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Knee pain while in Shoelace

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Joined: 23 Sep 2006
Posts: 1117
Location: Vancouver

PostPosted: Mon Jun 23, 2014 12:41 am    Post subject: Knee pain while in Shoelace Reply with quote

I recently received this question

I had a new student in my yin yoga class this week. She said that she had done yoga before including Yin. I quickly explained the principles as I always do to make -appropriate edge, give them permission to come out of a pose if they feel the need to do so early (especially beginners), check first if there are knee, hip, or back issues, etc. I noticed the student massaging her leg during Shoelace and she was making a face as if something was wrong. When I went to her, I noticed a long older scar from knee surgery on the top leg. She said it had been over two years since surgery. She had first felt a pleasurable sensation in her leg but then it changed and she was worried. She said she had not felt that sensation since the surgery. I suspected it was nearing pain and I told her to come out of Shoelace right away. She didnt really name the sensation with words maybe she said tingling, she definitely said it didnt feel right. I told her that perhaps it was not fully healed, perhaps it was healing on a new level - I honestly did not know for sure. Is it possible that some asana in yin could bring up some old sensations? Or awakening of nerve endings that had still been suppressed? For two years though? Id really love to hear your input. I hope to see this student again in my class so I can talk more with her and provide more info. And Id love to hear students and teachers insight as well. Thank you!

Your advice to the new student was appropriate: come out of the posture when you sense something is not right. But, the question is - was it the Yin Yoga that was causing the discomfort? Should she continue to do Yin Yoga, given her experience in the knee? Unfortunately, it is hard to say.

Shoelace is an external rotation of the hips, combined with adduction of the legs and flexion of the hips. If the hips are tight or restricted, the stress of the pose can easily travel down towards the knees. This may be what she was experiencing. I like the mantra, There are no knee openers in yoga. Of course there are times when we can safely and appropriately stress the knee, but we are not trying to increase knee range of motion. So, any pain in the knee area is always a one-way ticket out of that pose. Shoelaces intention is to open and stress the hips, and if it doesnt work for this student, we have other postures that may be more effective and less stressful for her knee: Swan, Winged Dragon, Butterfly, are some examples. Maybe she will have a better reaction to these asanas than she did in Shoelace. Maybe even Half-Shoelace may work for her.

In any case, you were wondering why Shoelace was re-awakening her knee issues: I can only speculate. There are a number of possible causes - scar tissue may have formed in the area. Scar tissue, over time, becomes re-vascularized and new nerves can grow through it. The scar tissue is not as pliant or flexible as the original tissue and this may lead to a reduce range of motion there. When she starts to work the joint, she may be stressing the scar tissue, which in turn is stressing the nerves. Unfortunately, working through that scar tissue may be what she needs, but if so - she should be working with a qualified therapist. Prolotherapy or some other intervention may be more appropriate for her, or simply earthing to reduce inflammation may help her. Another possible cause: she may have re-injured her knee, which again would require her to seek more qualified help. That would be more obvious if she starts to feel the pain not just when she is doing yoga, but in daily activities as well. You thought that maybe she felt tingling in the area: if so - that might point a finger at compression along the sciatic nerve. Maybe this has nothing to do with her operation, but with sciatica, in which case you may want to review this article for symptoms and solutions. You could ask her what type of operation she had: that can also give you a clue as to what may be causing the pain now. It is possible that she has re-injured the knee in the same way as before. Or it may be that she just folded her knee awkwardly that one time while going into the pose; and next time, she may be perfectly fine!

As you see, it is impossible to work out exactly what is going on remotely. I would encourage you to encourage her to pay close attention to the sensations and when they arise. Then together you can work out ways around where the pain appears so that there is no pain, or if there is no way around it, suggest more qualified professional help.

Good luck
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