Yoga for knee injuries

yoga for knee injuriesStrike a pose and possibly avoid surgery

I love research that shows conservative treatments—rest, diet and exercise—to be as effective (or more!) than drugs and surgery.

So when I ran across this article, “9 exercises to rehab a torn ACL without surgery,” I wanted to pass it on.

There are approximately 150,000 anterior cruciate ligament (ACL) tears a year, most of which need to be fixed surgically. However, new research at the Hospital for Special Surgery (HSS) in New York City found that about 25 percent of the ACL injured population does not need to undergo surgery because partially— and, rarely, fully torn— ACLs can heal with yoga and physical therapy.

Click on the image to see the recommended yoga poses.

If you do have an injured knee, you should check with your physician/physical therapist before attempting self rehab.

Also, I found an informative yoga post that explains (with pictures!) how improperly performed poses can put additional stress on the knee.

Even if you don’t have a knee injury, strength and flexibility exercises, such as yoga, can help prevent joint injuries.

Too many knee surgeries?

In 2010, The New England Journal of Medicine (NEJM) published a study out of Sweden that divided young adult athletes with torn ACLs into two groups: one group received surgical repair and rehab, the other just rehab. The results showed that “…60 per cent of these operations could be avoided, without negatively affecting treatment outcomes.”

“There are almost 10 000 scientific publications addressing the ACL and 50 per cent of these are about surgical treatment. However, none of these studies have shown that surgical reconstruction produces better results than rehabilitation alone. Despite this, we perform 3 000 cruciate ligament reconstructions a year in Sweden,” says Stefan Lohmander, professor and consultant at Lund University and Skåne University Hospital. “In the USA there are 200 000 operations of this type, at a cost of USD 3 billion!”

Sixty percent of 200,000 is 120,000. Could we really perform 120,000 fewer ACL repairs every year in the US?

Another NEJM study published in 2013 (this time out of Finland) looked at whether arthroscopic surgery for meniscus tears (cartilage within the knee) was really helpful.

Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the United States, performed, the study said, about 700,000 times a year at an estimated cost of $4 billion.

The results indicated that “… thousands of people may be undergoing unnecessary surgery.”

“Those who do research have been gradually showing that this popular operation is not of very much value,” said Dr. David Felson, a professor of medicine and epidemiology at Boston University. This study “provides information beautifully about whether the surgery that the orthopedist thinks he or she is doing is accomplishing anything. I think often the answer is no.”

Did you know the median income of an orthopedic surgeon in the US is $429,428?  An internist’s average salary is $193,673. Unfortunately, our quirky health care reimbursement system pays much more to physicians who perform surgery than physicians who advise rest, rehab and watchful waiting.

Any surgery or hospital stay runs the risk of complications: infection, blood clots, medical mistakes, to name just a few.

Personally, I would want to exhaust all possibilities of conservative treatment before going under the knife! Wouldn’t you, too?


Frugal Nurse

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Yoga for knee injuries — 16 Comments

  1. I get a bit upset reading articles like this and people who manage to function pretty much like normal after a complete ACL tear. I snapped mine a month ago. I have zero range of movement in the right knee (MRI showed no damage to any other ligaments or menisci, no fractures – just lots of bruising on my bones)

    I could maybe do half these yoga poses.

    I don’t really see I have any other option but surgery you know. Makes me feel a bit inferior like I’m not trying hard enough to heal it otherwise. But it’s literally dead locked and just gives way if I am not standing with my knee slightly bent. If o do a stair wrong. Or lean too far forward. Or to the side. It just collapses. It’s really getting me down.

    • Hi Missie, I’m sorry to hear about your knee injury. While I advocate being informed about the risks and benefits of all options, and taking a more conservative approach if possible before undergoing any surgery, sometimes surgery is the best option. That’s for you and your surgeon to decide. I hope you have a speedy recovery. Best, FN

  2. Hello,
    I recently torn both my minicus and acl and have been dealing with the pain for half a year. I was fortunate enough to have a great orthopedic who gave me options: stay as is, or surgery. I was a mediocre kind of active person who would hit the gym 2-3/week, merely one 5k marathon yearly. I did my research and decided to do surgery because I cannot do my regular activities w.o pain.

    • Hi Rosy, thanks for the comment. Sounds like you were able to talk to your surgeon about the risks and benefits of each choice and then make a decision based on what was best for you and your lifestyle. That’s great. Hope the knee heals up well! Cheers, FN

    • Hi Kerrie, good luck with the rehab and I hope you are back on the slopes soon! Thanks for commenting, FN

  3. hi! Great post! Would you happen to know if the same data / strengthening and favorable prognosis can be said of MCL injuries? I don’t think I need surgery, because I can still bear weight on it and run intermittently, but I feel pain afterward and sometimes during a run. I’ve had one steroid injection and it worked great almost immediately for about 3 days. Then it hurt again. I wear a brace and tape it up now, but I don’t know what else to do. I’m considering getting a referral for PT to see what can be done. The cortisone was pointless. I’m 47 and my elbow and knee tendons and ligaments are “systematically” complaining. Thanks.

    • Hi Molly, I know MCL injuries are usually not treated as aggressively as ACL injuries, so I assume conservative treatment–ice, rest, anti-inflammatories and strengthening exercises–work well for most patients. Because you are active and the injury is bothering you, I would definitely see a PT and learn more about which exercises would work best for you (including yoga), and get a better idea of how long a full recovery can take. Ligament injuries can take weeks (sometimes months) to heal. A PT can also make sure you don’t favor your injured leg too much and end up straining other muscles/joints! Steroid injections are difficult to hit the right spot, and too many can actually damage the tissue, so if they aren’t working for you, avoid them. Take care, FN

  4. Just stopping by to say thanks for the link to my ACL blog 🙂

    The decision to have vs not have surgery is so personal, individual, and difficult. You can never undo surgery, so carefully considering your options is always a good idea.

    • Hi Carry, thanks for the comment (and the great ACL post)! I hope what I’m doing with my blog is educating and encouraging everyone to explore all their options for medical treatments. Surgeons want to operate; it’s what they’re trained to do and it’s how they make a living. They are a good source of information, but people need to consider their own expectations and goals, ask lots of questions, and then make a treatment decision that is in their best interest. It may or may not be surgery, but it’s a truly informed decision.
      Cheers, FN

    • Ask lots of questions! How many of these surgeries has he done and what have been the results? How good are the chances the surgery will help? Will the pain be improved long-term or only temporarily? What are the risks? Is surgery really better in your case than physical therapy and other conservative treatments? What results are you hoping for from the surgery, and are your expectations in line with what your surgeon thinks will be the outcome? (Sometimes doc and patient are on totally different pages!) Again, good luck. FN

  5. I am having this surgery in about 3 weeks. How bad the meniscus tear is….I don’t know. The surgeon never contacted me about options after he received the disk showing the tear. I know this left knee hurts. I have had steriod injections in both knees and the “Chicken Shot” in the left. The results did not help w/ the pain and weakness. Being 68 y/o….well, I got a lotta miles on my legs…just gettin’ old hurts!! Guess I will get the surgery done tho. I’ve been thru all the experimaents so far, one more won’t hurt….I don’t think.

    • Hi E, thanks for your comment. Surgery should not be taken lightly, as there is always a risk of infection or something else going wrong. Consider a second opinion from an orthopedic surgeon that doesn’t practice at the same hospital (if your insurance allows). I heard an orthopedic surgeon talk last year about the problem of using MRIs to evaluate knee pain because they always show a meniscus tear (just very common) and then they feel obligated to do something about it, even though studies have shown that non-surgical treatment is just as effective for most. Good luck with whatever you decide, FN