We practice yoga to acquire strength and space in the body so it becomes more free to find stillness through our methods of self observance. During this process of becoming stronger and more mobile, are these asanas truly nurturing our joints or are we potentially sending damage into connective tissue like our cartilage?
Yoga, undeniably, improves flexibility and joint range of motion. But for many people, this increased mobility comes at a cost to the underlying joint structures. Lining the ends of most bones is cartilage (hyaline cartilage covers the ends of bones in our synovial joints) which is designed to cushion the bones and allows them to glide smoothly against one another. We also have segments of fibrocartilage within joints acting as shock absorbers (ie intervertebral discs of the spine / triangular fibrocartilage complex of the wrist).
With poor alignment, improper force load distribution, excess repetitive weighting of joints, and applications of sheer or torquing motions, cartilage can be worn down. Cartilage contains chondroblasts—cells that can produce new material to repair damage. These cells are limited, though, in their activities. Unlike muscle and bone tissue that are well vascularized (rich blood vessel supply), cartilage does not have direct access to blood supplies and receives nutrients via diffusion which results in an increased amount of time for regeneration and recovery (when damaged). As well, cumulative damage due to overuse, trauma, and other factors can overwhelm chrondroblasts’ capacity to repair tissue. More important to recognize is that once cartilage injury has accrued to a certain level, this damage is irreversible. In the case of hyaline cartilage, researchers have found that this damaged tissue becomes replaced by fibrocartilage scar tissue.
Examples of cartilage degeneration:
*In cadavaric examinations, a large percentage of the cases have demonstrated triangular fibrocartilage complex perforations and chondromalacia (softening, wearing, and degradation of cartilage often leading to irritation and pain) of the ulnar head, lunate and triquetrum.
*Chondromalacia patellae is the most common form of cartilage degeneration which occurs in the back of the knee cap due to wearing or shredding of soft tissue. This wearing of cartilage can also occur along the trochlea – the groove along the distal end of the femur (thigh bone) where the knee cap is designed to slide up and down.
*In the case of the spine, we can see degeneration, damage or wearing down of the annulus fibrosus—the outer rings of the intervertebral disc. This makes the spine less effective in resisting motion and this condition has been termed “micromotion” instability as it is usually not associated with gross instability (such as a slipped vertebral body or spondylolisthesis).
*We also see common injuries to the meniscus (C-shaped cartilage rings between the knees). A medical report by a friend showed an extreme case of cartilage damage including “medial meniscus is no longer visible” along with “complete loss of femoral and tibial cartilage”.
The onset of these degradations and losses of cartilages are typically accompanied by reduced joint function/stability as well as pain. Knowing how susceptible our joint structures can be and how the regeneration capacity is limited, I often step back to objectively question a great number of yoga poses and transitions. Do they truly serve the ultimate functional purpose and benefit of yoga? Are these poses taught in a manner that respects that we are all uniquely built and that some of us (regardless of alignment ‘perfection’) do not have the joint structure design to accommodate the range of motion or sheer forces required to achieve the desired variation of those specific asanas?
As Vanda Scaravelli stated, “Yoga must not be practiced to control the body: it is the opposite, it must bring freedom to the body, all the freedom it needs.” This approaches requires a dampening of WANTS and GOALS, and to instead purely listen attentively to what the sensory system of the body is telling us. Are there inherent restrictions in the body preventing me from performing this pose to the range that my Ego is salivating over? And when addressing these restrictions, do I truly understand the origin of these restrictions? Are they coming from muscular/fascial limitations that could be released over time with a nurturing attitude or more structural limitations that will never change and that I can joyfully respect? And overall, what are the fundamental benefits of each pose and am I overriding these benefits by directing unwanted damage into joint structures?
Be kind to your cartilage – it is less forgiving than what we think and often expect.