Yoga and Osgood-Schlatter syndrome

Protecting the Knees During Your Yoga Practice

Osgood-Schlatter syndrome (also known as tibial tuberosity apophysitis) is a knee condition that tends to affect about 13% of teenagers. This condition is prevalent in those who experience rapid growth spurts and typically who participate in high levels of physical activity (note: this condition appears to be more prevalent in boys than girls).

Osgood-Schlatter syndrome is believed to occur as a combination of a combination of a genetic and an overuse condition where the quadriceps tendon fails to develop as quickly as the lengthening bone. This creates a tightening effect of the quadriceps tendon and generates an excessive pulling force on the boney process just below the knee (tibial tuberosity). As a result of this excessive pulling force, the tibial tuberosity can experience inflammation that leads to tenderness or pain. Given that high levels of physical activity can shorten muscles, repetitive force loads like running can increase the risk of developing this syndrome.

Typically, with proper treatment and preventive care, Osgood-Schlatter syndrome will subside in the teen years. However, I had seen some young adults still experience problems with discomfort and pain years past this period of rapid bone growth. For young adults and teenagers with this condition, Yoga can be a challenging practice as many yoga poses are positioned directly on the knees, which can be painful and even possibly aggravate the condition further.

The first priorty with Osgood-Schlatter syndrome is to get it properly diagnosed by a health professional.

Some common symptoms with this condition:
*inflammation and swelling over the tibial tuberosity
*skin over the tibial tuberosity is red and also inflamed
*pain is experienced in the knee during running, climbing stairs, or high impact activities
*pain subsides with rest

Common remedies for Osgood-Schlatter:
*rest and ice to reduce inflammation and pain
*padding and knee protection where the pain and irritation occur the most
*proper and consistent stretching of the quadriceps, hamstring, and calf muscles
*avoiding high impact activities and exploring cross training methods of exercise to reduce the incidence of chronic loading of the quadriceps muscles

For the yoga practice, some may experience substantial discomfort being on the knees, therefore it will be important to avoid postures that place direct pressure on the knees and tibial tuberosities:
Cat Pose (Marjarasana)
Camel Pose (Ustrasana)
Childs Pose (Balasana)
Cresent Moon Pose or Low Lunge (Anjaneyasana)
Thunderbolt or Zen Pose (Vajrasana)
Gate Pose (Parighasana)
Ballet Pose

One can find relief from discomfort by practicing with extra cushioning under the knees – folded blankets or practicing on a carpet can be helpful. If clear swelling is present, avoid direct pressure altogether, give the quadriceps muscles the opportunity to rest, and consider also avoiding postures that place high force loads on the knee and thigh muscles:
Warrior poses (Virabhadrasana)
Chair Pose (Utkatasana)
Low Squats

Yoga can offer therapeutic treatment for Osgood-Schlatter syndrome. Once any deep pain and inflammation diminish, one can utilize yoga poses to stretch the quadriceps muscles and tendons thus helping prevent further development of this condition. Along with stretching poses, a health care provider will also prescribe holistic strengthening exercises to compliment the healing and balancing of the thigh muscles that act on the knee.

Kreg Weiss is a co-founder of My Yoga Online and certified Hatha Yoga Teacher. Several years ago, Kreg discovered yoga while teaching health and fitness. Yoga dramatically transformed Kreg's approach to teaching health and wellness as well as changed his personal life bringing new direction in finding physical, mental, and spiritual growth.

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