Suggestions for torn meniscus please ...

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BRgal
Posts: 4
Joined: Fri Feb 09, 2007 4:42 am

Suggestions for torn meniscus please ...

Post by BRgal »

Hi there. I have been diagnosed with a torn meniscus in my 47 year old right knee. As I have been pain free for about 1 month, I would like to avoid surgery. My knee still catches occasionally and locks every now and then. What type of poses should I be doing?
Many thanks! 8)
P.S. I am new to this board. I just saw Bernie on Flow Yoga today and here I am! :D
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Torn meniscus

Post by Bernie »

Hi BRGal ... welcome to the Kula.

Hopefully others will share their views on this topic, but it is one that I am intimately familiar with. I tore both of my medial menisci and looked high and low for some yoga therapy that would help them. I even had chances to ask some pretty senior teachers about it; Richard Freeman, Erich Schiffman and David Life

The problem with the meniscus is - there is very little blood flow to that area, so it is very hard for the body to heal this particular piece of cartilage. Of the teachers I questioned, only David Life said that it could be cured via Yoga: he had the same problem and did a lot of virasana postures (that is the hero pose: sitting between the heels.) The closest Yin Yoga pose to that is the Saddle pose. I tried this myself, but my knees were too far gone.

[I have no idea just how bad his knees were, nor how bad yours are. Every situation is unique and what worked one time, might not work the next time.]

David Williams (of Ashtanga fame) has a favourite saying: "Yoga can cure anything, except for problems caused by Yoga." I know how my menisci were torn: it was early in my Yoga practice. I stayed too long in Lotus, ignored the pain in the knees, and when I came out of the pose, the pain was there for good. I learned the hard way that "no pain: no gain" is bullshit. Pain is an important message from the body that something is terribly wrong!

I researched all the alternatives and latest medical techniques. Eventually I had both knees "scoped", with about a 2 year wait between sides. I was able to stay awake and watch the TV monitor. The surgeon showed me that about 1/3rd of the meniscus was torn and I watched as he trimmed it away. So I still have about 2/3rds left as a bit of a cushion. [Afterwards he gave me a guided tour of my knee: he showed me a bit of developing arthritis under the knee cap...it was kinda cool.] It took me a good 6 months to get back to my pre-operation range of motion, but I am really glad I had it down. [Of course there is a downside to this operation: there is less cushion now, so arthritis is more likely to occur and occur faster...but it was a trade off: now I have no pain at all and am fully functional. Before I wasn't functional.]

Today, I do a lot of hip openers, to ensure I never stress the knees again. Yin poses have been great for that: Square pose, Shoelace, Swan, Dragons... Also I sit on the floor whenever I can: I eat my dinner at my coffee table. And I have zero tolerance for any knee pains. If they hurt, I come right out of the posture.

Straddle pose is, I feel, a good pose for the inner knee, now that they are healed. But in your case, I am not sure. Yin Yoga is not restorative Yoga. I would rather you get healed first, and then try poses that challenges the knee, like Straddle. Instead I would recommend you focus on hip openers AS LONG AS THEY DON'T HURT THE KNEE MORE!

I hope this helps. Let us know how it goes.
cheers
Bernie
BRgal
Posts: 4
Joined: Fri Feb 09, 2007 4:42 am

Torn Meniscus

Post by BRgal »

Hi Bernie!
Thank-you for sharing your experience with me.
Luckily, I have been pain free for about a month now. I have been instinctively babying my knee.
I believe the Straddle Pose would be too much of a challenge for me right now. The Hero Pose can be accomplished successfully, but it does not feel right. I can sit on my heels now without any discomfort. When I first injured my knee I was not able to do the Child Pose!
I tried the lotus about 2 weeks ago. I felt okay in the pose, but after reading your story, I think I will totally avoid the full lotus! Are there any other poses I should totally avoid???
I will follow your advice and work on the hip openers you have so kindly outlined for me. Hopefully, with patience and prayers I can avoid surgery. Please let me know if you should discover other poses that would benefit my knee. I am so grateful for your advice. Blessings to you!
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Other poses for bad knees

Post by Bernie »

Hi again

As to which poses to avoid, obviously avoid any poses that feel uncomfortable. As long as the knee is damaged, you need to let it heal: so zero tolerance for any small tweaky-feelings in that area. [Remember, little tweaks become big tweaks, and big tweaks become expensive operations!] Lotus, shoelace (cowface), swan (pigeon), square pose (aka double pigeon to some)... all of these are great hip-openers, but if the knee feels tweaked in any of them, avoid them for now.

A couple of Iyengar teachers have showed me a pose to help "open" the knee safely, which supposedly Mr. Iyengar has recommended for knee problems. It is a version of virasana (sitting on the heels) but with three of those green, foam-chip blocks length-wise under the sitting bones. Then, either roll up a towel or some socks, or get a wooden dowel (about 1.25 inches in diameter) and place this under each knee. Sit for about one minute, then take away two blocks and roll the towel (or dowel) under the back of the thighs, so it presses into the calves. Sit for another minute, then go back to the towel (or dowel) right behind the knees again and sit on two blocks for a final minute. This is supposed to help open the knee joint. Eventually you can go to a larger diameter dowel.

I have tried this and found it helpful. I use the larger dowel now and do it in my opening posture when I start my own Yin Yoga session.

Surprisingly the Iyengar community is often negative against the Yin Yoga style, and yet the above example is just one of many times Mr Iyengar actually prescribes a yin posture! This one is a long held, passive pose that targets the yin tissues of a joint.

Cheers
Bernie
BRgal
Posts: 4
Joined: Fri Feb 09, 2007 4:42 am

Poses for Torn Mensicus

Post by BRgal »

Hi Bernie,

Thank-you again for your advice. I am looking forward to a full recovery.
(It is possible!) I will keep you posted on my progress.

Many blessings to you for your guidance.
moksaman
Posts: 12
Joined: Tue Sep 05, 2006 11:18 am
Location: Boston, MA

thanks Bernie

Post by moksaman »

Bernie,
I love your 'knee-opener', Iyengar-style.... I had forgotten about that one.
But it's great... I've started adding it back to my routine, too, and my knees are loving it. I've found that those really thin sticky mats are great under the knees if you roll them up into 8ths or 16ths. At any rate... thank you.

And I share in your bafflement about why the Iyengar folks are so negative on Yin... they're in a rigid, dogmatic 'church', and it's too scary for them to think outside the box, I think. Too bad.
BRgal
Posts: 4
Joined: Fri Feb 09, 2007 4:42 am

With thanks to Bernie!

Post by BRgal »

Bernie,
My right knee is pain-free now. My OS told me the MRI confirmed there is a medial tear in the right meniscus. As I am pain free, he is not recommending surgery! He has given me a couple of exercises to do. He was an absolute gem of a specialist as he explained everything and was willing to make suggestions to strengthen my quads and hamstrings so that I could avoid surgery.

I am so grateful for your advice. I am still very careful with my knee. I always keep in mind what you said, "litte tweaks become big tweaks." There are some poses that I naturally shy away from ... I consider them to be too risky for me. As soon as I feel any pain whatsoever, I get out of the pose.

Thank-you Bernie for all your suggestions.
Blessings to you
B
:D
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Great news!

Post by Bernie »

:D That is great to hear ... I am glad your knee is pain free. As I may have mentioned, I did have the operation and most of the time my knees are pain free, but it does come and go. When it gets bad, I re-invorgarate my practice (the Iyengar pose I mentioned) and it usually goes away.

Hopefully you will stay pain free, but if it does return, just remember it could just as easily go away again. Brief periods of pain may be "normal".

Cheers
Bernie
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Nasal Septum used for knee repair

Post by Bernie »

An interesting experiment is being tried, as explained in this article where they transplant cartilage cells from the nose (the nasal septum) into the knee. Seems to be promising! More tests needed though...
LisaRussell
Posts: 3
Joined: Tue Apr 24, 2018 2:38 am
Location: Sweden

Dull achy pain following meniscus surgery

Post by LisaRussell »

Hi Bernie

I wanted to ask your advice about dull pain I get following Butterfly Pose. I had meniscus repair surgery 7 months ago. I have been practising Yin Yoga to help with my recovery. I have found Butterfly Pose a great relief for my hips as they've been getting worse and worse since the initial injury over two years ago (I think from long periods not walking properly and not having my full ROM since January 2016). After I have come out of Butterfly Pose and am resting in a rebound position I get an intense dull ache in the front medial knee (surgery was medial posterior horn) and it lasts for a good 5 mins or so before subsiding. I understand that “dull, and “achy, are normal yin sensations but often it's quite an intense sensation. I can't proceed with my practice until the sensation has gone. I don't feel any sensation in the knee while I'm in the posture. I'm trying to work out what's going on there - is it scar tissues healing for example? And is it safe to continue practising Butterfly? I don't really get the same feeling following my yang style of practice.

Are you able to shed any light?

Thanks
Lisa
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Post by Bernie »

Hi Lisa

First things first--have you talked to your doctor or surgeon about your discomfort? I can only offer speculations, but they can work with you in person to determine what is going on.

It sounds to me that you may not be ready yet for much external rotation at the hips. If the hips are tight, the stress of trying to externally rotate further tends to end up in the medially side of the knee, sometimes crushing the medial meniscus. Since this is the site of your operation, I would speculate that too many external rotations may have contributed to your original conditions. You may be more sensitive now to such pressure, either through swelling after your operation (although by now, all swelling should have subsided) or through less cushioning between the tibia and femur. In any case, since you are experiencing strong discomfort there, I would suggest you stop doing Butterfly for a while.

If your intention is to rehab your knee, you may find this article of interest: Yin for the Knees.

If you are focussing on your hips, then I would suggest you determine what is stopping you: tension or compression? I suspect you have reached your limit of how much you can open your hips and now trying to get more than your body can offer is placing too much stress in your knees. If you are being stopped due to compression, there is no point trying to "open" those hips any further. You have reached your limit. It is nice to keep what you have, but don't try to go further. If Butterfly is putting too much stress into the knees but you want to keep working the hips, try other postures, like Winged Dragon or Swan pose. See how those feel on your knees.

Let us know how it goes.
Cheers
Bernie
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