How often do you think about your knees? If they are painful, probably more often than not. We humans tend to take for granted those body parts that just work well. How often have you looked down at those beautiful bony hinges and just said “Thank you knees. You da’ bomb”?
The knees are important joints to consider. Hanging out right there in the middle of the feet and the hips, the knees provide our means of moving forward in life, of taking the next step. When they are good they are very, very good, but when they are bad they are, well, horrid.
Knee replacements are commonplace nowadays. With a large, increasingly healthy aging population, this will no doubt only increase. But wouldn't it be better to avoid replacement all together in favor of keeping the knees safe and stable and strong and happy and healthy? I think so.
My Dad recently had a knee replacement. The recovery has been difficult. At 80, he was not prepared for the toll it would take on his body, soul and psyche. The family often would remind him, “You know Dad this was an elective surgery.” It did little to console him however. He is still rehabbing that knee three months later and will be doing so for a while.
My Dad was a jock in his youth (that is up until about age 75). He worked out, skied, waterskied, swam and enjoyed a healthy life. He worked hard and he played hard. But this took a toll on his knees. Now, I would venture to guess that he wouldn't have had it any other way, but the transition from being an active, vital participant in life to one who is much more sedentary and restricted has been hard on him. He is now having to take a serious look at how he wants to live his remaining years and where adjustments can be made. This inquiry requires both strength and flexibility. Strength to accept that things are just not the same and flexibility to try some new ways of living that will work with the limitations of the body. I imagine it is very humbling.
In the Yoga Sutras Patanjali refers to the qualities of sthira and sukha.
Sthira means stability and strength. Sukha refers to comfort, ease and openness/ flexibility even joy. Both are helpful in our yoga practice and in life. Whether you're out to guard against injury and disease or regain strength and flexibility after an injury, yoga can be a superb antidote to knee trouble. An article in Yoga Journal gives us some good tips for staying safe while we practice:
7 Ways to Protect Your Knees in Yoga
1. Avoid Hyperextending: When joints are overly mobile and flex too far back, they're hyperextended. In the knees, hyperextension often occurs in poses in which the legs are straightened, such as Trikonasana (Triangle Pose) and Paschimottanasana (Seated Forward Bend), putting an unhealthy tension on the ligaments. If you're prone to hyperextension, keep a slight bend in the knees during standing poses and keep your weight evenly distributed among the four corners of your feet. In seated forward bends, place a rolled-up sticky mat or towel under the knee of the extended leg or legs.
2. Start With Your Feet: Proper alignment through the feet is the key to building strength evenly in the ligaments on both sides of the knee; when all the ligaments are equally strong, the kneecap glides effortlessly up and down and the cartilage doesn't get worn down. Separate your toes and press actively through the four corners of your feet in every pose, even inversions. If your feet are out of alignment, your knees are going to suffer.
3. Keep Your Knees in Line: When moving into deep knee bends, such as Virabhadrasana II (Warrior Pose II) and Parsvakonasana (Side Angle Pose), first align your bent knee over your ankle, then draw your kneecap in line with your second toe. Maintain awareness in your back foot, pressing down evenly, while lifting up from the arch of your front foot. "If you let the arch drop, the knee falls inside the big toe, and you're set up to suffer a number of different kinds of overuse and acute knee injuries," says Angela Smith, a professor of orthopedic surgery.
4. Tune in to Subtle Signals: "Oftentimes, the knees don't give immediate feedback," explains Iyengar teacher Joni Yecalsik. "Only later do you realize you've gone too far. When it comes to the knees, the sensation that would normally proceed the red flag is the red flag." If you feel achiness when you come out of a bent-knee pose, you may have worked too hard.
5. Build Strength by Balancing: Balancing poses, especially those that require moving through a bent standing leg, such as Garudasana (Eagle Pose), are especially beneficial. "Very dynamic balancing protects the knee against future injury by training the functional alignment, not just working the muscle," Smith says.
6. Be Prop-Friendly: When it comes to seated asanas, nothing makes a tight knee happier than a bounty of props. In Virasana (Hero Pose), try raising your seat with blankets or a block. Anytime the knees are deeply bent, such as in Balasana (Child's Pose) or Marichyasana III (Pose Dedicated to the Sage Marichi III), pressure can be relieved by placing a rolled-up washcloth as far into the knee pit as possible before bending the joint.
7. Warm Up With Hip Openers: "If your big joints aren't open, your small joints will always take the stress," yoga instructor Sandy Blaine says. "Many people hurt their knees doing Lotus when their hips aren't ready." She recommends warming up with hip stretches like Baddha Konasana (Bound Angle Pose) and Gomukhasana (Cow Face Pose).
"Life is a balance of holding on and letting go" - Rumi
Yes, our healthy knees keep us moving forward in the world. When there is injury to the knee joint we might ask ourselves “What is it I am not wanting to move into?” Perhaps a reflection on this question would be helpful. We can strengthen our knees with exercise and/or regular yoga practice but we can also go within to look more honestly at what is keeping us from moving fluidly and easily forward in this life. Paying attention to the subtle clues that show up will point us in the direction of healing and further growth. Oftentimes what is keeping us stuck is simply our dear old friends Ego and Pride. The knees also represent humility - think kneeling in prayer or kneeling during a knighting ceremony. Being able to crawl is a natural stage that comes before walking (aka moving forward). It is interesting that many ancient Buddhist temples were built high on a mountain. The image of crawling up the mountain to one’s healing or enlightenment is evoked. Jesus (who knelt before John the Baptist at his own baptism) said, ‘He who humbles himself shall be exalted while he who exalts himself shall be humbled’. To crawl, to kneel, even to get “weak in the knees” from time to time points to living a full human experience. To remain strong but flexible in this complicated but miraculous joint, as in our lives, is a reminder that we are humbled by creation itself which loves us and is there to serve our highest good always.
To keep knees happy and healthy in general, here are a few pointers:
1. Lose weight if you are overweight. Excess pounds raise your risk of knee arthritis.
2. Play it safe. A knee injury will triple your risk of knee osteoarthritis. When you exercise, take proper precautions to avoid getting hurt.
3. Strengthen your quads. Weak quadriceps muscles are associated with knee arthritis, so work them out regularly, along with your hamstrings and all of your other leg muscles.
Prayer: May you come to an appreciation of this jazzy joint that we call the knee and may you move forward in your life with sthira and sukha, strength, stability, ease, oh and also flexibility. Here’s to our knees. We love you. We are grateful for you. You da’ bomb!
Affirmation: I am flexible and flowing. I forgive, let go, understand and look to the future with eager anticipation. I bend and flow with ease, and all is well.
Connie Bowman is an actress and yogi and author of Back to Happy a Journey of Hope, Healing and Waking Up.For more about Connie including her yoga classes and workshops, visit her website at www.conniebowman.com.