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Novice Meditation sitting periods and knee health?

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Joined: 23 Sep 2006
Posts: 1117
Location: Vancouver

PostPosted: Mon Mar 26, 2012 2:28 am    Post subject: Novice Meditation sitting periods and knee health? Reply with quote

I recently received this question:

Hi Bernie,
Your site is a gem among the internet. Thank you so much for the valuable wisdom in the yinsights and poses.
I have a question regarding the fascia in the knee joints that i would love some reassurance about. I recently attended a 10-day vipassana meditation retreat and there was lots of extended cross legged sitting periods with lots of pain in the kneee joints. I've heard that many serious meditators have to have knee surgery later on in life as their knees are in pretty bad shape from decades of sitting cross legged. Does this have any evidence behind it or is it just a coincidence? I've heard that knee health also depends not only on the fascia but proper muscle (yang?) strength for aligning the knee joint correctly.

Any advice is greatly appreciated.
Thanks so much

If you are asking for a medical study that investigates the incidence of knee surgery and meditation, I have not seen one. But I do have anecdotal evidence that this does happen. It comes from ignoring pain: when the body is about to be damaged, it sends out warning signal - ignore them at your own peril! Pain is a sign that something is wrong.

There are people who can sit with legs crossed for 10 hours a day and not have any pain or problems: these are rare individuals however. There are others who could sit for that long, but their hips are so tight from years of immobilized sitting in chairs, that they need to first do some yoga to open their hips and get rid of the tensile resistance in the hips that prevent their femurs from externally rotating enough to release any pressure felt in the knees. And there are others who, due to the shape of their femur bones and their hips sockets will never open their hips enough to allow comfortable sitting for any length of time. For these people, yoga is not going to help them sit without pain.

Sitting in meditation in a classical cross-legged position without pain has little to do with alignment of the knees or strengthening the muscles or fascia there: it is a problem of tightness in the hips. If the hips are tight, then the only way to get the knees low to the ground when sitting with legs crossed is to torque the knees. When the leg is straight, the ligaments and structure of the knee joint prohibit twisting of the tibia (the shin bone) with respect to the femur (thigh bone.) However, when the knee is bent, laxness in the ligaments does allow some twisting to occur. For some students, their unique anatomy allows more twist, some less but regardless, when the hips are tight and the femur can not externally rotate in the hip socket, then the rest of the stress of sitting cross-legged goes into twisting the knee joint. The pain arising here (usually in the inner knees, which indicates that the meniscus is being crushed) is not good. Ignoring it could result in the meniscus being shredded or torn and then surgery becomes the only option to stop the pain.

Burning in the knees should not be tolerated. This does not mean you have to stop meditating: there are many other sitting options available. You can support the thighs with blocks so that the knees do not feel pressure or pain. You can sit on a bench. You can sit on your heels with cushions between your feet. If just one knee complains, try sitting with that foot in closer to you (which means that that knees is more bent and can twist more easily.) You can also meditate without sitting at all! The Buddha once said that there are 4 basic meditation positions: sitting, standing, lying down and walking. There is no need to break your knees.

Now, to help open the hips so that there is less pressure in the knees, yoga can help, especially Yin Yoga. Square pose, Swan, Shoelace, Butterfly are some of the poses that may work for you. At some point, your hips will be as open as they will get: if you still feel pain in the knees when you sit, then find a different way to sit.

I hope this helps!
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