The Knee Joint

Essential Anatomy & Physiology

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 Agenda
• Knee anatomy essentials

• Knees & yoga

• Pose archetypes & challenges

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 The Bones – the Hard Tissues
• Femur: thigh bone
Femur
• Patella: kneecap

• Tibia: shin bone

Patella
• Fibula
Tibia

Fibula

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 Ligaments & Tendons
• Quadriceps tendon
• Patellar tendon (technically a ligament)
Quadriceps
tendon • MCL: medial collateral ligament connects the
Patella
femur to the tibia
PCL • LCL: lateral collateral ligament connects femur
LCL
Patella
MCL to fibula on the outside of the knee
Medial
tendon
meniscus
• ACL: anterior cruciate ligament crosses and
Lateral connects the femur to the tibia in front
meniscus ACL
• PCL: posterior cruciate ligament crosses and
connects the femur to the tibia in back

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 Cartilage of the Knee
• Articular cartilage: smooth white tissue at the
end of the bones for sliding
• Meniscus: crescent-shaped cartilage rings
Articular – Support the joint during tension, compression or
Lateral
meniscus cartilage torsion
– Flat on bottom, concave on top
– Outer ring has some blood circulation, inner ring is
avascular by adulthood
Patella • Low-to-no blood flow means slow or no
Medial healing potential
meniscus

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 A Closer Look – the Knee Joint
• Modified hinge joint: slight external and internal rotation

• Synovial joint

• Referred to as a “compound joint” because of 2 articulations

• Articulation #1: femur & tibia “tibiofemoral”

• Articulation #2: femur and patella “patellofemoral”

• Fun fact: patella is just cartilage at birth, changes to bone by ages 3 to 5

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 Knees in Yoga
• Yoga is extremely safe for knees--but injuries can and do happen

• Meniscus injuries are most common

• MCL and LCL injuries also happen

• ACL or PCL injuries are very unlikely

• Re-injury is much more common than injury

• Many students come to yoga to rehab injured knees

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 Archetypal Knee Shapes in Class
Shapes to Minimize Risk & Maximize Function

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 Standing Archetype: Knee to 90°
• Represents deepest bend, a larger angle (less bend)
is fine also

• Knee should not bend past toes, ideally right over

heel

• Greater flexion = less stability = less muscle control

= greater risk of injury

• Flexion plus load and/or leverage also increases risk

of injury

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 Exceptions to 90° Rule
• Extra support (back knee down)

• Reduced load/leverage (leg is bent in the air)

• Alignment is extra-important when bending

past 90-degrees

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 Hyperextension
• Rather than using “red tissues” (muscles) the
“white tissues” (tendons/ligaments/cartilage)
are doing all the work

• Slight bend to neutral (micro-bend) is the

solution

• “Hanging” on your joint is very common and

increases risk of injury

• Often seen in standing poses, can also show

up in seated poses
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 Collapsed Knee
• Collapsing in or out is natural range of motion but
decreases stability of joint and makes it more
susceptible to injury

• Collapsing in/out can be part of the pose (twisted

side angle) but the arm/elbow/shoulder can brace
and support it

• NOTE: knee collapsing cannot always be fixed, but

should be worked on and watched

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 Flexion, Rotation, Leverage/Load

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 Challenges On the Floor
• Deep flexion, rotation, and/or leverage and
load are included in many poses

• Hyperextension is seen when the heel is lifted

off the floor when your legs are extended

• The same poses that can help can also hurt—

it’s all about mindful practice

• Setup, alignment, and modification are the

keys to keeping your knees safe
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 Modify to Relieve Pain
• Reduce load and leverage

• Reduce rotation

• Reduce flexion

• Use props if needed

• Take all pain seriously, the knee should not hurt

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 YOGABODY Approach to Knees
• Take all student knee complaints seriously

• Err on the side of caution

• Minimize risk to knees as much as possible

• Save high risk poses for advanced classes—or

not at all

• Modify and adjust as needed to keep students

pain-free

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 Knee Anatomy & Physiology Learning
• The biggest joint in the body

• White tissues are strong, but vulnerable to

injury

• Alignment in yoga is most-important in

reference to the knee

• Modify as needed to relieve pain

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