Yoga after knee surgery can be a very useful tool in the rehabilitation process when carried out mindfully and with an awareness of your limitations throughout each stage of the recovery period. Yoga can help to minimise or even eliminate bad postural habits that you may have had before surgery, which could have even been a contributing factor to your knee problems.
The range of motion in your knee will depend on various factors including how much R.O.M you lost before surgery, how long ago the surgery was carried out, and if you’ve been following an exercise plan post-operation recommended to you by your physiotherapist.
Things to consider when returning to yoga after knee surgery
The basic indicator of how easily you can get up and down from the floor is a good place to start with when considering what yoga poses you can and cannot do.
Post-op alignment in yoga is very important when returing to your yoga practice to prevent recurrence of any knee issues. Avoid torque forces through the knee joint which will affect the cement in the joint (the meniscus). It’s important that you keep your toes and knees tracking in the same direction in poses such as Warrior 1 and Goddess.
Stacking the joints from the base up in standing poses will not only help prevent future knee issues but will also give you more stability in your standing poses. Remember to pull back from poses such as Warrior 2 until you feel that you have the strength to go deeper, and try to avoid passing the knee beyond the ankle.
Contrary to what you may think though, kneeling is problematic but not necessarily injurious to the new knee. Using props such as blankets or cushions under your knee when doing poses performed on all fours may help ease any discomfort. Be conscious of when the right time to perform poses in which you’re on your knees is, such as Camel pose. And remember that often the pose can be taken standing up or cross-legged as a variation if you find that you’re putting too much weight on your knees for comfort.
Don’t just focus on the knee itself
One of the key factors in using yoga as part of the therapeutic process after a knee replacement is that you’re not just bringing your focus to the knee itself. Strengthening all the muscles that cross the knee will greatly help towards a successful recovery. This means working with the whole area from the hips down to the feet to make them stronger in their supporting role.
Strengthening your quadriceps and hamstrings will be highly beneficial, as these are often weakened in surgery and recovery. And if you have tight hips or hamstrings make sure that you modify the pose to allow these areas to properly open and stabilise, preventing strain on or incorrect movement patterns in the knees.
Standing poses if carried out mindfully can help to strengthen the quadriceps and hamstrings, but make sure you take them slowly and pay special attention to alignment. If taken in small steps these standing poses will help maximise a full range of motion in the knee. Any poses that require deep flexion of the knees can be propped or you can use a chair or wall to help take some of the weight out of the pose or avoid these poses altogether whilst recovering. Poses that strengthen the hips and ankles will help to further stabilise the knee joint.
Questions to consider with your yoga teacher or therapist before starting to practise yoga again after knee replacement surgery.
1. How long ago was the surgery?
2. Are you still in pain?
3. Are you still in physical therapy?
4. Do you have any hip or back pain (either before or after the knee replacement)?
5. How much mobility do you currently have? Can you get up and down from the floor?
6. Do you have arthritis in any other joints?
For further reading on yoga after knee replacement therapy click here
Yoga poses for strengthening the supporting the muscles of the knees
Warrior 1 and 2
Strengthen and stretches the leg muscles and hip flexors. Building strength in the quadriceps of the front leg and the lower outer leg muscles of the back leg. Helps build awareness in proper tracking of the knee. Your knee should be aiming towards being in line with your second and third toe of the bent knee leg.
Bridge pose
Works with strengthening your hamstrings. Stretch your hip flexors and lightly engage the hip extensors in the buttocks. Make sure that your knees are tracking in the same direction as your feet, which are in turn in line with your hips. Press actively into all 4 corners of your feet to recruit all of your leg muscles.
Tadasana on block
Practice leg lifts out to the side and back to centre whilst standing on a raised prop. Building strength in your abductors (outer hip) and adductors (inner thigh). Stabilises the pelvis.
Locust variations
Stabilises the sacrum at the end of the spine. Stretches and strengthens the hip abductors on the outer hips and tones the quadriceps, glutes and along the spine.
Extended hand to big toe with the wall
You don’t have to come into the full expression of this pose. Bring yourself to a wall and lightly place your fingers on the wall to help with balance. Use a belt around the toes of the extended leg if you can’t reach without rounding through the spine. Try to maintain stability in the pelvis by keeping your hip bones in line.
Yoga poses with counter-indications after knee surgery
Pigeon pose
Take a figure of 4 on your back instead of full Pigeon pose to take the weight off your knees. You could also try leaning forward with 90/90 legs, also known as Reclining Deer pose.
Eagle pose
Pace a block by the outside of your standing leg and don’t fully wrap the leg that you’re crossing. Probably best to avoid this pose altogether if too close to surgery.
Low Squat
Try a higher Goddess pose instead of Malasana. Alternatively, place a block or two under your sit bones to help take the weight off the knees, but whilst still decompressing your sacrum. Make sure that your knees are tracking in line with your feet.
Hero pose
Sit on a block or bolster or avoid this pose altogether.
Childs
Place a cushion or blanket under your knees to cushion them and also between your calves and thighs to help take the pressure off your knees. alternatively try Dangling to decompress your back line.
Check out more yoga therapy advice here
