practice,” says Olivia Zurcher, a 200 RYT yoga instructor in Des Moines who had two ACL repairs after sustaining injuries while participating in collegiate cheerleading. “However, it is critical to listen to your body, whether you are practicing at home or with an experienced teacher. If you are practicing at a studio with an instructor, inform your instructor about your injury, past or present. This is key to keeping yourself safe. This information also impacts the verbal cues and potential assists your teacher provides for class,” she adds.

But it may depend on the injury.

Lyndsay Hirst, a physiotherapist who teaches clinical yoga and pilates, notes that one’s physical ability depends on the type of knee problem. “If someone has a meniscal tear (cartilage problem that might present with specific pain on the inside of the joint), they might find it uncomfortable to fully bend the knee, so positions such as sitting back into child’s pose might be difficult,” she explains.

Those suffering from general degeneration due to wear and tear, or arthritis, can use yoga as a way to stretch their joints. Hirst says this won’t lead to any harm or danger. It may feel uncomfortable at first, but will get easier over time. One of the best parts of yoga is the fact that it can be customized to any person. And that means anyone dealing with an injury can modify it to fit their needs.

“There are floor sequences that will keep your knees safe, and, of course, arm balances and inversions give you plenty of yoga with no risk to your knees,” shares yoga instructor Shana Meyerson. “When it comes to leg-intensive postures, you can still practice as long as you are incredibly conscientious about your movement. All yoga requires that you are extraordinarily mindful as you practice. So, in a way, injuries bring you deeper into your practice, as they make you more aware and in-tune,” she says.

What are easy modifications you can make during yoga?

“Give yourself permission to take variations of poses and transitions,” says Zurcher. “Use slower transitions to prevent re-injury or inflammation. Modify a pose to reduce or eliminate irritation or pain. Skip the ones that don’t feel good presently, or use props.”

According to Meyerson, there are two core elements to knee safety during yoga, particularly for those with an injury of any sort. She recommends avoiding any over-bend in your knee during lunges, as well as hyperextending in straight-leg positions.

“Maintain a micro-bend in your knee to keep it safe. This means a bend you can feel, but others may not necessarily see,” says Meyerson. “Not only will this prevent hyperextension, but also ignite the muscles surrounding the knee to build strength and support. If knee over ankle is too intense in your lunges, don’t bend that far. It’s always okay for the knee to bend short of the ankle—just not past it,” she instructs.

To help, Zurcher offers knee modification options for a few common yoga poses:

  • Warrior II pose to triangle pose: “When transitioning from warrior II pose, which has a flexed knee joint, to triangle pose, which has an extended knee joint, activate your leg muscles, specifically your quadriceps, to avoid hyperextension.”
  • Half pigeon pose: “The gravitational weight of your body in this posture puts pressure in your knee joint. Some days it may be fine. Other days skip it. Take a reclined figure four pose to allow more control over how much sensation you’ll feel in your joint. Additionally, flex your toes towards your shins to keep the muscles around your knees activated and prevent injury.”
  • Child’s pose: “Your knee is in extreme flexion in this pose and can be irritated—especially when the posture is held for a long duration. Place a block or bolster underneath your body, or transition to supported hero’s pose or a comfortable seat.”

Should I avoid certain poses?

Loren Fishman, MD, an Iyengar-certified teacher and therapist, says it depends on the injury. But, in general, the safest poses are those that don’t involve the knees, or those with little weight-bearing or pressure on the knees.

“With a medial meniscal tear or medial collateral ligamentous injury, Virasana, Trianga Mukhaikapada Paschimottanasana and seated twists with knee(s) bent are out of the question,” he warns. “If it’s an anterior cruciate ligament injury, then standing poses such as Warrior I and II must be avoided, but Boat pose and Headstand would be fine.”

Other poses worth modifying for anyone with knee issues:

  • Half Frog pose: Meyerson says any pose can be made accessible with proper alignment, instruction and modification. But some deep knee postures, like this one, should be approached with “extreme caution and moderation, using props when necessary.”
  • Deep Side Lunge pose: “Skandasana (deep side lunge) is traditionally cued to bend deeply in your knee joint, so your seat rests on your lifted heel,” states Zurcher. “If you’ve got a knee injury, limit the range of motion to 90 degrees or greater when practicing this pose. This will look more like a side lunge. Note: this variation requires more strength to hold!”
  • Toestand pose: Instead of trying to lower your seat toward your heel in this pose, Zurcher recommends focuses on the balancing element of this pose, which requires additional strength and focus, and will help avoid knee irritation.
  • Lotus pose: “This pose requires deep external hip rotation and can cause pain in the knee joint, especially the lateral collateral ligament (LCL), if forced or [if there is] not enough flexibility in the hips and knees,” says Zurcher. “Half lotus is a great substitute, but I like baddha konasana or janu sirsasana. With or without a block under your bent knee(s), these seated poses require external rotation. But don’t put pressure on the knee joint.”

How do I know if yoga is okay for my knee?

“The bottom line is this: if it hurts, don’t do it,” says Meyerson. “With any injury, you have to be smart about keeping yourself safe. If a posture feels intuitively wrong, get out. No pose is worth risking deeper, long-term, or even permanent injury. Avoid or adjust anything that sends sharp pain or feels like it is straining your knee in an excessive manner,” she suggests.

“With any injury, always talk to your provider before any physical activity,” says Zurcher. “If there is any pain at all, the yoga pose is not for you today. This does not mean you’ll never do the pose again. Pay attention. Listen to how your body is feeling each day and adjust accordingly. Also, try out other parts of yoga, like meditation and breathwork.”


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