After Shari’s recent post about her swollen knee (see Yoga and Pain Management), a reader left this question for her in the comments section. We like to answer these questions on Fridays, just in case there are other readers out there who might be interested in the discussion. For all you new readers, feel free to ask questions about yoga as comments on any post, even older posts. or to email me via the Contact Us page on the blog. We’re keeping track of all questions and will answer them all eventually! —Nina
Q: Re: your swollen knee – can I use these poses for someone with a meniscus tear? I have been avoiding balasana, but am wondering whether cat/cow is okay as the weight is split between 4 points of the hands and knees. Would be grateful for any other useful pointers.
A: With a meniscal tear, there will range of motion loss, especially in flexion (bending the knee). Extension (straightening) can also sometimes have a slight loss of range of motion. That said, any pose that doesn’t cause swelling afterward is okay. Pain may or may not be the limiting factor but swelling definitely is. As to specific poses like Balasana (Child’s pose), if you have pain, use a prop, like a block or a bolster, to limit the knee flexion. Cat-Cow pose is certainly a weight-bearing pose through the patella (kneecap), but that may or may not be a factor. You’ll have to try it and see what happens. Using padding under the knees would be helpful. Definitely avoid knee movements that involve rotation, as it will cause pain and swelling.
—Shari
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Shari,
It's been my experience that you can enhance range and increase comfort with Child's Pose for those with degenerative changes to include meniscal tears by first placing a rolled mat behind their knees that creates a fulcrum to gap the tibio-femoral joint, then place a folded blanket over their heels and have them slowly sit back far enough to create a modest stretch pressure around the knee (no sharpness), be sure the blanket touches their buttocks (this reassures the brain there's support and allows them to "let go" deeper into the pose). They can then either bring arms to the side or often like arms extended overhead to control surrender. To come out they draw the hands in close and load up through the arms to slowly extend/straighten the knee.
Hope that's helpful. ~ matt
Hi Matt;
Your suggestions are correct but sometimes with alot of swelling regardless of the cause Balasasana can't be done no matter how you prop it. So then using a chair facing a chair with a bolster and or block allows you to access the pose without the deep knee flexion. Trying to figure out how to recreate "the shape of the pose" and allow access is wonderfully empowering for the teacher as well as the student.
Shari