Alignment & Engagement: Teaching Considerations for Knee Issues & Promoting Knee Health

Following are general advisements for alignment and muscular engagement in all poses. To explore each consideration, select the link in parentheses.

  1. Avoid hyperextension of knees. (Knees: Function & Issues)
  2. In weight-bearing asanas, ensure knee is tracking properly. (Alignment Cueing: Standing Poses)
  3. Bear weight evenly on feet in standing poses. (Teaching Considerations: Feet)
  4. Ensure students know how to engage quads to support knees. (Support the Knee in Your Yoga Practice)
  5. See below for information on engaging glutes.
  6. In bent-knee poses, ensure the inner portion of knee isn’t stretching or contracting more than the outer.
  7. If knee flexion is limited, an adaptation for poses such as Virasana (Hero Pose) is to place props behind knees to create more space for the joint.

Hip & Ankle Alignment Related to Knees

The knee has 16 muscles that influence its mechanics and function. Some of the muscles that cross the knee also influence the hip, and others influence the ankle. It’s important to consider both your hip and your ankle alignment during yoga because of the direct relationship both have on proper knee function. The most relevant muscles to consider for knee stability are those that cross the knee: the quadricep group and the hamstrings. The gluteals (buttocks) and the peroneal muscles (ankle evertors) are also relevant due to the effect they have on hip and ankle alignment. – Christine Carr

Avoiding Hyperextension

Although engaging the [inner quad] properly can prevent hyper-extension of the knee, doing so is essentially useless if the knee is already hyper-extended. Consequently, it’s important to consciously avoid hyper-extension in the first place, rather than relying on the strengthening exercises to prevent it. This is critical, because the habit of hyper-extension will otherwise pull you right back into your imbalanced patterns of knee extension. – Doug Keller

Engaging Glute Maximus

Engagement of gluteus maximus causes the co-contraction of vastus medialis, increasing the chances for healthy knees. – Doug Keller

Engaging Glute Medius

“My IT bands are tight and my knees hurt. Therefore, I should apply the roller to my IT bands to solve these problems, right?” Unfortunately, more often than not the answer to this question is a resounding “no.” It’s quite possible you’re actually doing more harm than help and further stretching an already abused and over-elongated piece of tissue… Your IT band is attached to a smallish muscle called your tensor fascia latae (TFL), which is meant to stabilize your knee and assist in abduction, but the prime mover is actually your gluteus medius, one of the muscles in your buttocks (found, perhaps unsurprisingly on the upper part of the lateral aspect of your glutes). I would say that in 90% of the cases that present with IT band issues it is the gluteus medius… that is actually the culprit behind the pain. – Robert Camaco