injury prevention

A Yoga Sequence for Healthy Feet and Ankles

The feet are the very foundation of our skeleton and as such, play a critical role in our posture and movement habits. With 26 bones in each foot and multiple joint surfaces, a healthy, balanced foot has the capacity for an enormous amount of mobility and adaptability to the surfaces it walks upon. Unfortunately due to restrictive footwear and the monotony of much of the surfaces we now walk on (think carpets, tarmac, flat surfaces) the feet are not getting exposed to the kinds of challenging terrain and environments that keep them supple, strong and healthy.

Our feet are becoming increasingly stiff. The aches of our feet which are critical for healthy biomechanics in the knees, hips and spine begin to collapse, and in so doing we suffer from a sort of internal collapse (the ability to connect to our pelvic floor and core are very much linked to the support of our foot arches). Our toes shrivel, curl and deform and as the feet lose their mobility and strength we become vulnerable to a whole host of foot disorders such as plantarfasciitis, sprained ankles, bunions, shin splints and neuromas.

Dysfunctions in the biomechanics of the feet also have a tendency to ripple upwards causing instability and poor tracking in the knees, pain and dysfunction in the hips and even back pain. Indeed many therapists, including myself, look at the feet as a key contributory factor in lower back pain.

This makes sense when you think of the following analogy. In a building, if the foundations are unstable or weak, this will lead to subsidence and ultimately structural failure or collapse as you go higher up the levels of the building. Our skeletons are much the same, lack of mobility and stability in the feet can, and most likely will, end up causing problems for the joints that stack above them.

When I work with a client for the first time I spend quite a bit of time educating them about the important role of the feet and how they should be moving. The following exercises are just some of the ones I regularly turn to when working to bring the feet back to balance.

The Sequence:

Credit: Tummee.com

Massage, Sensitisation and Circulation

The first few exercises are all geared to re-awakening your brain-body connection with your feet. The soles of our feet are covered in nerve endings that transmit important information about the environment to our nervous systems and brain. Many of my clients are working with feet that are often de-sensitised and lack good circulation which is what these first few exercises work to address:

Plantarfascia ball rolling

I have a love-hate relationship with this exercise but it is one of my favourites for both waking up the feet and helping to work through tension and tightness in the sole of the foot. Thanks to our increased understanding about the role of fascia/connective tissue and its impact on our mobility we now know that rolling out the fascia of our feet has a knock-on positive benefit on the flexibility and mobility of the whole back of the body. Try this: From standing, come into a forward bend position reaching your fingers towards your toes. Take a few breaths and just notice how you feel, the level of intensity of stretch/sensations and where the tightness is located. Now take a spiky ball and roll it firmly under the sole of your foot for 1 minute. Put enough pressure through the foot to be uncomfortable but stop before the point you start to cry!

You can make long scrubbing motions, little circles or even just hold the ball still as you apply pressure through a particularly tender spot.Repeat on the other foot. Now come into your forward bend position again, reaching down to touch your toes. Notice the difference! How does the body feel now? What is the level of intensity? Most people find the second forward bend a lot easier, with more range of motion and less overall tension particularly in the spine and hamstrings. The moral of the story is this – if you have a tight lower back or hamstrings, roll out your feet!

This is also a particularly useful exercise for clients working with plantarfasciitis, heel pain and neuromas. Aim to do this at lease once a day or even keep these balls under your desk for you to roll your feet out whilst you work!

Fingers Between Toes and Foot Massage

I encourage my clients to get into the habit of massaging their feet or better yet getting a loving friend, partner, family member to step in. If you are prone to foot cramps you could do this with magnesium oil, which is thought to help reduce cramping and soreness in the feet.

Start by using your thumbs to rub firmly through the soles of the feet. Work into the heels, balls of the feet and around the toes.

Next thread each finger between each toe. Do the best you can – if you can’t get each finger between each toe that’s fine – just do what you can, it does get easier with time. Now stretch the fingers out to spread the toes out. Repeat this a few times. You can also point and flex the foot and roll it around in circles, keeping the fingers threaded between the toes. Continue for 1 minute and then repeat on the second side.

Mobility, Flexibility

These next few stretches are about improving the pliability and mobility of the feet. It’s worth saying that many of these exercises can be quite uncomfortable and awkward when you first do them. Persevere – work within a tolerable range of sensation and avoid anything that brings on acute pain. Monitor the sensations in the foot both as you’re holding the pose and also after and adjust your position accordingly. Aim to hold each stretch for a minimum of 30 seconds, gradually building up to 2 minutes for each pose:

Toe Squat

Sometimes jokingly called Broken Toe Pose! Not an easy posture but so valuable and worth persevering with particularly if you do a lot of sport or running. Again, like many of these exercises it gets easier with time. Play with your edge but don’t push into acute pain. If you have bunions be mindful to keep the weight even across the ball of the foot and try to get the toes pointing straight forwards as much as possible rather than out to the sides.

Come into a squat position with your toes tucked under and your knees parallel and hip-width apart. Make sure that all your toes are tucked under you – you may need to work to get the pinky toes under! Make sure that your feels are not sickling outwards but instead gently draw the heels towards each other so that all 10 toes are pointing straight forwards and the heels are right behind the balls of the feet.

If your knees are sensitive you may need to lean into the hands, lifting the hips slightly or try rolling up a blanket/towel and tucking it behind your knees before bringing your hips back towards your heels.

You can rest your hands on your thighs (more intense), bring blocks under your hands or bring your hands to the floor either side of your knees (less intense) to help take some of the weight off the feet.

Ankle Stretch

Start by coming into a kneeling position with the toes pointing straight back and the tops of the feet on the floor. This pose may be enough if you’re already feeling a stretch in the tops of the feet or front of thighs. Again, make sure that your heels are not sickling outwards but instead gently draw the heels towards each other so that all 10 toes are pointing straight back and the heels are right behind the balls of the feet. Putting a tight yoga strap around the ankles can also help with this.

If your knees are sensitive you may need to lean into the hands, lifting the hips slightly or try rolling up a blanket/towel and tucking it behind your knees before bringing your hips back towards your heels. Skip this pose if the knees are acutely painful.

The next stage is to explore lifting either one or both knees away from the ground. This will increase the stretch through the top of the foot and shinbone. Again make sure heels don’t roll outwards, keep them hugging in. Hold for 30 seconds and build up to 2 minutes hold.

Half forward bend with a rolled blanket or yoga block

Take a yoga mat and roll it up to about 2-3” thickness in diameter. Step the balls of the feet onto the roll with the heels on the floor.

You can bring a chair or 2 yoga blocks on the floor in front of you for support. Hinging from your hips and keeping your spine long (avoid hunching over), bend your knees slightly and start to forward bend bringing your hands to the chair, block or floor.

Shift your weight so that it’s balanced right over the front of the heels. Without rounding your back, locking out the knees or shifting your weight back, gently try to press the thighs back. You should feel a deep release around the ankles, calves and up into the hamstrings. Hold for 30 seconds and build up to 2 minutes hold.

Garland pose with a rolled blanket or mat under the heels

Start with your feet a little wider than your hips with the heels on the mat roll and the toes on the floor. You can keep the feet parallel or allow the feet to turn out slightly – check that the kneecaps are pointing in the same direction as your toes.

Keeping your spine long and lower abdominals lightly engaged, start to bend your knees and lower your hips towards a squat. If the heels lift, put more height under your heels. Allow the heels to sink down and feel the pelvis hang away from the spine. You can bring your elbows inside of your knees and use the arms to gently press the thighs out, knees over toes.

If this pose is relatively easy for you, you can do this without any mat roll under the heels. Hold for 30 seconds and build up to 2 minutes hold.

Strength, Stability, Proprioception and Balance

These last few exercises are designed to work on the stability and strength of the foot, ankles and lower legs. Be prepared for a lot of wobbling! In fact the wobbles and constant micro-adjustments are all part and parcel of the body building strength and you will find these decrease as you get more stable. Standing on the block whilst balancing adds another challenge dynamic into the mix – as you get stronger you can make the surface you stand on less stable for example by layering a soft spongy blanket on top of the block. Closing the eyes also ups the challenge level quite significantly!

Mountain pose – feet hipwidth apart

This is a useful exercise to see how you distribute your body weight through your feet and to make some micro-adjustments to be in greater balance.

Come to stand with your feet hip-width apart. Stand with your feet parallel with the 2nd/3rd toes pointing straight ahead, or if more comfortable for the knees slightly turned out with the big-toes  pointing straight forward.

Standing tall with your spine tall and your knees unlocked, close your eyes and notice where your weight is. Is it more on the right foot or left? More towards the front balls of the feet or towards the heels? Now explore the following 4 small adjustments:

  • Explore shifting your weight so that you are balanced between left and right foot.
  • Bring the weight to the center of each foot, with the weight right in front of each heel.
  • Now lift all 10 toes off the floor (keeping the balls of the feet on the ground). Notice how this action lifts the inner and outer arches of the feet. Can you keep this lift of the arches as you gently relax the toes down?
  • Try to bring an even sense of weight between the big toe, little toe and center of each heel – like a tripod of support.

Notice how these little micro-adjustments change the feeling throughout the rest of the body.

Big toes raised

Now keeping the adjustments you just made in mountain pose intact, see if you can lift just your big toes off the floor, whilst keeping the other toes on the ground. Can you do this without locking your knees, or rolling to the outer edges of the feet? Try this a few times! It will potentially be very frustrating/difficult to do when you start but persevere – we are strengthening the neuro-muscular pathways of the feet. Repeat this action 10 times.

Four toes raised

The same as above but this time keep the big toes down and try to lift the other four toes off the ground. See again if you can do this without rolling to the inner edges of the feet or locking the knees. Repeat this action 10 times. Even if the toes don’t cooperate there is still value in just thinking about doing the movement – eventually the brain and the body will cooperate!

Heel raises with a chair

The key with this is to lift the heel straight up so that the weight is spread evenly between the balls of the feet. Avoid rolling the ankles outwards or inwards as you lift and lower. Squeeze and engage the glutes and legs as you lift and lower – you should feel this work in the glutes and backs of the legs.

Holding onto the back of a chair. Place your feet hip-width apart and parallel to each other. Inhale to lift your heels up, coming onto your tip-toes. Exhale to lower the heels. Make sure your body stays upright – try to avoid leaning forwards or back as you lift and lower. Repeat this action 10 times. Take a rest and then repeat 10 more times.

Hip stabilisation – leg circles

This exercise is designed to strengthen the muscles of the outer hips and improve the biomechanics between the feet, ankles, knees and hips.

Stand your right foot on the block (or book) and hover the left leg up so that the hip bones are now level. The standing right knee should be unlocked and the outer hips firming in. You will start to feel the outer hip of the standing leg working. Make sure the standing right foot doesn’t turn out but points straight ahead.

With control and without moving the hips or upper body, start to gently circle the hovering left leg and foot, forwards, out to the side and backwards as if you were tracing a circle with your big toe on the floor. Keep the outer hips firm and still and watch that the standing knee continues to track forwards over the toes – don’t let it roll in! Do not let the upper body lean forwards and backwards – isolate the movement just into the leg. Do this 5 times in one direction and then 5 times in the other direction. Switch sides.

Tree

Standing tall place your left foot onto the inner ankle, calf or thigh of your right leg. Make sure the foot is placed above or below the knee rather than directly on the side of the knee.  Keep the hips and toes of your standing foot pointing forwards, as you widen the right thigh to the right by squeezing the buttock muscles gently.  Find one point of focus to gaze at for greater balance and stability. Firm the muscles of your legs and outer hips in, lift tall through the sides of the waist and extend the crown of the head to the sky. Hands can rest on your hips, in prayer at the chest or reach them skywards.

To make this pose more challenging for the muscles of the feet, ankles and hips, you can stand on a soft surface such as a rolled blanket or spongy yoga block. To test your balance and proprioception still further you could explore closing the eyes! Hold for 5 breaths and then switch sides.

6 Ways to Build more Strength in your Yoga Practice

It’s probably fairly obvious to say given that this is a blog about yoga, but I love yoga. I mean really love it. If I could get away with spending most of my time just practicing yoga I would (with the occasional break to explore my other two loves, reading and cooking).

Some years ago though, I experienced something of an uncomfortable revelation. I was running late to teach a yoga class and had to run like the wind to get to the studio in time. I made it (just), but was so out of breath that it took me a good few minutes, bent over double to recover myself before I could walk into the studio with any sense of composure. To give some context, at that time in my life, I was practicing vinyasa yoga at least 60-90 minutes a day, walked everywhere, and to look at seemed in pretty good shape, but in that moment, gasping for breath, I was somewhat appalled to discover I was not as fit as I had thought. I resolved then and there to start switching up my movement patterns and activity to develop a more well-rounded level of overall fitness.

This is when I started to explore the concept of general fitness vs fitness specificity. General fitness programs look at creating a balance across a few key areas such as strength, endurance, speed and flexibility. To do this we need to practise a varied movement diet. However, when we train mainly in a specific movement practice such as running, cycling or yoga we develop fitness specificity for that type of movement i.e. our body adapts over time to become super efficient at handling the stresses of that particular way of training. This is a good thing and enables us to become highly skilled and proficient in our sport of choice.  However, these days professional athletes and sportsmen understand the importance of cross-training with other kinds of movement practices, not only because the more you train in only one kind of movement type, the greater the potential for imbalance and injury, but also because cross-training will actually make you better in your chosen sport.

So to address the imbalance, I started lifting weights, doing some more cardio and HIIT. I kept the yoga separate and sometimes missed having the time to do long practices as I tried to squeeze in other kinds of training. As time went on however, I wanted to explore how I could bring more of a cross-training mindset into my yoga practice. I started to weave in other kinds of movement. My sense of what yoga was or could be started to broaden. I began to realise that the fundamental component of any physical yoga practice was a) a strong sense of the breath and b) mindfulness, and with these two elements intact I could bring the feel of yoga to any kind of movement.

It was from this place that I started to evolve how I was teaching – looking to bring a more well-rounded physical experience to my students, so that they too could benefit from a more inclusive, all-encompassing way of moving. Below are the 6 big changes I have made to my own yoga practice and the way that I teach – the result being that I feel stronger and fitter than ever before.

 

 

  1. Get creative – bring in ideas from other movement modalities

One of the things I love about yoga is how alive it is as a discipline. Yoga is a constantly evolving, growing practice – new poses and ways of moving around the mat are constantly being added to the repetoire. Over the past few years I’ve noticed teachers weaving lots of other movement modalities and disciplines into their teaching. I have seen inspiration from Pilates, somatics, functional movement, Feldenkrais, ballet, bodyweight strength training, calisthenics, plyometrics and HIIT being incorporated into yoga in exciting and creative ways that challenge our bodies and minds to stay present and connected.

A big part of this approach requires us to redefine our idea of what yoga is or what it ‘should’ look like. For me, yoga is more about cultivating a certain quality of attention. It’s about learning to be more present, more focused, more disciplined and the body becomes a tool through which I can hone these skills.  That being the case then, any movement practices could be thought of as yoga once combined with breath awareness and mindfulness.

As a long-term yoga practitioner I know how easy it is to get stuck in the yoga treadmill – the same poses, the same movement patterns and sequences – and how easy it becomes for the mind to tune out and the body to go onto auto-pilot. It’s very hard to stay curious, exploratory and present when this happens. Our bodies, nervous systems and brains also stop learning and growing when something becomes familiar and it becomes too easy to fall into ingrained habits and repetition.

Doing the same kinds of physical training over and over is also a sure fire way to create imbalance. Yoga is fantastic for improving pushing strength through all of its weight-bearing work in poses such as plank and downward-facing dog, and for increasing joint mobility and flexibility, but perhaps not so good for developing others areas of fitness such as cardiovascular endurance or pulling strength (more on this specifically later). Another common area of imbalance for yogis is the tendancy to train hip flexion (when the knee comes towards the chest) more than extension (when the leg goes back behind the hip). Yogis tend to be strong in their quads and pectorals due to all the lunges and chaturangas, but not necessarily as comfortable with movements that engage the extensor chain such as hamstrings, glutes and middle/lower trapezius.

In order to become stronger (and more mentally engaged) we need to continuously challenge the muscles and joints in new ways – to move them out of their comfort range, to explore new transitions, new joint angles, movement patterns and investigate the end range of our mobility. This end range has been described by Gary Ward in his fantastic book ‘What The Foot’ as the ‘dark zone’ and he suggests ‘growth and potential develop only when you step into the unknown and challenge yourself to do or be better’. When we move only within our comfort zone we limit ourselves and can not develop our true potential for strength and mobility.

So think outside the box – weave in ideas from other movement practices, play with new patterns and enjoy how your experience of yoga evolves and the potential of your body opens up.

 

 

  1. Incorporate mobility and strength drills (not just static holds) into your yoga practice

A healthy muscle should be able to shorten, lengthen and relax at optimal length, and healthy movement patterns rely on the ability of each and every muscle to do this. With this in mind, we need to start incorporating eccentric, concentric and isometric loading in our practice through movement, not just static holds of yoga poses. To clear things up a little let’s start by defining these terms:

Concentric strengthening– this is where we strengthen a muscle as its shortening under load

Eccentric strengthening – this is where we strengthen a muscle as its lengthening under load

Isometric strengthening – this is when we strengthen a muscle in a static length under load – i.e it is neither shortening or lengthening

In styles of yoga where we hold poses for longer periods of time such as Iyengar we do a lot of work in the isometric range. Working in the isometric range is useful for stabilisation and can be helpful particularly for students working with back pain. Muscles, however, need a wide variety of movement and to be strengthened at various different lengths in order to work at their optimum.

How might this look in a practical sense in a yoga pose? Say our desire was to strengthen our core and we wanted to practice forearm plank. One way we could challenge the abdominals to work in a new pattern is by incorporating a cat-cow type movement into our forearm plank so as we inhale we allow the lower belly to move towards the floor, lengthening the abdominal muscles as we keep them engaged (eccentric load), and as we exhale lifting the belly, contracting the abs and trying to round the spine towards the ceiling (concentric load). The neutral place between those two movements would be where we’d hit isometric strengthening but note this happens naturally anyway between the eccentric and concentric action.

When we start to look at this way of training the muscles in yoga it opens up an exciting range of movement possibilities. I have learnt and created lots of mobility/strength drills over the past couple of years and feel not only stronger but a lot more fluid and controlled as I move around the mat as a result.

 

 

  1. Bring in some equipment

When I first started yoga I remember naively thinking that needing props in yoga was a sign you were a beginner. These days my car is filled to the brim with yoga kit, and I personally use lots of it in my own practice and with clients. I’m not necessarily suggesting we need to go so far as bringing dumbbells into our yoga classes (although why not), but I do love to use equipment that can be used to introduce more resistance or movement opportunities.

Yoga straps and blocks can be super useful for helping to bring awareness to certain muscles. For example, I use straps to help students with mini lat pull-down type movements, or blocks between thighs in mountain pose to help students feel the adductors and pelvic floor turn on.

I have also recently fallen in love with mini-bands and resistance bands and use these in class to help with glute activation and to develop better awareness of how to set the shoulders for weight-bearing poses such as plank and downdog.

I use tea towels and blankets to act as foot sliders for movements such as hamstring curls in bridge or to practice hip pikes in sun salutations. I also love the small Pilates balls to help with spinal articulation and core work. There is really so much to choose from – the key again is to get creative and playful.

 

 

  1. Include plyometric movements

Plyometric movements are movements that require the rapid stretching and contracting of muscle fibres to increase muscle power and strength such as sprinting, jumping and hopping.

Most traditional yoga styles are steady, slow affairs. In Ashtanga and vinyasa styles there are some elements of jumping, particularly during the transition movements in sun salutations but there are not really enough of them to significantly boost the aerobic function of the heart and not varied enough to challenge the body in new and interesting ways.

This brings us to the difference between slow and fast twitch muscle fibres. Slow twitch muscle fibres are used for endurance activities, like taking a long 90 minute vinyasa class, whilst fast twitch muscle fibres are developed through short, sudden bursts of activity like running for the bus or jumping to catch a ball. To cultivate balanced strength ideally we want to incorpoate both types of movement into our training.

By incorporating drills in our yoga practice that incorporate plyometric-style movements such as jumping or hopping we can improve our cardiovascular health, train our fast-twitch muscle fibres and potentially improve the health of our bones, reducing the risk of osteoporosis. Some ideas include:

  • adding burpee style jumps into our sun salutations
  • mountain climbers
  • downdog bunny hops
  • plank-to-squat jumps

The options are huge and only limited by one’s imagination!

 

 

  1. To build more strength in a pose, do 1 or a combo of these:
  • Increase duration of hold
  • Increase the number of repetitions
  • Increase the load
  • Add movement variations to introduce variety, challenge and complexity

If you want to get stronger in a specific yoga pose there are 4 main ways to go about it – you could work with just one or try a combination. What you choose to do will depend a lot on the type of pose or movement you’re doing, but to give a simple example, let’s imagine you wanted to improve your strength in plank pose:

  • You could simply increase the length of time you hold plank, for example, from 30 seconds to 45 seconds
  • You could increase the number of times you practice plank in your yoga practice say from 5 times to 10 times.
  • You could place a sandbag or heavy cork yoga block on the back of your hips to hold up whilst in plank thus increasing the load.
  • You could incorporate the cat-cow movement as described in section 2 to provide a different kind of challenge.

 

 

  1. Buy a pull-up bar, monkey bars or rings

Ok, so technically this may not be something you’d incorporate within the yoga practice per se, but I do believe this has made a huge change to my overall body strength and has addressed a significant area for potential imbalance from doing only yoga, so I had to incorporate it in here.

Through my consistent yoga practice I have no issues with holding plank for at least a couple of minutes. I’m also very comfortable with the majority of regular arm balances in yoga. In terms of pushing shoulder strength I’d say I’m pretty strong. However, the first time I tried to lift my bodyweight up on a pull-up bar was very humbling to say the least. Basically I couldn’t do it, my feet weren’t going anywhere, let alone lifting off the floor!

Since then, I have worked hard to incorporate some amount of pulling work into my movement routines. I have a pull-up bar above my bedroom door and try to incorporate a few pull ups with different grip positions throughout the week. There are a lot of benefits to hanging including strengthening the wrist, elbow and shoulder joints – all essential for any aspiring yogi who wants to practice long-term. For more info and a list of the benefits I highly recommend checking out Ido Portal’s blog on ‘Hanging’ and his 7-minute daily hanging challenge he outlines.

A Yoga Sequence for Knee Health

Please remember that this post only provides general guidance around knee health. If you have had a knee injury or recent knee surgery there are many factors that need to be considered before engaging in any rehabilitative exercise regime and its best to consult your doctor, health-care team or physio before starting yoga. 

It may seem a rather obtuse or clinical title for a yoga sequence – certainly not as sexy as A Yoga Sequence for Better Sleep for example (although that is coming soon!) – but building greater knee strength is a subject matter close to my heart, and has been a massive part of my yoga regime for years.

In fact the whole reason I came to yoga was because I had dislocated my knee several times and I faced the hearbreaking realisation that a dance career was just not going to be for me. Yoga early on presented an alternative. I loved the movement, the mindful connection to breath. The grace. It’s not a coincidence that many yogis and yoga teachers are ex-dancers.

Whilst yoga is often touted for its ability to enhance flexibility and range-of-motion, what I often find gets missed is yoga’s fantastic strengthening and stabilising qualities. To be sure it doesn’t have the grunt appeal or forehead-mopping benefits of lifting heavy weights or working with a resistance band but I believe yoga has a LOT to offer those of us with sore, sensitive or unstable knees.  As always it’s all about what you practice.

 

5 Reasons Why Yoga is Great for Knees:

  1. Its low impact i.e. in most forms and styles of yoga we don’t jump or bounce therefore reducing the amount of load, force and therefore stress on the joint.
  2. We use a lot of Closed Kinetic Chain (CKC) style movements and postures which are generally safer for knees that feel weak or unstable and are easier to control and therefore maintain good form whilst doing. CKC movements involve having the foot fixed on a solid surface e.g. the floor, as you do the movement or posture.
  3. We move slowly and mindfully which gives us a chance to focus on good tracking alignment of the knee (misalignment of the knee is a big factor in weak, unstable or injured knees). By taking our time as we consciously move in and out of positions we can retrain our habits and postural tendencies.
  4. Yoga recognises the holistic nature of the body and that knee problems often have their source in musculo-skeletal imbalances further up or down the body. Remember that the site of the injury is often not the source of the problem. When I have clients come to me with knee injuries, I always look at what’s happening in the position and alignment of their feet, hips and spines.
  5. In yoga we build isometric and eccentric strength which are fantastic for building strength and stability in our joints.
    • In isometric work we are holding the muscles and joints in a loaded static position – think of what happens to the muscles of your legs as you hold a Warrior 2 position for example.
    • In eccentric strength work, we gradually lengthen the muscles as we load them, for example, when we hinge forwards from standing into a forward bend the hamstrings are eccentrically lengthening.

 

Designing a Well-Balanced Yoga Practice for Knee Health

With the above in mind, the following sequence is designed to not only work all of the muscles that surround and stabilise the knee but also some muscle groups that seem relatively distant and unconnected. We will also work on stretching out some muscles that when tight can often cause knee tracking issues. Here’s a nifty table that outlines some of the major muscles and connective tissues you need to address for optimal knee health.

Strenghten Stretch
Quadriceps (muscles on the front of the thigh) Iliotibial Band or ITB (a tract of connective tissue running down the side of the upper leg)
Hamstrings (muscles at the back of the thigh) Outer quadriceps (when tight can pull the knee-cap outwards)
Glutes (your bottom!) Tensor Fasciae Latae or TFL (a muscle on the outer side of the hip)
Adductors (the inner leg muscles) Adductors (the inner leg muscles)
Vastus Medialis Obliqus VMO (a small tear-shaped muscle in the inner knee)

 

A couple of tips for practice:

As always the devil is in the details. I often say to my students – you spend the first 6 months in yoga just learning the basics, where do your hands and feet go, the general shape of a pose, remembering to breathe. You spend the rest of your life learning all the little details that make this practice so rich and exciting!

With that in mind there are a few small alignment tips that I think make all the difference when you are working on knee health.

 

  • Root down through the heel bone. When you press your heel firmly into the floor you will feel the muscles and connective tissue around your sitbone engage helping to strengthen the glutes and stabilise the hips. Strengthening the glutes plays a HUGE role in knee health.
  • Check your foot to knee-cap positioning again and again. The knees are the prisoners of whatever is happening in the feet and the hips! If the feet are turned out but the knees are pointing forwards (or even inwards) then your knees end up taking the strain of this misalignment. Happy knees are ones which track in the same direction as the centre of the ankle/2nd or 3rd
  • Engage the VMO. Getting the VMO (that tiny little tear-shaped muscle at the inner knee) to switch on can be tricky. If you’ve injured your knee it is likely that this muscle won’t be firing properly. Rooting through the heel bone can help to switch this muscle on but I also like to bring my fingertips to the area to help give me tactile feedback so that I know when it’s engaging.
  • Do not lock the knee. There is a tendancy for many students to “lock” the knee cap backwards in standing poses, particularly balance poses. Unfortunately this can often lead to torsion, instability and potential wear and tear of the knee joint. Instead we want to keep what I refer to as a slight micro-bend of the knee joint (the leg will still look straight) whilst engaging ALL of the musculature evenly around the knee (front-to-back and side-to-side).

The following practice gives some ideas for the sorts of poses that I regularly use with clients when working improve knee health. All of the poses/movements are designed to be repeated several times through until you feel a comfortable level of fatigue in the muscles without losing good form and technique. The exception to this is the two standing balances – Standing Quad Stretch Pose and Tree Pose which should be held for 30 seconds on each side, and the supine stretches at the end of the sequence which you can hold for up 1 minute on each side. Enjoy and feel free to leave any questions or comments below! 🙂