You've heard the quote: 'Practice and all is coming.' It turns out that this is true. ALL is coming...the good, the bad...and for me, the knee pain.
To have chronic knee pain was a surprise for me. You see, I've been practicing yoga for a long, long time. I first started 2 decades ago. For the last 5 years, I've maintained a daily Ashtanga home practice of full Primary and now Primary & Intermediate. Never before have I had knee issues. My knees have no prior sport-related injuries. I'm particular about checking my alignment to protect my knees. I don't wear heels very often. So...My knees were fine. Until they weren't.
As crazy as it sounds, what a gift this pain has been for my practice...but I'm jumping ahead of this story.
My knee pain started rather suddenly. First in one, and then in both knees. I couldn't point to one particular posture or any injury that caused it. It just appeared. It would seem to get better and then it would get worse. I only see my teacher intermittently at workshops so I didn't have anyone to ask. So what did I do?
I figured it out...one practice at a time. This is what I learned:
1. Slow way, WAY down. Listen & then, modify. My practice became an exercise of slow movement and constant attention to the tiniest whisper of discomfort. I added breaths...lots of breaths...to many asanas. If anything felt the least bit uncomfortable, I stopped. If I could relax the muscles and then proceed without pain, I would. If not, I would modify the shape of the asana. I practiced what I could WHILE remaining pain-free. For a time, Ardha Baddha Padmottanasana (Half Bound Lotus Forward Bend) became Tree pose or a Balancing Figure 4 Hip stretch (see photo). Janu Sirsasana C was not possible for a few weeks. In fact, neither was Janu A or B or Tirangmukhaikapada Paschimattanasana or Padmasana...and least not until I implemented the next suggestions.
2. Keep the thigh bone in hip socket. By slowing down and paying very close attention to the subtlety of my body, I noticed that I was pulling my right thigh bone out of the hip socket in many of the postures. By visualising the bone and socket joint, I imagined pulling the bone deeper into the socket instead of pushing it out. If I did this, I found that I triggered a tiny muscular engagement in my hip that eased some of the knee pain. This muscular engagement also helped to deepen my engagement of Mula Bandha. Brilliant! But this wasn't the complete answer.
3. Microfibre cloth roll in knee crease. I also started to place a small rolled microfibre cloth in my knee crease any time I deeply bent my knee. The cloth roll seemed to create space in the knee joint which helped transfer any muscular stretch to my hip, where I needed it. Suddenly, Janu Sirsasana A, B & C became possible as did half lotus. (Note: I tried using a regular wash cloth, but this was too thick for me.)
These two adjustments, used in combination, worked for a while, but then the knee pain started to return though not to its original intensity.
4. Bandhas and more bandhas. By again slowing down and paying attention, I noticed that I could relieve knee pain by engaging my bandhas. In fact, any knee pain was a sign that I was not using my bandhas as deeply as I could. Bandha engagement helped to lift the weight of my torso out of my hip and knee, freeing it to move without pain. particularly in any forward bends.
5. Soft ball rolling. No matter how pain free my practice might be, my knees would often tighten up throughout the day. I now keep 2 soft squash balls under my desk. I roll my feet over these balls several times a day and this helps to release muscular tension in my knees, legs and hips. Though golf balls are the same size, I found them to be too hard and harsh on my foot. There is something about the softness of the squash balls that works miracles.
And 6. (I know...I promised 5! You get an extra bonus tip! :) ) LOTS of hip stretching. This sort of ties into the soft ball rolling. The more I stretched my hips and rolled my feet, the happier my knees seem to be.
So why did I have knee pain? And why now? The honest answer is that I don't really know. I do have a theory. I suspect my work in Intermediate has something to do with it. NOT because I'm mis-practicing the postures during my practice, but because I need more internal connection and strength to progress in them. My patterning issues (I have a slight scoliosis and so am lopsided...as we all are in one way or another...) could no longer be left unaddressed. My knee pain has made me aware of how I engage and use my shoulder girdle, my bandhas and how I need to adjust for the scoliosis. I've learned a LOT in these last 3 months. And I feel stronger and lighter in my practice as a result.
So yes, practice and all is coming. My knee pain was the best thing that happened to my practice.
Please note: I am not a doctor or a physical therapist. This article is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.