Our classes are mixed with ‘knees’ of all sorts! healthy and otherwise AND lately a few who have nothing wrong with their knees but who are fearful of Lock the Knee instruction and being overly protective of healthy knees. This post is not written to be all encompassing about knees, their variations or problems. Its purpose is to remove fear without creating a cavalier attitude in relation to one action of the knee: KNEE ‘EXTENSION’.
The LOCK THE KNEE cue is sometimes misunderstood and recently we have had a few (just a few) taking up practice that seem very fearful of the LTK instruction for a different reason ~ so worried about hyper-hyperextension that they won’t even create normal extension! This little spate of fear is kind of surprising to us; as in our world this fear of LTK is outdated (that and fear of our use of heat were like a grand ‘couple’ a few DECADES ago and I am quite surprised to see LTK fear cropping up again as I thought it had long been laid to rest; it seems like a step back in time. The world is flat again.
In Bikram method ‘LOCK THE KNEE’ is a term used to describe a technique. When you are new to practice, all things being equal, the ‘normal’ challenge to Lock the Knee requires very focused work. How I wish I had given it more attention in the early days of practice. It is hard to ‘Lock the Knee’ when you are new and there is so much else to think about in Yogasana. I kinda put ‘Lock the Knee’ on the long finger 🙂 . But hindsight being the great teacher it is I would urge all to learn the lesson of Lock the Knee early in your practice, learn it well and then move on! You will have laid a good foundation that will serve you well to build on. The instruction being ‘misunderstood’ is one simple thing and this is usually easily rectified by coming to class! Hear the technique detail described and voila! Demystified. Lock the Knee is NOT an instruction to hyperextend a hypermobile knee. It is not an instruction to ‘force’ or ‘jam’ the knee back or go beyond any normal limit.
The ‘new to Bikram’ (super flexy or otherwise) sometimes struggle with this instruction largely because of the that fear that has been instilled in them previously e.g. cautioned against ‘locking’ their joints in other contexts where it would not be appropriate or cautioned by people who simply don’t understand the concept of the instruction in Yogasana class or just some fear mongers at it again (it is always fascinating that fear mongers still like to trawl/use ancient misconceptions to try to put people off trying out for Bikram class). In these practitioners it can take a while for them to start trusting the process (but hey! we have time). But in the meantime they are so worried about it they are doing the opposite of instruction and unnecessarily keeping their knee in a micro-bend and adding balancing actions on top of that bend! They are erring on the side of doing too little and perhaps creating a different kind of risk. Inherent in the process of creating a microbend in practice the knee is being prevented from receiving the good stress it needs to stay healthy. The loose packed position of a microbend allows for roll, slide or rotation to occur. You are then wobbly, trying to keep your balance and creating an uneven pressure on the knee. When movements of the lower leg and upper leg relationship occur and you are trying to balance on a bending leg that is supporting all the body weight this is when injury can happen too. A microbend might be a good place for a few knees (see later in this blog) but for the majority it does not allow for putting the right kind of stresses on the ligaments the way they are best designed to bear load.
LOCK THE KNEE = STABLE AND SAFE FOUNDATIONS: The reason the knee joint is safer to balance on in the locked position is because of the way the knee joint is built. When the knee is fully extended the ligaments help stabilize the knee. The closed packed position of LTK is a safe and natural place to be where the congruent join is supported by its associated connective tissue. The knee is least vulnerable when the leg is straight because the collateral ligaments on the inner and outer knee are the most supportive in this position. Maximum stability for you to add balancing on top of. Remember! You are not ‘jumping’ around in class. There is nothing ‘ballistic’ occurring in the 90 minutes. You are static (or trying to be static).
WHAT IS HYPEREXTENSION? Online dictionary: noun: hyper-extension “the forceful extension of a limb or joint beyond its normal limits, either in exercise or therapy or so as to cause injury.” ; read that again! The knee is forced past its normal ROM; FORCED; e.g. trauma, momentum from a dynamic movement.
WHAT IS HYPERMOBILITY? Online definition: Hypermobility means your joints are more flexible than other people’s. When this causes pain, it might be joint hypermobility syndrome. This IS a pathology.
WHAT IS FULL (or NORMAL) EXTENSION? Many textbook and articles show ideal alignment of knees at 0 degrees. It is pretty; conforms to a nice symmetrical view of the world. BUT. the AVERAGE person can extend knees -5 degrees-ish beyond that 0! and THEY DON’T HAVE KNEE PROBLEMS; Or you (as some would) could say the AVERAGE PERSON can {hyper}extend knees -5 degrees-ish and it is NORMAL and they are fine and their knees are fine. (And of course some people can go more because variation in the human body is just so wide.) But if you are talking AVERAGES, ‘0’ degrees of extension IS NOT FULL EXTENSION. Full extension point should be shifted to ‘-5’ point; what many currently term as ‘hyper’extension AND ALL the negative connotations that the word ‘hyper’ carry with it in context of human body anatomy and physiology!
So the average person can ‘hyper’extend easily (but it still varies in the individual: 99% women average -6.7degrees 95% men average -5.5 degrees (see any pic of BKS Iyengar; he represents this average perfectly) and that is normal range of motion for them. {ref Bernie Clark}
So now you know. Not everyone who fully extends (or ‘hyper’extends as seems to be the common language) their knees to the degrees mentioned has lax knee ligaments! But everyone who has lax ligaments hyperextends. The distinction has to be made. The limit of hyperextension (in the context of hypermobility) over the ‘average’ may or may not be a problem depending on the health of the knee ligaments and other factors (e.g. body weight).
It is tricky because the word ‘hyper’ tends to mean excessive. So immediately warning bells are going off in people’s minds! Too much too much!!. But in this context you have to make the distinction between -5 being NORMAL ROM AND WHETHER EXCESSIVE FORCE IS BEING APPLIED TO FORCE THE JOINT BEYOND ITS NORMAL ROM. So really in the case of this person who is -5 they are not ‘hyper’ extended they are ‘fully’ extended. Don’t worry about the knee; as long as it is fully extended, you have right distribution of weight, the quads are tight, solid and the glutes engaged, then you are fine.
In Bikram method we are not hyperextending (think about the definition of what that is). We are not forcing the knee past a current normal range of motion (as in trauma/dynamic movement), yet the few are fearful. {It reminds me of a student who said to me they were told they had lumbar lordosis and they were quite worried! I do not like those conversations; I have to get into territory of ‘adjusting’ either someone else’s misinformation or someone’s mishearing of information. It is mostly a ‘language’ issue, but I cannot let the student continue with such misinformation/understanding. Ya have to tell them that normal lumber spines have a ‘lordosis’, it simply being an anatomical term for the natural curve of the lumbar spine and ‘Lordosis’ is not a ‘diagnosis’ per se (and no that individual didn’t have excessive lumbar lordosis / ‘hyperlordosis’ either)}.
WHEN YOU ARE NEW, IF YOU WANT TO BUILD YOUR POSTURE ON A ROCK, THE ROCK~IS THE LOCK~IN YOUR KNEE!!
GROUND YOURSELF: New practitioners tend to ‘rely on their heel’ and the outer edge of the foot too much. This can make it more difficult to balance and can augment any real hyperextension at the knee joint. First, get yourself a good spread of the toes and distribute your body weight equally around your foot. This is KEY to accessing support in the harder to sense areas of the inner, outer and back of the knee. Proper weight distribution will help create a stronger foundation for a more sustainable pose.
Press the mound of the big toe into the floor will help recruit more muscles up the leg, calf, inner thigh, upper thigh, hip, glutes, psoas, lower back and help align everything towards the mid line of the body, moving it towards proper skeletal alignment and muscle control and core stability. We access reciprocal inhibition for the hamstrings. This creates a lifting sensation of the whole thigh, away from the knee joint. You should be feeling this rather than an achy feeling at the back of the knee.
NOW WHAT IF YOU ARE THAT ACTUAL REAL LIVE ‘HYPERMOBILE AT THE KNEES’ PERSON (congenital muscle weakness or have damage/injury)? Even then it might biomechanically be safe for the knees but may or may not affect other areas of the body.
“THE KNEE BONE CONNECTED TO THE.. THIGH BONE. THE THIGH BONE CONNECTED TO THE.. HIP BONE. THE HIP BONE CONNECTED TO THE. BACK BONE… DEM BONES DEM BONES 🙂 ” If you ARE hypermobile, as you begin to adjust your knee alignment, you may become aware that your hyperextended knees are part of a bigger postural problem. As the knees curve back there may be a tendency for the pelvis to push forward, the chest to collapse and forward head to appear in compensation thus exacerbating knee problems and contributing to problems/pain elsewhere. So as you work to adjust your knee/thigh alignment you should also check your pelvis, chest, neck/head (the whole of your vertical alignment).
WHAT ABOUT STACKING JOINTS? Another example of ‘there are no straight lines in the human body’. It doesn’t help when an article from YogaJournal2007 that is still available online that says “In normal standing alignment, the leg forms a straight line from ankle to hip, with knee over ankle and hip over knee.” “If your knee is hyperextended, however, the leg will appear to curve back, with the knee behind an imaginary straight line drawn from ankle to hip.” Again, adding to the impression that a backward curve of the knee to ANY extent is a bad/no no for EVERY BODY! They need to update / clarify.
If you are that average hyperextend person or if you are hypermobile in the knee joint person you are just not going to be able to stack your leg joints in this way. HYPEREXTENSION AND HYPERMOBILITY MEANS THE KNEE EXTENDS BACK BEYOND THE PLUMBLINE OF ANKLE, KNEE, HIP. If you were to stack them here you would have to bend your knee. Please don’t. If you ARE hypermobile make sure you have right distribution of weight on feet and make sure the hip is over the ankle and co-contract your quads and hamstrings. With right weight distribution on their foot people often do the rest unconsciously, but feel free to do it consciously. Ask in studio if you are not sure how to do this.
There is no magic formula to prevent an accident (dynamic stress) that forces chronic knee hyperextension but you CAN take steps in a mindful Yoga practice to prevent routine instances of allowing your knee joint to open too widely at its back if you are hypermobile. For instance, during some yoga poses it is easier for hypermobile people to hyperextend the knee RATHER THAN TO DO THE WORK of engaging the quads, they tend to just push their knee joints back, lazy posturing stylie. TRAIN THE QUADS to be active and strong in straight-knee poses. Strengthening exercises for the quad muscles will keep you from relying on hyperextending your knees or ‘hanging out’ on the joint.
Bernie Clarke says “In cases where hyperextension leads to knee damage the precipitating event was always dynamic; a blow to the knee in a contact sport or a sudden stop and turning or a hard land after a jump. In none of the case studies was static hyperextension cited as a cause of knee damage.”
LOCK THE KNEE IS THE KEY i.e. engage your quads. If you are hypermobile or chronic knee extender you can co-contract! The quads and the hamstrings. You have nothing to worry about, you will still be effecting Lock the Knee. In Bikram Yoga, all things being equal, everyone has to Lock the Knee or be trying to Lock the Knee. All things not being equal, you modify approach/actions taken to effect your ‘Lock the Knee’. Follow the detail the instructor gives you. WHY? In Bikram Yoga, whilst we have dynamic postures WE DO NOT SUBJECT THE KNEE TO DYNAMIC STRESS. Our static stresses (using newtons/units of force) are way below the level of a healthy knee’s tolerance even in the case of older knees/ACLs.
PERSISTENT RESISTERS OF LOCK THE KNEE 🙂 If you insist on not Locking the Knee (normal knee) or modified action to Lock the knee (hypermobile knee) you may be sending incorrect forces into your lower back, continuing to tighten hamstrings, hip flexors and are more likely to be a floor/toe gripper; sending all the wrong efforts/forces through your body and you are not giving good attention to your knees allowing them to fulfil their Dharma 🙂
Extract from ‘Anatomy of Hatha Yoga’ by David Coulter : “WHAT CAN BE DONE TO PREVENT AND RESOLVE MINOR KNEE PROBLEMS? The answer is simple- regular and prolonged muscular tension applied to the extended knee joint. Under those circumstances all parts of the joint fit together perfectly, allowing it to withstand intense isometric contraction of the surrounding muscles” pg 207 … “This {Locking the Knee} is a uniquely human gesture – a natural consequence and indeed the culmination of the evolution of our upright posture. An all-encompassing condemnation of the practice {of Lock the Knee} is ill-advised if not downright foolish.” pg 311
WHEN DOES IT BECOME AN ISSUE? “Loose joints” or hypermobility i.e. the ability of a joint to move beyond its normal range of motion – is common in children and often self limiting (decreases with age as muscle size and strength increases). In knee hypermobility the tibia moves past the femur in extension (way past the average). Ligaments and tendons play a major role in preventing excessive motion / hypermobility. If those tissues become too loose the joint can become vulnerable to being moved in ways that cause damage or set the stage for injury.
In some people hypermobility causes joint pain and results in a higher incidence of dislocations, sprains and secondary osteoarthritis. Doctors refer to this as Benign Hypermobility Syndrome (‘BHS’). In BHS the ligaments that provide joint stability are loose and weak. This increases the risk of ligament injury or strain and can cause pain. Aside from the standard measures to check for hypermobility (Beighton scores) in Yoga terms, the following abilities can also be a sign:
- easily lay your palms flat on the floor with your knees fully extended
- slip into full Yoga splits with ease
- possess the ability to press the thumb all the way back to the wrist, or other party tricks, often called double jointedness.
IF YOU HAVE CHRONIC PAIN IN YOUR KNEES, HIPS, BACK OR OTHER JOINTS YOU SHOULD HAVE THESE EVALUATED BY A DOCTOR TO DETERMINE THE CAUSE AND ELIMINATE ANY UNDERLYING DISORDERS. YOU MUST FIND OUT WHAT YOU ARE WORKING WITH.
BHS usually does not require treatment beyond moving your body with awareness and care. HOWEVER, if you are naturally very flexible, your joints may lack sufficient resistance to hyperextension, leaving the bones and connective tissues vulnerable to the wear and tear of over stretching. Moving too far into a Yoga pose over and over again WITHOUT PROPERLY ENGAGING THE MUSCLES first can cause pain and suffering in the long term. If you are hypermobile and continue to ignore the fact in your asana practice, you may get away with it for a while if you are young and supple. For a while. But it will catch up with you. Please, don’t spend 10 years overstretching already lax ligaments at the back of your knees. Stop all of this type of hyperextension now. Follow the instructions for quad activation and distribution of weight and start to feel the softening at the back of your knees. It can take a while to get back on track. Start today. You’ll be glad in ten years that you did!
SO WHAT ‘TO DO’ IF HYPEREXTENSION/CHRONIC HYPEREXTENSION IS A PROBLEM?
- Move your body with awareness
- Consider, how does it FEEL?
- Do not overly rely on your heels ~ ensure balls of feet stay firmly weighted
- WHAT THOSE AT RISK OF HYPEREXTENSION OF KNEE REALLY NEED to do is co-contract (engaging hamstrings and quads) to stop the femur from internally rotating
- Do not ‘jam’ the knee backwards so that the tibia moves past femur in extension (past point of being straight)
- Ensure quads are engaged and active lifting kneecaps (the quads create the lift and support your knee joints)
- Ensure the hamstrings are working as well
- Do this standing both legs. Watch this in the front mirror. Notice when your knees chronic hyperextend how the knees separate? Use the muscles deep in your hip (hip rotators) to bring the backs of the knees closer (for some the knees will touch/others there will still be a gap).
- Now do it watching in a side mirror to see when the legs become exactly straight. There it is! When you have a sense of how to stop the internal rotation.
- Then you can start to apply it to one leg balancing postures.
- You can practice this in any standing posture.
WHEN/ WHERE DOES MICRO BENDING THE KNEE COME INTO ALL THIS? Because you are unique! Yoga is NEVER one size fits all. If you have CHRONIC hyperextension/hypermobile then Soften or ‘Micro’ bend the knee might just be for you to stop you going to end ROM! Use the side mirrors to get a visual aid to help with this; this is not like a normal bend of the knee and for people who are hypermobile will produce the effect of a straight or straighter leg rather than a ‘bow’ back leg. I have been reading books and articles for years on the pros and cons of locking and / or micro bending with a trend at one point (outside the Bikram community I might add) for microbends everywhere for various reasons, changing the energy of the postures, the effect on the body, practitioners of course discovering that it was sometimes harder, engaging muscles in a different way, working out whether they were using or overusing muscles/bones/ligaments to effect posture, feeling like it was some sort of revelation and just because it was so totally different to what they had done before or how they had effected posture before that it must then surely be the ‘enlightment’ about their posture they had been waiting for. There have definitely been cues that have become fashionable or misunderstood/applied over the years. The ‘Lock the Knee’ cue has never changed. Only some well meaning teachers decided to change some instances of its application or not application because the word ‘hyper’ has such negative connotations attached to it at some point a new teaching to counter this hyper even started to creep in to some Bikram teachers cues and they began teaching a ‘microbend’ of the knee to EVERYbody/whole classes and it started to creep and be applied across the board where it wasn’t needed. As an aside, I heard something similar happened in the 90s in the Astanga community. A teacher started saying to relax the glutes in backbends (because they themselves were really flexible and that cue worked for them). Many thought that was the gold standard of ‘arriving’ in backbending postures and started teaching it to all students. 10 years later all of those teachers developed back and si joint issues too late in realising that the glutes were essential in stabilizing the pelvis. Yet ‘relax the butt’ keeps getting repeated in backbends because someone heard it and repeated it and someone heard that and repeated it.
- FOR THE OVERLY CAUTIOUS (who are not chronic hyperextending) remember, we evolved to hyperextend at the knee when we walk and if we lose that ability to hyperextend through injury it is important to restore it in rehab. If you are overly cautious and apply microbend where you don’t need to you may prevent the proper stress needed to keep the knees healthy; it is such a hard call for the overly cautious person but it is their call.
FINAL NOTE There is one thing that makes teaching Yogasana really hard and that is the prevailing large quantity of images online of super flexible people (hypermobile/contortionists) whose photographs are held up as being some sort of ideal for the rest of us to achieve. Many of them have moved into these positions with great ease (because of super mobile joints) but may not be activating the right muscles to create the move; and what you cannot see from the photos is they may not be able to hold the posture because of lack of muscle activation/lack of strength and they are just exploiting flexibility of joints and possibly ‘hanging’ on their joints. For these people I see it is much more difficult to focus on building strength when the rest of the world is ‘ooohing’ and ‘aaaahing’ at their flexibility prowess. When I was young Yogi I did my fair share of ‘ooohing’ at some of the pics (but the contortionists always did and still do give me the shudders). NOW I am so glad I am not super flexy; I LOVE the feeling of stability and that I can create flexibility by right effort on top of it.
Another dilemma as an instructor is that I cannot see many practitioners’ knees in class because of a fashion for wearing long/baggier leggings to practice in; the knees are shielded from my view. So there may be a few people may not even know they are chronic hyperextending or those that do may not realise that they need to work slightly differently to the generic techniques being verbalized by me (this requires private conversations outside of class environment).
In our public classes we are not testing individual students’ normal range of motion. We don’t have the equipment. I don’t think this should to be over ‘thought’. People don’t need to panic. WE ARE TRYING TO TEACH people to connect their body and mind; to have body consciousness; to become their own best teachers; to LISTEN to their body; LISTEN TO THEIR KNEES; discover HOW TO TAKE CARE OF THEMSELVES, find their physical and mental limits and so much more.
LOCK THE KNEE instruction is not just Lock the Knee. It is the foundation stone for stability and success in practice. Yes it might take a while to ‘get it’, but perceived mistakes on the journey are really only stepping stones to success. Come to class to ‘unlock’ Lock the Knee instruction! Think of how you apply yourself to ‘Lock The Knee’ as a metaphor for how you apply yourself to the job of living. With honesty try to Lock the Knee. Energetically your practice of Lock the Knee will come from a place of best alignment, right intent and ease/relaxation. When practiced in this way there will be an automatic shifting to the right muscle engagement. Given time you will find this is simple and the most natural occurrence (best effort, never force) and there will be little resistance to your emerging asana.
Welcome to your safe, sustainable practice.
Om Om Om Rock ON! Lock ON! Same Same 🙂
Trisha
March 2019