Anatomy: ACL Tear and Yoga

Anterior Cruciate Ligament on Knee (left) from posterior view

I get this question quite often. “One of my students has had an ACL tear a few years ago. What poses should they avoid?” Well, in order to answer this question, it’s useful to know what it is and how an injury can happen to this area.

What is it?

ACL or Anterior Cruciate (KROO-she-ate) Ligament extends from a condyle of Tibia to the posterior side of Femur = it connects and helps hold together a little area of slightly front part of tibia (the shin bone) and the back side of femur (bottom of thigh bone). You can see how small it is and it’s just one of many complicated criss cross ligaments we have in the knee joint.

How does it get injured?

Often, there is a collateral damage when one of these ligaments injured. When ACL is damaged, it is likely that there was a damage or stress in PCL (posterior cruciate ligament) or menisci (plural of a meniscus).

Often, these ares injured due to sports or activities involving sudden stops, changes in direction like landing in an awkward position from a jump, direct blow to knee, basketball, football. Most people hear a “pop” when it happens (yikes!). It swells fairly quickly and comes with a severe pain that feels like it is deep inside the knee.

When can they return to yoga?

It’s a ligament injury, so you guessed it: it takes a little longer. Depending on the severity, it may be anywhere from six weeks to six months. As usual, always ask your student if his/her doctor cleared them for physical activities.

What poses?

Assuming that they have been cleared, your students can start strengthening muscles around the knees to further prevent such injuries:

Vastus Medialis
  • Alignment – the most important thing when returning to yoga is to inquire what is the correct alignment of the knee in poses. Take Virabhadrasana B (warrior 2), for example. Are the front knee and the second toe pointing the same direction or completely opposite?
  • Consider Vastus Medialis- Vastus medialis is a tear-drop shape muscle just inside of the knee. It’s the muscle that starts to burn first if you held Virabhadrasana B (warrior 2). This muscle is especially helpful in stabilising the knee joint.

Strengtheners:

  • Virabhadrasana B (warrior 2)
  • Uttitha Trikonasana (triangle)
  • Pasvottanasana (pyramid)
  • Virabhadrasana C (warrior 3)

Stretchers :

  • Natarajasana (dancer)
  • Utthita Ashwa Sanchalasana (high lunge)
  • Uttanasana (standing forward fold)
  • Paschimottanasana (seated forward fold)

Avoid:

  • Agnistambhasana (fire log/double pigeon)
  • Garudasana (eagle)
  • Malasana (yogi squat)
  • Anahatasana (heart-melting pose)

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