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  • Dayna Culwell

Here's the latest scoop from Yoga by Dayna

Before you delve into this fascinating scoop on knee pain and surgery possibilities, please take a look at the bottom of the page. The brand-new schedule is ready for YOU. With our new simple platform, you don't even need to reserve a spot for classes. Simply click on the link that I send out each morning and you are set. If you don't book and pay before class, you'll receive your easy invoice. Even better, if I have your CC on file, I'll take care of it for you. I want to make this as easy as possible for you. We all have very busy schedules but your yoga practice can still be a rich part of your day. The upcoming holiday season will throw a few curve balls at you. Be consistent with your yoga practice and you will rise above those distractions. One of those distractions may be illness or injury. Today we are focusing on two different but related types of knee pain, the causes, and the remedies. Take a look!


When kneecap pain keeps you from doing the things you love, it’s time to explore what’s causing the pain, where the pain is located, and what are your options. Your pain may be caused by the kneecap itself or the underlying cartilage that is slowly wearing out overtime.

Chondromalacia patella is a disease of the cartilage underneath the kneecap that causes knee pain. The medical word for the kneecap is “patella”. The term “chondro” refers to the collagen or the cartilage, and “malacia” indicates disease.

Chondromalacia patella causes pain and a burning sensation in the knees, usually in the anterior knee. If that cartilage becomes inflamed, it can get very painful. You might notice a little bit of a burning sensation, or feel a grinding sensation. Often, you might feel pain just sitting, especially for long periods of time, like in a car, or at the theater. That's because the way your legs are configured in that position puts more tension on the kneecap and holds it more tightly against the femur underneath. You may also notice a decreased range of motion or pain along that range of motion.

Unlike the more traditional arthritis, this can happen in younger, and more athletic people. It's often referred to as “runner's knee” or “jumper's knee.” Repetitive motion can create a lot of stress on the kneecap. It can also simply develop overtime from wear and tear while living life. Sometimes alignment issues can lead to the kneecap becoming irritated.

So what happens? In knee osteoarthritis, the cartilage protecting the bones of the knee slowly wears away. As the cartilage wears away, it becomes frayed and the underlying bone may become exposed. Moving the bones along this rough surface is painful. This can occur throughout the knee joint or in just a single area of the knee.

Surgery: The goal of Chondromalacia surgery is to help remove or fix damaged tissue and cartilage surrounding the knee.

Some candidates have kneecap pain that is limited to one specific location. If this fits your situation, you may be able to take advantage of Patellofemoral Replacement. Candidates for this procedure typically have pain only behind the kneecap, or anterior knee pain. This pain usually occurs during activities that put pressure on the kneecap, such as:

  • Going up and down stairs

  • Sitting with the knee bent

  • Rising from a chair

One advantage of patellofemoral replacement over total knee replacement is that healthy parts of the knee are preserved, which helps to maintain more natural-feeling function of the knee.

Who would not be a good candidate for Patellofemoral Knee Replacement? If you have any of the following, you may not be a good candidate for the procedure:

  • Knee stiffness

  • Ligament damage

  • Poor patellar (kneecap) tracking

  • Major deformity of the leg

  • Inflammatory arthritis (such as rheumatoid arthritis)

  • Crystalline arthritis (such as gout)

  • Morbid obesity

I find it interesting that poor patella tracking can prevent a patellofemoral replacement from being successful, but it makes sense. Whatever is causing the poor tracking would probably continue and cause the injury to happen again unless you can correct the alignment.

Depending on which type of procedure you qualify for, your recovery depends on your surgeon, your physical therapist, and YOU! Let’s look at what YOU can do to expedite the healing process (once you get clearance from your doctor).

Here are some of my favorite exercises to strengthen the muscles needed for proper tracking and a better muscle balance.

Five Strength and Alignment Exercises

There are some techniques that you can do to help correct for those alignment issues if you have any, and help strengthen some of the muscles that might be weaker. These five exercises can help strengthen your quadriceps muscle, on the front of your thigh, or create a better balance in the muscles on the interior and exterior part of your thigh. Be very aware of how your kneecap tracks in the trochlear groove. Notice if it appears to pull to one side or another. Never do any exercise to the point of pain. Discomfort is acceptable. Just listen to what your body is telling you. Don’t make it shout.

Straight leg lift

  • Start by lying down on the floor or a mat.

  • Keep one leg just bent with your foot flat on the floor

  • Sweep the floor, keeping the foot flexed

  • Raise the leg at the hip joint, about 45 degrees, and hold for about two or three seconds

  • Lower it back down, keeping your movement controlled

  • Maintain a good connection of your backside body to the floor at all times. Shoulders stay heavy.

Clam Exercise

This movement will really strengthen the adductors and abductors of your legs. The adductors “add” your legs to the body. The abductors “abduct” or move the legs away from the body. These muscles support the knee joint.

  • Lie on your side to start, with your knees bent

  • Open your top leg and raise the upper leg up, keeping the knee bent. Your knee should now be pointing at the ceiling. Feet stay closed.

  • Hold it there for two or three seconds

  • Slowly go back down, again, with control

Wall Slide

  • Find a wall and stand with your back to it. Place your feet about six inches to a foot away from the wall, hip-width apart and your bottom against the wall. You can place your hands against the wall as well. Keep your belly to your spine.

  • Slide down the wall, until you reach a 45-degree angle.

  • Hold that 5 to 10 seconds, and then press your feet into the ground in order to slowly push yourself back up the wall.

This photo is a variation on the back to the wall pose. I'm adding a block (or ball) to activate adductor muscles.

Parade Rest Lift

This sixth exercise is a little more intense, so be very careful to follow excellent form. Stand with your feet hip-distance apart. This exercise is going to strengthen a lot of those muscles in your quads and in your hamstrings. This will basically help balance out and protect the alignment of your kneecap.

  • Start in a forward fold. Breathe in, half way up. Breathe out, place both hands behind your back. Palms face away from you. One palm rests over the other.

  • Turn on your abs and tighten your glutes. With your knees soft, your chest and head up, slowly rise. Be sure to press into the three points of each foot.

  • You are tightening your core, the small of your back, and your abs.

  • Keep your knees safely over your second toe and not in front of your toes.

  • Breathe in. Using the same form, slowly descend.

Do these exercises after you have gently warmed up your muscles. Do some gentle standing stretches to flex, extend, and rotate your spine. It will be very helpful to practice in front of a mirror. Even better, have someone who is experienced in body alignment demonstrate and watch you (like your yoga therapist).

Remember to give your joints lots of love. All of your joints need fresh, oxygenated blood to flow through. Work your ankles, your knees, your hips, your wrists, and your neck. There are many obstacles to staying in top physical shape. Car accidents, sports injuries, falls from running the dog. Accept what can’t be changed. Change what you can change. Oh, and remember to breathe. Do me a favor, take a long, slow breath right now. Slowly exhale. There, that's better!

Helpful resource links can be found at:

International Journal of Yoga Therapy




MONDAY 12 p.m. Delicious Deep Stretch

TUESDAY 12 p.m. Perfect Posture Yoga

WEDNESDAY 12:15 p.m. Delicious Deep Stretch

THURSDAY 12 p.m. Perfect Posture Yoga

FRIDAY 10 a.m. Half & Half Yoga

HALF & HALF will satisfy almost everyone’s need for strength training and deep stretching. At 10 a.m., we will be doing standing stretches and warrior poses. At 10:30 a.m. we take a quick water break and then proceed to the floor. Relaxing, restorative poses will follow.


MONDAY makes me smile


9:15 a.m. Thank you Judy and Andy

10:30 a.m. Welcome back Christine!

1:15 p.m. Welcome back Karen!


TUESDAY totally rocks


10:30 a.m. Thank you Brookdale Living


4:30 p.m. Thank you Susan and Paula

5:45 p.m. Thank you Christopher


9 a.m. Thank you Chris & Carol

10:30 p.m. Thank you Jenny

1:30 p.m. Thank you Christina

3:15 p.m. Thank you Brookdale Nursing


THURSDAY thrives

9 a.m. Welcome Christina!

10:30 am Welcome Belmont!


FRIDAY flies

8:30 a.m. Welcome Paula and Susan!


I appreciate you!! Warm wishes to everyone,

Dayna Culwell, C-IAYT

Owner & Instructor, Yoga by Dayna

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