Is Yoga Good for Your Knees? It Depends on the Style & Pose

Every client is different. As a trainer or coach, it’s up to you to create a program that works with those differences. Sometimes the difference lies in their fitness goals. Another difference that exists between clients is their bodies. Not only size and shape but also functionality and potential issues. And one area of the body where you may see more concerns or challenges is the knee—even in a younger clientele.

Prevalence of Knee Issues

A 2019 study involved the interview of 314 university staff and students (1). It found that roughly 31.8% of the young adults surveyed had some type of knee problem. In this study, “young adult” referred to individuals between the ages of 18 and 39. Additionally, the most common symptom was knee pain at 65%.

Chronic knee pain has many possible causes. Arthritis is one. Arthritis is an inflammation in the joints, generally leading to joint pain. It comes in many forms, with two of the most well-known being rheumatoid arthritis and osteoarthritis. Research suggests that knee osteoarthritis has doubled since the mid-1900s (2). If the osteoarthritis pain is severe enough, it can result in total knee replacement.

Knee pain can also result from injury. Maybe they fell while running and fractured their patella, also known as the kneecap. Or they were playing football, twisted their knee, and tore their anterior cruciate ligament (ACL).

Sometimes the issue revolves more around knee strength than injury. This is often referred to as weak knees. Though injury can lead to weak knees, it can be caused by overuse or underuse. In both cases, the soft tissue in that area cannot fully support the knee. This lack of support can degrade knee function.

Why the Knee Joint Is So Vulnerable

The knee joint is a hinge joint that joins the femur (thigh) and tibia (shin) bones. Within this joint are two cartilage cushions: the lateral and medial meniscus. Various ligaments help stabilize the knee joint, as does muscle within the legs. If an injury occurs to these or arthritis sets in, problems can result.

Johns Hopkins adds that knee problems are also caused by aging, continual wear and tear, and knee joint stress (3). If you think about it, you use your knees all of the time. Your knees flex and extend every time you sit down or stand up. Walking, biking, and hiking all utilize the knee.

This makes the knee joint easy to overuse. It is more vulnerable because of its involvement in so many activities. Keeping the knee healthy promotes good joint function. But is yoga the type of exercise that provides this effect?

Is Yoga Good for Knees?

According to research, the answer is yes. Yoga does offer a few benefits for the knees. Here are just a few studies that have found that a yoga practice can have a positive impact on knee function and pain:

• A 2018 study involved 31 women with knee osteoarthritis (4). Each arthritis patient was assigned to a 12-week intervention. Those practicing yoga had more significant improvements in pain and knee function than the control. They also reported a higher quality of life.

• A 2012 study involved 250 participants with osteoarthritis (5). Some did Hatha yoga, and others did therapeutic exercises. After three months, the yoga group had less pain while walking and reduced joint tenderness. They also had better knee flexion and less swelling.

• A 2018 study looked at research involving osteoarthritis or rheumatoid arthritis patients (6). Thirteen individual pieces of research were reviewed and included 1,557 patients. Each one made positive associations between yoga and knee pain and disability. They all also connected yoga with general well-being.

• A 2020 study questioned whether yoga could help reduce an athlete’s injury risk (7). Thirty-one male soccer players completed surveys three different times surrounding a yoga intervention. Results indicated that this type of practice might mitigate injury risk by changing the athlete’s perception of their likelihood of sustaining an injury and by reducing fatigue.

While all of this is good, it doesn’t mean that every style of yoga or every pose is beneficial for knee health. Some are better than others, with certain options better if avoided completely.

Best Yoga Styles for Knee Pain Relief

Certain yoga styles may be better for alleviating pain in the knee. For instance, Hatha yoga and Iyengar yoga are easier on the body than more rigorous styles such as Bikram yoga or Power yoga. The latter two may place too much stress on the knee joint.

Restorative yoga is another option when pain exists. This gentle yoga is easier on the joints. It involves holding a yoga pose for more extended periods than in some other styles. It also typically uses props, such as a yoga block, to help keep the body in proper form. These props take the stress off the joints so they don’t become as agitated.

Improve Knee Strength with These Poses

In some cases, pain can be reduced by increasing knee strength. Build up the muscles in the quadriceps, inner thigh, outer thigh, hamstrings, and calves to better support the knee. This increased muscle support makes it easier to keep proper alignment. Proper alignment reduces pain and injury risk.

Here are a few yoga poses (each called an asana) that increase leg muscle strength, thus also strengthening the knee:

• Mountain pose

• Bridge pose

• Chair pose

• Side Angle pose

• Reclining Bound Angle pose

• Triangle pose

Modifying Poses for Better Knee Safety

Clients with knee joint pain may need to modify certain poses, making them easier on this area of the body. Take Warrior 2 pose, for example. Keeping the knees slightly bent versus straightening the back leg completely can help keep the joint from hyperextending. This requires the quadriceps (thigh muscles) to do more work but reduces the stress on the knee.

Not bending the knee so much in yoga lunge positions can also reduce knee stress. This includes the Low Lunge pose and High Lunge pose. When lunging forward on the right foot, don’t let the right knee go past the right ankle. Follow the same guidelines when lunging on the left side.

Some poses can be modified to improve knee safety by using yoga props. In some cases, the props can provide more direct support to the knee. Other times, they may be placed under different body areas to reduce knee flexion or extension.

Poses to Avoid with Bad Knees

If a client has an existing knee injury, some poses may be best if avoided completely to avoid damaging the area further. Depending on the severity of their knee problems, this might include:

• Child’s pose, due to its excessive knee bend

• Pigeon pose, in which the knee bends to the side

• Lotus pose, especially if the client has tight hips

Creating a Safe Yoga Practice

It should be noted that, while yoga has a lower injury risk than higher-impact exercises—and severe injury is rare—the National Center for Complementary and Integrative Health (NCCIH) does indicate that the knee and lower leg are the two body parts with the most significant injury risk when engaged in this type of practice (8).

Therefore, if there is any question about whether yoga is safe for a particular client, ask them to check with their doctor. This healthcare professional is familiar with the client’s health condition and history. So, they will know best whether a yoga practice should be pursued. They’ll also understand what types of poses to avoid to make it the safest practice possible.

To avoid getting hurt while doing yoga, the NCCIH also recommends practicing “under the guidance of a qualified instructor.” If you’re not yet certified to teach yoga, ISSA offers Yoga Instructor Certification. This course teaches yoga history and philosophy. You also learn how to break down each yoga asana to teach clients safe and proper form.

References

1. Ibeachu, Chukwuemeka, James Selfe, Chris J. Sutton, and Paola Dey. 2019. "Knee Problems Are Common In Young Adults And Associated With Physical Activity And Not Obesity: The Findings Of A Cross-Sectional Survey In A University Cohort". BMC Musculoskeletal Disorders 20 (1). doi:10.1186/s12891-019-2487-2.

2. Wallace, Ian J., Steven Worthington, David T. Felson, Robert D. Jurmain, Kimberly T. Wren, Heli Maijanen, Robert J. Woods, and Daniel E. Lieberman. 2017. "Knee Osteoarthritis Has Doubled In Prevalence Since The Mid-20Th Century". Proceedings Of The National Academy Of Sciences 114 (35): 9332-9336. doi:10.1073/pnas.1703856114.

3. "Knee Pain And Problems". 2022. Hopkinsmedicine.Org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/knee-pain-and-problems.

4. Kuntz, Alexander B., Jaclyn N. Chopp-Hurley, Elora C. Brenneman, Sarah Karampatos, Emily G. Wiebenga, Jonathan D. Adachi, Michael D. Noseworthy, and Monica R. Maly. 2018. "Efficacy Of A Biomechanically-Based Yoga Exercise Program In Knee Osteoarthritis: A Randomized Controlled Trial". PLOS ONE 13 (4): e0195653. doi:10.1371/journal.pone.0195653.

5. Ebnezar, John, Raghuram Nagarathna, Bali Yogitha, and Hongasandra Ramarao Nagendra. 2012. "Effects Of An Integrated Approach Of Hatha Yoga Therapy On Functional Disability, Pain, And Flexibility In Osteoarthritis Of The Knee Joint: A Randomized Controlled Study". The Journal Of Alternative And Complementary Medicine 18 (5): 463-472. doi:10.1089/acm.2010.0320.

6. Wang, Yiguo, Shibi Lu, Ruomei Wang, Peng Jiang, Feng Rao, Bo Wang, Yong Zhu, Yihe Hu, and Jianxi Zhu. 2018. "Integrative Effect Of Yoga Practice In Patients With Knee Arthritis". Medicine 97 (31): e11742. doi:10.1097/md.0000000000011742.

7. Arbo, GregoryD, Christiane Brems, and TamaraE Tasker. 2020. "Mitigating The Antecedents Of Sports-Related Injury Through Yoga". International Journal Of Yoga 13 (2): 120. doi:10.4103/ijoy.ijoy_93_19.

8. "Yoga: What You Need To Know". 2021. National Center For Complementary And Integrative Health. https://www.nccih.nih.gov/health/yoga-what-you-need-to-know.