Friday, October 28, 2011

Injury: Back to Square... One? Zero? (I really don't know)

I hate to have to admit this on the blogosphere, but I think I better, since I always try to write in a way that is real and not (or at least not too) fake. So here it is: I officially injured my left knee. Probably did something to the meniscus. Which is rather ironic, in a way, since I have always thought it the stronger side. This, on top of the fact that I have a sore throat right now and can barely speak (but can still blog :-)) makes for a very interesting time.

I think the whole knee issue started a few weeks ago, when I decided to try going into Utkatasana from a squatting position in Surya B. The first few days I tried this, my left knee felt sore. And then my SI joint went out. So I switched to doing primary and the first few backbends of second to try to straighten out this issue. The SI joint healed, but the soreness/tweakiness in the left knee joint persisted. Basically, I discovered that postures which involve closing the left knee joint and bringing the left foot close to the left hip (Triangmukhaikapada Paschimottasana, Krounchasana, Bhekasana) tend to aggravate the left knee. Things got somewhat better on Wednesday, which was a moon day, presumably because I didn't practice and the body got to rest. And then during yesterday's practice, I definitely pushed past my limit in Bhekasana (I'm one of those people who can get the entire sole of the foot to the ground in this pose, which is a good thing when you are not injured. If you are injured, well, not so...), because my left knee felt really stiff after practice. (Why do I do this to myself? Ego. Guilty as charged...) 

And, to add insult to injury, when I got off the bus to campus yesterday, I jumped off the bus, landed on my left foot, and immediately felt that something was very wrong. For the rest of the day, I couldn't put pressure on the left foot while walking without feeling pain in my inner knee. Walking up the stairs is fine, but walking down the stairs hurts. I felt around my left knee, and found this tender spot on the inner knee. No good, no good. I spoke with a couple of people about this, and they suggested that I go get an MRI and get it checked out. It looks like I don't have a choice with this one; did I ever tell you that I dread/hate going to the doctor's? But what to do? 

This morning, I did a shorter practice: Primary up to Triangmukhaikapada Paschimottanasa, then skip to Baddha Konasana, followed by the rest of primary and finishing. I noticed a few things:

(1) When I stepped out into the standing postures (Trikonasana, Parsvakonasana, etc.), I felt pain in my left knee, as if the stepping out movement was pulling on something in the left knee.

(2) When I got to Ardha Baddha Padmottanasana, I really hesitated about doing the posture on the left side, but decided to try going into it very slowly on the left side. There was some discomfort closing the knee joint, but it closed, and I was then able to get into half-lotus. As I went into half-lotus, I felt something shift in the knee joint.

After I did Ardha Baddha Padmottanasana, I decided, on a whim, to try the stepping out movement again. This time, it did not hurt. It appears that whatever was hurting the knee the first time had something to do with whatever it was that had shifted in the knee.

(3) I skipped the Marichyasanas today, because the act of closing the left knee joint combined with twisting or bending forward causes pain in that knee. Would one way of modifying the Marichyasanas be to not close the knee joint completely and/or not bend forward or twist fully? If any of you out there have any suggestions on this, I would live to hear them. 

So, this morning's practice was not great, but it was definitely healing. A few minutes after practice, I tried walking down the stairs in my apartment, and discovered that my knee did not hurt anymore. Which is good, because otherwise I won't be able to leave the house today. But injuries are really a bummer... 

Oh, and by the way, I am not writing this post to glorify injury or to advocate wearing injury like a badge of courage/honor/whatever. Injuries, as you can see, suck. But maybe they are part and parcel of the process for some people (i.e. me). So I will do my best to swallow my ego and try to learn from this. In the meantime, between my knee and my sore throat, you may find me posting less over the net few days. Not that you'd care, necessarily. But just thought I'd let you know :-)


  1. Okay, no injury badge medal for you then.;) I'm curious, did you feel anything during Virabhadrasana I &II? Or did you skip those? I hope it is just inflammation and it responds to rest.

  2. Injuries suck... I'm sorry. Take care of yourself.

  3. sereneflavor, I did feel some intermittent pressure on the knee when the left knee is in the straight-legged position in Vira I. Perhaps this means I should skip Surya B. But Surya B feels so good in every other area... Or is this my ego speaking again? I don't know. I'll have to think about this.

    Thanks for your kind thoughts, wandering mb :-)

  4. Sorry to read about the injury Nobel, good luck working around and with it.

  5. Thanks for your kind thoughts, Grimmly. Good luck working with your gastroenteritis too; it looks like you have a good practice plan going :-) Me, I'm still working things out.

  6. I'm sorry about your injury, but thanks for listing poses that hurt and don't hurt the knees. My knees aren't that great either and it's good to know which poses to pay more attention to my own knees.

  7. Thanks Yyogini. Honestly, I'm not sure how helpful my list really is. All I have done is list postures that hurt and don't hurt my knees at this particular point in time, given the particular injury that I have. For example, many people with knee issues find any lotus variation painful. But this is not true for me; in fact, it seems that lotus postures, if done carefully, seem to help rather than hurt my condition at this point. It's postures like Bhekasana and Krounchasana that hurt me. But other people might find some variation of these postures to be therapeutic. Well... isn't there a Chinese saying that the knee is the joint of a thousand problems?

  8. Hi Nobel,

    I've written perhaps a little too extensively about my knee injury from late July. The funny thing is that although I hurt the inside of my left knee, like you, it must be a different spot because I can do bhekasana (although I only do one foot at a time and not to the floor) and krounchasana just fine. It's ardha baddha padma paschimottanasana and ardha baddha padmottanansa that bother me, and janu sirsasana is no longer the joy it once was. So if half lotus is out for me, I can't bind in mari b (never had d anyway), athough a and c are fine. Different, yes? I suspect the medial collateral ligament with possible meniscus involvement, but never had an MRI. Can you see it? "Dr.. XYZ, when I put my left knee in half lotus position and attempt to wrap my left arm around my back, there is this unbearable pain." Hmmm, have you tried not doing that?
    Anyway, I just went to my first acupuncture session and am cautiously optimistic. I'll report more later. But she said that it would have been great if I came when I first injured it instead of waiting two months. Of course, I was hoping that it would have healed itself in this time. Apparently there is low blood flow to the inner knee area and injuries heal slowly or (gulp) not at all (from internet research). The acupuncturist suggested alternating applications of heat and cold, as many as I have time for, to get things moving.
    I hope this helps! I'll be following....

  9. Hi Nobel - So sorry to hear about the knee. I've injured both of my knees through negligent practice and all I can say is: be patient and be cautious. My knee-healing mantra the second time around was, "any sensation is too much."

    Do NOTHING that causes sensation in the knee. To modify the Marichyasanas, avoid taking the leg into half lotus and just tuck the foot behind your front heel.

  10. BTW, While my knee was injured, I did all of Primary without any half-lotus or lotus for at least a month, maybe two. I think some of my posts during the knee recovery period outline the modified, knee-safe Primary approach.

  11. Uh oh, I am sorry to hear this Nobel, as everyone else. Hope you find the patience to work through it! Sending you light!

  12. hi Nobel
    sorry to hear that. injuries are always scary ;-( maybe you should take a break and see someone about it not to aggravate it? healing wishes to you my cyber-hood ashtangi. may the force be with you ;-) ivana

  13. Oh dear! Sounds like your body's going through a fair amount of stress at the moment, maybe it's just a sign for you to take it easy and not push too much. Megan's mantra sounds pretty sensible too.

    Sending you healing vibes and hope all the discomfort dissipates soon!

  14. Actually, I was wondering if you were "OK" cos you hadn't posted in a few days:). Injuries blow big time chunks for sure. This too shall pass, and if it doesn't, then oh well, you will find a way to practice that honours where you are, not where you were or will be...remember Nobel, you are not this body:) Hope you feel better soon:)

  15. Hi Nobel!
    Sorry to hear about your injury. Unfortunately, I feel like when the something in the low back goes out (i.e. the SI joint...) the rest of my leg is put in a vulnerable position. I hope that it turns out to be the best case scenario and heals well. In any case, it's amazing how the body can heal itself when you are cautious and take care. Best wishes, Erica. xom.

  16. Thank you everybody for your kind thoughts and words.

    Hello Deborah, thanks for sharing. Actually, a couple of friends have also suggested acupuncture to me. I am going to go check out this TCM place near my place very soon. Actually, last year, I had an injury on my right knee that is very similar to the one you are having. Through patient practice (I found that one thing that really helped was to close the right knee joint before trying to bring the foot into lotus; this enables you to avoid torquing the knee) and doing a lot of hip openers outside of practice, I was able to heal the injury over the course of a year (Yes, these things do take time to heal). There are still days when I experience a little stiffness and/or tweakiness in the right knee, but overall, it's feeling great.

    Unfortunately, this thing I am now having with my left knee seems to be a different animal altogether. It seems that every knee injury is different.

  17. Hello Megan,

    "any sensation is too much." Thanks. This is good. I will keep this mind as I heal myself.

    Thanks Claudia, Ivana and Savasanaaddict. I will be patient and heal.

    Thank you for the kind thoughts and words, JayaKrishna. I think your insight ("this too shall pass...") is very, well, insightful :-)

  18. Hello Erica,
    your observation is very spot on. The last two times I've had problems with my knees (including this one) have been accompanied by or preceded by SI joint problems. Perhaps the body tries to relieve the pressure on the SI joint by shifting more pressure onto the knees? Just a thought. In any case, I have to devote my energy to healing now. Thanks for your words and thoughts :-)

  19. dear Nobel
    i'm sorry to read about the left knee injury. i have an injury to that knee area as well. i call it "area" so as to not think about it too much. i don't think i want to know the knitty gritty of which part of the anatomy is injured.

    it sounds like the Carlin joke of how he hated airline stewards saying, "we are landing in the San Diego area" - he did not want to land in an area, he wanted to land on the ground. but i digress.

    last may i had been doing traditional ashtanga quite intensively in my teacher's room. he attributed my trouble to using a bike without gears to go to the shala. the pushing motion to get the bike going, he thought, made the muscles tighter. so he suggested i buy an electric bike. i could not bend the leg in the same poses you mention. although i switched to an electrical bike, the problem still persisted. i have to modify on that side for all binding poses. on very rare ocassions i can get past the pain. if i push it, it will hurt. i have to switch to practicing other poses and avoid those that agravate the knee. now my practices are much shorter (and infrequent, alas) because of my schedule. so i do a lot of substitution poses, since i've lost some flexibility :(.


  20. Thanks for sharing, Arturo. So you are also a George Carlin fan :-)

    "i don't think i want to know the knitty gritty of which part of the anatomy is injured."

    I hear you on this. I'm pretty conflicted on this as well. It might be good, on the one hand, to know what exactly is wrong with one's body, so one can perhaps know better what one is dealing with. But there's also a part of me that doesn't really need to know; what I really need is to heal, and I don't really care how this happens. Do I sound irresponsible? I don't know.

    I think there is a similarity between your injury and mine, because I also feel a certain tightness in the front thigh muscles, although I don't know what exactly is causing the tightness. My guess right now is that the tightness is probably due to those muscles working extra hard to compensate for some other imbalance somewhere else.