When I worked as a physiotherapist I treated many patients with chronic pain.
This covered a host of conditions, from longstanding muscle issues to joint dysfunction and even acute nerve pain.
When rehabilitating patients individually, I drew on my personal meditation experiences to incorporate body scan practices into the regimen.
I also ran group exercise classes, of which mindful breathing and relaxation were always core components.
In both cases, bad backs and knees were particularly common complaints and these patients often struggled with certain positions.
So if you’re after some advice, you’re [hopefully] in the right place.
Disclaimer alert and the lotus
Quick disclaimer – if you have knee pain, go and see a healthcare professional. Especially if:
- The pain is constant and unremitting, irrespective of your position
- You have pins and needles or numbness
- You’re experiencing regular swelling
Many meditation instructions involve the lotus position, which even for those without pain, is often incredibly uncomfortable.
I don’t do the lotus myself, mainly due to an old hip injury. So firstly, don’t worry if you can’t go cross-legged.
The fact is, mindfulness is not dependant on your position.
You can meditate standing up or even standing on your head if you focus your awareness.
In this way, rather than being contingent on extrinsic factors, meditation is more a state of being.
The best meditation positions for bad knees
The best meditation positions for bad knees are sitting and crook lying.
It’s advisable to perform crook lying on a bed as getting down and back up from the floor might provoke knee pain.
Knee pain is often worse when the joint is fully straightened, bent or twisted.
That’s why its generally best to avoid these end range provoking positions and keep your knee in an aligned, neutral position, between 60-120 degrees.
When sitting, try to keep your hips and knees at right angles, which is mid-range for the knee joint and less likely to provoke your symptoms.
If you’re accustomed to meditating on the floor, you might be inclined to test a meditation cushion or bench to relieve the pressure on your knees.
I generally recommend a bench like this and a cushion like this to help with knee pain.
For more severe symptoms, however, you likely have to adopt the positions recommended above.
Having said that, it might depend on the exact nature of your condition, so let’s have a quick look at the common structural complaints.
Common knee conditions
Arthritis
If you experience knee joint arthritis, you generally won’t be able to bend your knee fully, as increased friction between the joint surfaces and possible presence of bony spurs make the manoeuvre particularly uncomfortable.
Pushing into this movement, necessitated by the lotus position, would cause immediate pain and latent inflammation.
Often, I would simply ask these patients to sit with their knee at a 90-degree angle.
Meniscus injury
The cartilage in our knees, which is the rubbery substance sitting between the joint surfaces, is also prone to injury.
While arthritic degeneration may lead to micro-tears, twisting injuries of the knee might create more substantial tears, impeding normal joint movement.
In these instances, either bending or straightening your knee fully may be problematic.
Ligament injury
Ligament issues are usually the result of acute injury, after falling over or twisting your knee.
Structurally, the medial or lateral collateral ligaments on either side of the knee may be affected, which in the event of a partial tear, may cause discomfort in fully bent or straightened positions.
It could also be the anterior or posterior cruciate ligaments.
A partial tear may present pain at end of range movements, while a complete tear may result in a loose, unstable knee and associated discomfort.
Kneecap pain (patellofemoral joint dysfunction)
This condition refers to the area around your kneecap and is often the result of:
- Overuse (lots of hillwalking)
- Direct compression (excessive kneeling)
- A symptom of the degenerative arthritic process.
Pain will generally present when you’re squatting and placing your body weight through your knee, including the movement of sitting down and lowering yourself to the floor.
With this condition, it’s generally best to avoid kneeling positions, which may inflame the kneecap.
Loose body
This is a loose or floating obstruction within the knee, which prevents normal movement of the joint.
It can create a sharp stabbing or acute catching pain depending on the severity and location of the impingement.
The type of condition can cause sudden or unexpected twinges of pain with relatively minor movements.
Meditate on the pain
When you’ve been given the all clear by a medical professional, you can begin to use the pain as an object of meditation.
Perhaps it’s a dull ache or throb from which you mentally attempt to escape.
Try focusing your awareness on the discomfort and accept the sensation like any other.
Easier said than done I know, but many of my patients, even those with chronic pain, found that it became easier with practice.
Summary
Knee pain can be hugely debilitating.
Often it’s necessary to avoid exacerbating positions.
If you’re experiencing mild symptoms, by all means, try a cushion or bench.
The best positions I’ve found for practitioners, however, are sitting with the knee in a neutral position at 90 degrees (right angles) or in crook lying on a bed.
