Anatomy in Yoga?

I appreciate that at times anatomy and applying anatomy to yoga can be confusing and at times unnecessary. I have seen people with little to no knowledge of anatomy flourish in their asana practice. In fact the individuals who I feel have furthered their asana practice more than anyone else, progressed without any anatomy knowledge at all. They progressed with only a book (Light on Yoga - B.K.S Iyengar) and a steadfast willingness to improve. However, there are some of us who with our various injuries, need to apply some anatomical understanding to our poses. Because if we don't, we are likely to reinjure or just not progress. And progress is what we are constantly striving for in our asana practice. Without the goal of progress in our minds, we are not really practising yoga.

The understanding of our Vastus Medialis, as described below helps us understand what muscles help stabilise our knee when in standing poses. This is essential in keeping the knee safe. When we fail to utilise this muscle in standing poses, we pressure our knee joint in a way that is not congruent with the way the knee is designed. So the information below is relevant to anyone who doesn't fully straighten the standing leg in standing poses.

Before you continue let's clear up what I mean by straightening the leg. I mean literally straighten the leg in a way that it is designed to do. I am not saying 'lock the knee'. Often when we hear 'straighten the leg', our instinct is to forcefully lock the joint without any muscular control or awareness. This can over time put strain on the knee and for some, even feel uncomfortable straightaway. When I say straighten the leg, I am referring to you squeezing your thigh muscles to straighten the leg. If you feel your quadricep muscles (the thighs) squeezing, you are correct. If you feel your knee hurting, this is incorrect. So bend the knee and try again.

The Vastus Medialis

The position of the vastus medialis is just above and to the inside of the knee cap.

The specific role of vastus medialis is to straighten the leg and stabilise the knee. Weakness in the vastus medialis causes mal-tracking of the patella and subsequent damage to surrounding structures and aching pain. The vastus medialis is often the weakest muscle in the quadriceps group, says sports medicine specialists at the Poliquin Performance Center in Chicago. It is usually the first part of the muscle to atrophy, and the last to rehabilitate.

The muscle is a common centre of weakness because it will not become fully strengthened unless the leg is regularly extended FULLY. Therefore, quadriceps exercises that involve a FULL range of motion are best for strengthening this muscle. If this muscle becomes dormant, the knee no longer has the stabilisation it requires to withstand the forces of everyday life.

A technique to strengthen, or simply 'wake-up' the vastus medialis is to apply isometric or static contraction. This involves gently squeezing the vastus medialis and encouraging the muscle to straighten the leg. The constant repetition of this isometric exercise will ensure the vastus medialis can do its job of supporting the knee.

If you want to keep the knee healthy you need to strengthen the vastus medialis (the inner quadriceps). In fact, physical therapists consider exercises that strengthen this neglected muscle key in the rehabilitation of knee injuries - Yoga International 2013

An example of this in your yoga asana is Warrior 3 (image below). The instinct is to bend the balancing leg. “When you bend the knees in standing poses, the knee ends up in an unstable, unprotected position,” says Julie Gudmestad, a physical therapist and Iyengar yoga teacher. Bending the balancing knee requires all the muscles in your leg to work overtime to try and stabilise the knee. Yet the very muscle that is designed to stabilise the leg is not being used.

Image taken from Ray Long.

Squeeze this quadricep muscle just to the inside of your leg. Feel this muscle tighten and straighten your leg. Your knee now has the stabilisation it requires so you can perform Warrior 3 safely and effectively.

Try also to feel your Vastus Medialis in your various straight leg postures. Take Warrior 2 (below). Feel the Vastus Medialis stabilise the back leg in this pose.

David Kiel author of Functional Anatomy of Yoga says "Although patellofemoral joint syndrome is complex and all causes are not completely understood, weakness or fatigue of the vastus medialis is thought to be one factor that can contribute to this syndrome. Strengthening the vastus medialis is generally part of the recommended treatment for patellofemoral syndrome."

Knee pain is a problem for many. Even if you are one of the lucky ones who has yet to experience discomfort in your knee, keep your knee strong and stable. Utilise the vastus medialis in your yoga asanas and remain injury free.

Our 'Understanding of the Knee Joint - Anatomy Series' is on Sunday 15th January 2017 at 1pm. Visit our WORKSHOP page for more information.