Patello-Femoral Syndrome
This is a problem affecting the knees. Yoga can help protect the knee from this condition. It is important to ensure alignment in yoga is correct however to avoid causing problems in the knees.
Understanding the Patella (Kneecap)
The patello-femoral joint is where the patella (kneecap) meets the femur.
The patella aligns the movement at the knee. It keeps flexion and extension as true to straight as possible and is also designed for leverage.
It is essential to the strength we have when we extend the knee. Without this bone the tendon would rub on the bones as we move the knee joint, eventually it would fray and tear from friction.
The underside of the patella has cartilage which allows it to slide on the groove of the femur.
The patella is held in place by the thick patella ligament (patella tendon). This ligament doesn’t allow very much movement up or down the patella once it becomes taut. Instead, as the knee bends in flexion, the femur slides under the patella. This helps keep the movement as straight as possible.
What is Patello-Femoral Syndrome?
The syndrome is caused by wearing away of the cartilage on the underside of the patella.
Symptoms:
Pain deep inside the knee
Stiffness after long immobility
Stiffness after long sustained use
There are other issues or conditions that can cause pain the knees so it is advisable to speak to your doctor to get a specific diagnosis.
What causes Patello-Femoral Syndrome?
The cause could be a result of one or more of the following:
Usually overuse of the joint.
High impact activities
Prolonged sitting or kneeling
Depending on genetics people start off with different amounts of cartilage
Alignment of the knee – If the muscles that control the patella (quadriceps on the front of the thigh) are imbalanced, they add to the amount of pressure on the patella
Alignment of the bones - the angle your thigh bone (femur) connects to the shin bone (tibia), the way the knee cap (patella) fits onto your femur, and the way your ankle and foot line up with the shin bone
Muscle strength - the muscles that influence the hips, knees and ankle all influence your alignment and knee function
Muscle tightness - if the muscles that cross the knee and attach to the patella are tight, it will influence the way the patella moves
Other consequences:
It can be a precursor to arthritis at the joint.
How Yoga Can Help:
Yoga poses promote correct alignment and improve strength.
Yoga Guidance:
To prevent developing issues in the knees from yoga it is important to ensure the alignment of the knees is correct and you need to provide appropriate support for the knees through engaging the important surrounding muscles.
Standing poses with bent knees (e.g. lunges, warrior 1, warrior 2) – The knee should be placed directly over the ankle. Overshooting the knee over the ankle can create a compressive force on the patella.
Standing poses with straight legs (e.g. Triangle) – Micro-bend the knee. Keep the muscles active to avoid pressure on the patellar tendon. Pressing through the ball of the foot activates the muscles in the leg and keeps the hips in line.
Pulling on the feet from behind (e.g. Bow, Dancer pose) – Activate the thigh muscles and push the feet into the hands. This allows strength and support to the joint and lengthens the muscles.
Sitting poses impacting the knees (e.g. Hero, Pigeon) – these postures shouldn’t hurt so seek advice from your yoga teacher if you feel pain in the knees. The discomfort may be prevented through support from use of a block but if not the pose should be avoided.
If you are new to yoga it is advisable to practice under the guidance of a qualified teacher so they can help advise and correct alignment.
