Healthy and Unhealthy Stretching Sensations

by Nina

Flames by Melina Meza

Ever hear someone else groaning in a yoga class? Or maybe that you? Yes, when you are stretching a tight area of your body, you can experience quite a bit of sensation. And while healthy stretches can provoke an intense feeling, it�s a good idea to pay attention to the type of sensation you�re experiencing because this may indicate you should back off the stretch.

As we discussed in previous posts (see What is Flexibility, Anyway?), stretching a muscle or muscle group and fascia is healthy and beneficial, but stretching a tendon or ligament can cause an injury, such as a tear, inflammation, tendonitis, or tendonosis. In addition, compressing a joint when you are stretching can pinch the tissues caught between the bones closing in toward each other, which cause pain and lead to inflammation. So it�s important to learn to tell the difference between the sensations of healthy stretch of a tight muscle versus the pain, pinching, or �smashed together� feelings that are warnings of potential injury. 

Healthy Sensations. You will feel generally feel healthy stretch of a muscle in the mid-portion of a muscle, farther away from the tendons and ligaments are located close to joints. A good place to become familiar with this type of sensation is the hamstring muscle at the backs of your thighs, which you stretch in Standing Forward Bend (Uttanasana) and Reclined Leg Stretch (Supta Padangusthasana). As most of you know, the intensity of the stretch sensation there can be quite strong, and yet it generally doesn�t mean you are injuring yourself. So when you experience this type of sensation, as long as the stretch is a moderate one, take a deep breath and try to relax into the stretch. 

Unhealthy Sensations. You will generally feel an unhealthy stretch of muscle, tendon, or ligaments closer to a joint, such as your hip, knee, shoulder or elbow joint. And the quality of feeling will be different than a healthy stretch, maybe burning, sharp, stabbing, throbbing, or tearing in quality. For example, with the hamstring muscles, if you feel a tender burning sensation up toward your buttocks, this could be an indication you are overstretching the attachments. In all cases, when you experience these types of sensations, you should immediately back off the stretch if possible to see if that helps. If not, come out of the pose entirely.

It is possible to feel this burning, sharp, stabbing, throbbing, or tearing sensation in the muscle body as a result of a sudden, intense, quick stretch, so that is why we always recommend moving slowly and with in control into your stretches. 

Joint Compression. Sometimes when you are stretching a muscle, the joint that is bending can become compressed. For example, when you deeply bend your knee joints, as in Child�s pose (Balasana), the tissues at the back of the knee joint can become pinched together. This is potentially dangerous because the compression could produce tissue damage and inflammation, or even could injure nerves or blood vessels, leading to acute or chronic pain and dysfunction.

In general what you�ll feel when a joint is compressed is either a sensation of muscles, skins, tendons, fascia, and/or bones being �smashed together� or a pinching sensation. For example, some of less flexible folks feel smashed together or pinching sensations in our front hip when doing Extended Side Angle pose (Utthita Parsvakonasana) with our hand on the floor. Both of these sensations indicate that you are overdoing it, and you should back off the stretch, possibly by adding a prop. If you can�t eliminate the joint compression, come out of the pose. 

Compression can also put pressure on blood vessels and nerves, so if you have an unusual pressure sensation in the joint or feel numbness and tingling downstream from the compressed area, that is an indication that you are overdoing it and should back off the stretch or come out of the pose.

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Friday Practical Pointers: Who Should Avoid Certain Knee Movements?

by Baxter

Flexion and Eternal Rotation by Melina Meza

Our tour through the body�s major joints continues today with a look at who should avoid certain knee movements. When it comes to possible movements, the knee joint is a quite a bit simpler than the hip and the shoulder as it is mostly about bending and straightening. But because of its role in standing, walking, and running, the knee is one of the most commonly injured joints and very frequently affected by the wear and tear of osteoarthritis. 

Movements of the Knee Joint

Flexion: Bending your knee (moving the lower leg bones backwards toward the upper leg). You make this movement when you move into bent-knee standing poses such as Warrior 1, 2 and Side Angle Pose when the front leg goes from straight to bending the knee over the ankle. The movement is also essential for bending your knee more deeply, such as when sitting in Hero pose (Virasana) or Child�s pose (Balasana). 

Extension: Starting from a bent knee position, straightening your knee (moving the lower leg bone forward and away from the upper leg). The opposite movement of flexion is extension, so anytime your knee is bent and moves towards straightening, your knee is going into extension. You make this movement when you exit from Warrior I or 2 (Virabradrasana 1 or 2) or Extended Side Angle pose (Utthita Parsvokanasana) or in the transition from Warrior 1 to Warrior 3. You also make this movement when you lift your back leg in Hunting Dog pose, come into Cobra pose (Bujangasana) from Child�s pose (Balasana), or move into Downward-Facing Dog pose (Adho Mukha Svanasana) from all fours. 

Internal Rotation: When your knee is bent, rolling the lower leg bones in, towards the midline of your body. The lower leg can internally rotate a small amount at the knee joint only when the knee is in flexion. You make this movement in Hero pose (Virasana), both seated and reclined versions, as well as in the many seated poses that have one leg in Hero pose. 

External Rotation: When your knee is bent, rolling the lower leg bones outward, away from the midline. The lower leg can externally rotate a small amount at the knee joint when the knee is in flexion. You make this movement in many bent-knee seated and reclined poses, including simple ones like Cobbler�s pose (Baddha Konasana), both seated and reclined, more complex ones like Half and Full Lotus poses (Padmasana). 

Note: When the knee joint is in full extension, such as in Mountain pose (Tadasana), your lower leg cannot independently rotate from the knee, either internally or externally. In this case, when your upper leg rotates from the hip, your lower leg goes along for the ride. You can see this when you turn your front leg out to prepare for pose a standing pose like Triangle pose (Trikonasana) or in a straight leg seated pose, such Wide-Angle Seated Forward Bend (Upavista Konasana).

Cautions for the Knee Joint

Now let�s look at who should avoid or minimize certain knee movements. Keep in mind, however, that we want to maintain as much of our full range of movement of the knee joint as possible. So, in many instances, my caution will not mean �don�t� or �never,� but rather approach cautiously and stop if the movement worsens pain. In general, you should avoid or minimize any knee movement if you have:

1. Acute painful injury to the knee area that gets worse with that movement, whether from a sports activity, such as acute ligament sprains, or a problem like acute bursitis that is the result of bumping your knee cap or over use.
2. Chronic issues that flare with that movement, such as those with knee joint arthritis or those with meniscal and ACL ligament injuries that have not been repaired or even, in some cases, that have been surgically repaired. 

Now for the specific movements. Who should avoid or minimize the following movements?

Flexion

1. Those with significant swelling in the joint, whether from an acute injury or the flare of a chronic condition, such that the swelling actually inhibits movement or elicits significant pain when movement takes place.
2. Those with Patellar Femoral Syndrome, a fairly common condition affecting the knee cap and knee joint, which often is worse with flexion.
3. Those with arthritis of the knee that become more painful with flexion.
4. Those with bursitis at the kneecap area or with a Baker�s cyst at the back of the knee.
5. Those with ACL repairs who need to avoid extreme flexion, such is in full Child�s pose (Balasana).

Extension

1. Those with tears to the ACL ligament need to avoid sudden strong extension, such as stepping from Lunge pose (Vanarasana) to Downward-Facing Dog pose (Adho Mukha Svanasana), or jumping from Standing Forward Bend (Uttanasana) to Downward-Facing Dog pose.
2. Those with hyperflexible knees may want to avoid full extension in straight leg poses to avoid wear and tear on the internal knee structures and ligament over-stretching.

Internal Rotation 

1. Those who experience increase pain in the knee in poses where the knee is both flexed and internally rotating, such as Hero pose (Virasana), both seated and reclined, and the seated twists where one leg is in Half Hero pose (Adra Virasana).
2. Those with tears to the meniscus (the half moon cushion of the knee) where increased pain or locking of the knee occurs with flexion and internal rotation.

External Rotation

1. Those who experience pain in the knees where the knee is both flexed and externally rotating, such as Cobbler�s pose (Baddha Konasana), both seated and reclined, Half and Full Lotus poses (Padmasana). 
2. Those with tears to the meniscus (the half moon cushion of the knee) where increased pain or locking of the knee occurs with flexion and external rotation.

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Protecting Your Joints

by Baxter

Today I�d like to review the idea of protecting your joints via your yoga practice. I will share with you why this is a good�maybe essential�idea, and then provide info about how and when to do it. 

Why Protect Your Joints

Our joints are the pivot points by which our myofascial system moves our bodies around. So healthy joints means healthy movement. I define a healthy joint as allowing for the full range of movement�whether it is weight bearing or not�that is smooth and pain-free. Learning to protect your joints while they are still healthy has a preventative benefit over time. After all, we have all heard by now that the protective surfaces of joints, coated with cartilage, are subject to wear and tear over time, especially if we do a lot of repetitive movements at certain joints (you runners out there perking up?). And of course, many joints (think ankles, knees, shoulders, and wrists) are subject to acute injuries that our yoga practice might also help prevent with good technique. Finally, if we have already developed joint issues, such as osteoarthritis or a joint injury, protecting the joints could allow for healing, reduced pain, and improved movement. 

How to Protect Your Joints

Supporting Your Joints. One technique you can employ in your yoga asana is to protect your joints by consciously firming the muscles that support the joint. This is beneficial for problem joints as well as for protecting healthy joints. 

Nina described technique in her post Why and How to Activate Your Muscles in Yoga Poses. She said that, for example, if you have knee arthritis, firming the muscles on all sides of your thighs in Extended Side Angle pose (Utthita Parsvakonasana) will help support your knees. And for people who are overly flexible and can bend easily into deep forward bends and backbends, consciously activating the muscles that are supporting you in the pose will prevent you from hanging from your joints, which can cause injury. For example, instead of passively dropping into a pose where you bend backward or forward from the hips, such as Camel pose (Ustrasana) and Standing Forward Bend, (Uttanasana), you can protect your hip joints by activating your upper thigh and lower buttock muscles. (For flexible folks this will actually mean focusing more on firming the muscles and not going as deep into a stretch as they can actually go.)

For joint safety, you want to emphasize strength and stability rather than promoting more flexibility. So practice as you would for increasing bone or muscle strength by firming the muscles that support your joints. For example, to protect your front knee in Warrior 2 pose, you might shorten the distance between your feet so you are not bending your front knee through such a deep range of motion, and then, when your knee is positioned over your ankle joint, focus on firming the muscles on all sides of the knee joint toward the bone. 

If you have healthy joints now, you can use this technique to support any joint that is weight bearing, such as the joints of the legs in standing poses or the joints of the arms in poses where you are supported by your arms, such as, Cat/Cow, Downward-Facing Dog pose, and Upward Facing Dog pose. Although this technique will be easier to turn on in poses that you hold for longer periods of time, with practice, you may be able to bring a bit of this feeling into even some dynamic work.

Making Space. In addition to this firming technique that Nina described, I also recommend the technique of �making space� in the joints for people who are having problems. For ankles, knees, hips, wrists and elbows, to make space in the joint, lift the bone immediately above the joint, relative to gravity. For example, if someone with knee pain from arthritis is working in standing poses, you would lift your thighbones (femurs) away from the lower leg bones as you are entering, holding, and exiting a pose. In inverted poses, this same person could move their shinbones up away from their thighbones (even though in non-weight bearing positions the knee might be symptom free).

This internal action of lifting one bone away from another creates a bit more space between the boney surfaces of the joint and can provide improved pain-free range of motion. I find it personally helpful with my left hip that may have some early arthritis changes and many of my students have adopted it for their affected joints.

The only potential downside to this technique is that the joints above and below the joint where you are creating more space will cinch down a bit, so you lose some space in those healthier, non-arthritic joints. So don�t use it for problem joints if it doesn�t provide you with relief. And don�t use it regularly for your healthy joints. 

Although this technique will be easier to turn on in poses that you hold for longer periods of time, with practice, you may be able to bring a bit of this feeling into even some dynamic work.

If you have joint problems now, see if this technique is helpful for you. You can use this technique alone or in combination with the muscular contraction technique if it works for you. Although we don�t recommend using the making space technique regularly for healthy joints, you could also experiment a bit it, just to have it in your bag of tricks should you need it down the road. 

Propping in Restorative Poses. One of the best features of restorative poses is that once you are set up, you get to relax your body and let the pose, props, and gravity do the work of stretching your body. This does not mean, however, that your joints are necessarily safe in all restorative poses. Although you do not want to use our two joint protection techniques in restorative poses�as it goes against their underlying principle of relaxing your muscles�you should still make sure that you are not noticing any compression sensation, pinching sensation, or pain at your joints. A classic example where this can happen is pain or pinching in the knees in Supported Childs pose. In such a case, add just enough additional lift for your body so that the pinching or pain goes away, even if that means feeling less of a stretch.

And just as over-stretching can cause joint problems an active pose, it can do so also in restorative poses, leading to potential strain on the joints. Therefore, if you notice pain in your joints after practicing restorative poses with less support, we recommend that you add in more support, aiming for a lighter feeling of stretch. 

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