I’m getting a lot of inquiries about knee problems and here are some basic guidelines on knee health. 15 years ago I seriously blew out both of my knees (shifting furniture and landscaping) and have subsequently healed them with yoga. I took 1.5 years of work to get 95% of quality back and another 5 years for the remaining 5%. I believe that my knees are now healthier than they would have been in the case of using surgery. However, surgery may be the way to go in some cases.
I have given a lot of information pertaining the knee health in my first book Ashtanga Yoga Practice and Philosophy but here a few details:
Daily before your asana practice sit in Virasana with a pile of blankets under your sit bones so that you feel a mild tension in your knees and quads but nothing painful. Slowly day-by-day, week-by-week and month-by-month reduce the height of your blanket and thus the stretch of your quadriceps until you can completely flex the knee joint. In order to perform lotus and half-lotus postures safely you need to be able to move the femur (thighbone) and tibia (shinbone) as close together as possible and then move them as a unity on the way in and out of the posture. Transiting in and out of lotus and half-lotus postures tibia and femur should not move relative towards each other at all. It took me nine months of daily practice to arrive with my sit bones on the floor in Virasana. Continue to use the posture daily until your knees are completely healed and even beyond that point you may use it as a safety precaution. Knee problems are sometimes caused or exacerbated by wrong articulation of tibia, femur or patella towards each other. Virasana goes a long way in correcting it but only then when your feet and toes point straight backwards and never out to the side.
In standing asanas, never ever let the inner arch of your feet collapse. This will weaken the inner menisci. Again there is a correlation between collapsed arches and/or knocked knees and knee problems. Knocked knees are contributed to by fallen inner arches of the feet but also by tight adductors and weak abductors.
In all standing postures such as Trikonasana, micro-bend (2 degrees) the front leg and make a swiping movement with your front foot towards the back foot. Never ever push out through the knee down to the floor in an attempt to hyperextend the leg. This would weaken and stretch your cruciate ligaments. The vast majority of knee injuries shows an involvement of ligamentous laxity of the cruciates prior to the actual meniscus tear.
In standing postures be precise in placement of the feet, i.e. turn out of 85 degrees means 85 degrees and not 84. This will make a big difference.
In postures such as Downward Dog, Padangushtasana, etc the centreline of the feet going through the second toe and the centre of the heel need to be parallel to each other. Do not turn the feet out.
If you are in the habit of turning the feet out while you are walking you need to gradually and cautiously correct that. This otherwise will also weaken the inner meniscus.
Bring femur and tibia closely together before you go into half-lotus and precisely follow the stages in and out of lotus and half-lotus postures as I have described it in Ashtanga Yoga Yoga Practice and Philosophy (see the photos of Ardha Baddha Padmottanasana). Both transitions need to be pedantically and tediously broken down into their respective phases of movement.
Completely master the rotation pattern of the femur in the Primary Series (Ardha Baddha Padma Pashimottanasana to Janushirshasana C) as described in Ashtanga Yoga Practice and Philosophy. Again be precise and pedantic like a taxation officer, or the like.
Be sensitive, listen to your body and correct your mistakes as fast as possible. That’s really important. Do not, I repeat, do not re-injure yourself. In order to be able to interprete your bodies signals change every day only one thing in your practice. If your knee gets sore again this one thing that you changed needs to get eliminated. Most people change to many things around how they work in the postures and for that reason can never clearly allocate the effects.
Be gentle and never ever force the knee into position and never strain it. If necessary leave out postures, modify them as needed and ask your teacher to not adjust you in postures where you feel discomfort. Contrary to what’s believed in the contemporary Ashtanga-cult, you do not get browny points in heaven for sticking to a particular series despite obvious detriment.
Consider placing a ferrite magnet on your knee using sports tape. Change the location slightly and study the impact of the change. It seems to be helpful to use magnets but its important to find the right spot.
Consider using MSM Chondroiten, Glucosamine and Vitamin C with Bioflavonoids daily for at least 9 months. Helpful in many cases.
Place both hands on your knees. Visualize the Divine in whatever form you worship It in your heart. Become aware of the healing potential of the Divine. Breathe that healing energy from your heart, through your arms and hands into your knee.
If you are a seasoned pranayama practitioner then visualize extracting life force from air during internal kumbhaka and absorbing it into Manipura chakra. During the exhalation visualize distribution of prana into your knee or other area that needs healing.