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Old 01-26-2013, 02:39 AM   #1
ChrisMikk
 
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unusual seiza problem - pain in BACK of knee

I started aikido a couple weeks ago. I am having intense pain during seiza, but it is in the back of the knee. Anyone heard of this before or have any suggestions?

From talking with instructors and reading on the web, it seems most people either have (1) stiffness in the front of the knee when they first start aikido or (2) legs falling asleep with (3) shin/ankle/foot problems in a smaller number of newbies. But these are not my problems.

I did seiza years ago in kendo and karate. It was always uncomfortable, but I could do it and the more I trained, the better I felt during seiza. My current situation is quite different. I cannot get into proper seiza now. My butt is up in the air, and my upper body is forward. The first few classes, my knees simply felt incredibly stiff, and I was trying to get back/lower. Then I started having pain in the back and along the sides of the knee, in what seems to be the hamstring tendons. I am 95% sure this is from seiza and not an acute injury from other training. Anyhow, the pain is only there during seiza or shikko. The knees were swollen at one point, but using Ice Compression and Elevation, the swelling went away.

Obviously, one's first thought is problems with tendons and ligaments, but what I don't understand is how you could have pain in tendons on the back of the knee from seiza. I can understand pain in the front of the knee, but the back? Even if I have very stiff hamstrings, it seems like the flexion during seiza should be less of a problem than with the legs extended.

Before starting aikido, I was doing heavy weight training for 2 years, then 7 months travel without exercise and mostly sitting on buses and trains. My legs are rather large, but I have seen fat Japanese doing seiza properly and also there are several large gentlemen in my dojo who have no problem with it.

Any thoughts?
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Old 01-26-2013, 03:29 AM   #2
Michael Varin
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Re: unusual seiza problem - pain in BACK of knee

Christian,

My guess is that your lower body is currently in a very unnatural state. Your tissues are far to tight and your joints are not free to move as they should. Sadly, this is all too common.

The good news is that with commitment and effort, I bet you can make significant changes in three months to a year.

Some ideas: Start foam rolling, learn proper deep squats, and work on hip and ankle mobility (you can find numerous videos of all these on YouTube). And let go. We create the tension in our bodies.

-Michael
"Through aiki we can feel the mind of the enemy who comes to attack and are thus able to respond immediately." - M. Mochizuki
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Old 01-26-2013, 11:39 AM   #3
Rob Watson
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Re: unusual seiza problem - pain in BACK of knee

I started aikido in 1992 and I still have excruciating pain in my knees from sieza ... I kind of just ignore it now.

After watching Chiba sensei get up after sitting for a few minutes and stumble as he could not get his legs under him I figured there was no hope so I stopped thinking about it. I figured the point was to be able to ignore the discomfort - that kind of training does have its benefits.

"In my opinion, the time of spreading aikido to the world is finished; now we have to focus on quality." Yamada Yoshimitsu

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Old 01-26-2013, 12:32 PM   #4
hughrbeyer
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Re: unusual seiza problem - pain in BACK of knee

I also know people who bought into semi-permanent injuries by gritting it out. Knees and shoulders are not joints to screw with.

For the OP, I totally wouldn't trust any internet diagnosis. I'd just advise not doing things that hurt more than you can help (so seiza to bow in and out but not otherwise unless you must) and work with people who are there with you on what the real problem is.

Evolution doesn't prove God doesn't exist, any more than hammers prove carpenters don't exist.
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Old 01-26-2013, 12:58 PM   #5
Janet Rosen
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Re: unusual seiza problem - pain in BACK of knee

If it hurts that much, it's a signal something is wrong. Options: check in with a PT or sports doc, work on gentle stretching routine on your own at home(always maling sure musckes are warmed up from walking and range of motion before stretching) and avoiding what hurts

Janet Rosen
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Old 01-26-2013, 02:38 PM   #6
Robert Cowham
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Re: unusual seiza problem - pain in BACK of knee

It took me quite a while (years) to be able to sit in seiza with my bum actually resting on my ankles - as opposed to being suspended in mid air. Take your time about this stuff, and as recommended by others, don't overdo it as you can injure things - it's a challenge to learn the difference between pain which is just discomfort, and pain which means you are injuring things. Trust your intuition, and if in doubt I would err on the side of safety!

I find that the exercise furitama in seiza (hands clasped in front of you and being shaken up and down - but with an imaginary pebble between palms and with wrists and arms as relaxed as possible) helps a lot.
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Old 01-26-2013, 02:42 PM   #7
aikidoc
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Re: unusual seiza problem - pain in BACK of knee

If the pain is in the back side of the knee and not just behind the knee cap it could be anything from compression of soft tissue structures to a Baker's cyst. Baker's cysts sometimes accompany rheumatoid arthritis and some people just have them-I have a small one in one knee. Other considerations could be vascular issues-cutting off circulation to the tissue, aneurysm.

If the pain is more behind the knee cap, the I would consider chondromalacia patella which is softening and roughening of the cartilage on the back side of the knee cap. You may want to get it looked at if the pain is excruciating.
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Old 01-26-2013, 09:26 PM   #8
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Re: unusual seiza problem - pain in BACK of knee

Thank you for all the replies. I agree with Janet that there is something wrong. I have had strains and overworked muscles before, but this pain in the hamstrings tendons is something different.

John,
I considered Baker's cyst (and have family hx of RA), but the pain from a cyst should be in the popliteal fossa and not in the tendons on either side, right? Maybe I'm wrong about that. I also considered vascular because, when my knees swelled up, I had swelling in my ankles, too. However, again, it seems like the pain should be in the fossa with vascular or in the calf or thigh muscles, right? I was wondering about compression of soft tissues, as in maybe there is just too much mass in the calves, thighs, and knee joint, but I've seen other large people doing seiza, so I don't know.

I definitely have chondromalacia, but I can't get low enough into seiza to trigger that pain yet. That is one I'll just have to grit out, and maybe take guclosamine.

I will try the furitama. I am sad to hear about taking years to get into proper seiza. I can already see and experience that some suwariwaza don't work unless you can get your hara down and engage it properly.

Thanks again.
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Old 01-26-2013, 09:42 PM   #9
aikidoc
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Re: unusual seiza problem - pain in BACK of knee

You are accurate, however, sometimes it is difficult to localize the source. If you can do that, and it is more in the tendons, then it is easier. If you cannot put your finger on it, then it is more difficult. I too have knee problems, however, mine is difficult to isolate. i just get them shot up with synvisc every 6 months which seems to help some. Seiza is pretty much a thing of the past for me. Cracked the cartilage twice in the one knee and once in the other plus chondromalacia.
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Old 01-26-2013, 10:28 PM   #10
Michael Varin
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Re: unusual seiza problem - pain in BACK of knee

Quote:
Christian Mikkelson wrote: View Post
I am sad to hear about taking years to get into proper seiza. I can already see and experience that some suwariwaza don't work unless you can get your hara down and engage it properly.
Don't be!

Other peoples' limitations are not your own. Your body is fluid and maliable. It doesn't take years if you are training smart.

-Michael
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Old 01-27-2013, 08:11 AM   #11
Eric in Denver
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Re: unusual seiza problem - pain in BACK of knee

I have had pain in those tendons before, too. When I first started aikido and was having knee trouble (mainly due to poor from going into seiza), someone recommended kneepads. However, they tended to bunch up behind my knee when I was in seiza, and made the tendons sore. When I stopped using them, the pain went away. I then started having the issue again when I started wearing the hakama -- when I would go down into seiza, sometimes it would bunch up behind the knee and cause pain the back of the knee. Once I started making sure it wasn't bunching under the knee, it wasn't a problem.
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Old 01-27-2013, 10:09 AM   #12
Walter Martindale
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Re: unusual seiza problem - pain in BACK of knee

Um... MRI anyone?
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Old 01-27-2013, 02:57 PM   #13
Cliff Judge
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Re: unusual seiza problem - pain in BACK of knee

I had something similar. Had some arthroscopy done to my knee, slower recovery than I would have hoped for but I am about 90%.

I understand my issue to be my quads. In seiza, my butt generally does not make it to my heels. I am trying to get serious about addressing this. I have been doing squats with very little weight on the barbell, trying to go as deep as I can and do a high number of reps. Two or three times a day I try to sit in seiza for an increasing amount of time, and I try to hit the foam roller once a day too. Progress is pretty slow so far.

Make sure you get your doctor to give you an MRI - you can have lots of issues with meniscuses that don't show up on an X-ray.
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Old 01-27-2013, 09:42 PM   #14
Janet Rosen
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Re: unusual seiza problem - pain in BACK of knee

This RN is going to play devils' advocate here and say MRIs are not the end all-be all. For one thing, a LOT depends on who is setting up the machine parameters and telling it what to do and then on who is reading it. Often the MRI suggests one problem and the arthroscopy reveals a totally different problem

Then there is the fact that there can be a disparity between a clear abnormality and the actual source of pain. This has been proven in the case of back surgeries (poor to no actual correlation between abnormal back scans, bulging discs, etc and the actual pain, so surgery often results in no improvement in symptoms)

And again as has been said, people like to share anecdotes, but your pain behind the knee may have nothing to do with their meniscus issues and is certainly not a quadriceps issue.

I DO think seeing a sports medicine doc or at least a good PT is the next step

Janet Rosen
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Old 01-29-2013, 05:19 PM   #15
miso
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Re: unusual seiza problem - pain in BACK of knee

If you have intense pain you stop immediately. Nothing helps like a break.

Get any medical advice you can, talk to the sensei before or after you do so, it's nothing bad, He/she wouldn't disagree.

When the pains go away, you can think about doing a limited return to those kinds of practice, your sensei can get you working in a 3 instead of a two, missing every second round...something like that so you're only doing 1/6 of it.

I don't like those techniques, apart from kokyu-dosa.
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Old 01-30-2013, 06:50 AM   #16
phitruong
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Re: unusual seiza problem - pain in BACK of knee

i had similar problem last month. very strange. it turned out i got a pinched nerve or two or three somewhere in lower back and hips region. i told my chiropractor and he did his usual snap-crackle-n-pop to my lower back and the problem went away. but the pain now moves up to my ass, which i think is caused by a pinch nerve in my brain which made me saying things, that would activate "boot kicking up ass" respond from other folks.

"budo is putting on cold, wet, sweat stained gi with a smile and a snarl" - your truly
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Old 01-30-2013, 10:04 PM   #17
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Re: unusual seiza problem - pain in BACK of knee

Thanks again for all the replies.

If you have intense pain you stop immediately. Nothing helps like a break.

Yes, but two problems: (1) "intense" is subjective--if a doctor said there was nothing wrong, I would be inclined to think I just need to try to force myself lower and get over the pain (maybe I'm just weak); (2) whatever else might be wrong, there is underlying inflexibility in the knee, which needs to get stretched out in order to do seiza properly, so I can't just stop training for every discomfort.

I DO think seeing a sports medicine doc or at least a good PT is the next step.

Yes, I am working on that. I tried to go to a knee clinic in Osaka yesterday, but the doctor wouldn't see me because I don't speak Japanese and didn't have an interpreter with me. I had a friend standing by on a cell phone to translate over the phone, but that didn't cut it. I never even got past the registration desk. Trying to decide now whether to go to a regular doctor in Kyoto or wait a week to try for the knee clinic again...

there can be a disparity between a clear abnormality and the actual source of pain

Yes, I am wondering about that, as my lower legs both appear to me to be shifted slightly laterally rather than being in a real straight line from the upper legs. I've always wondered if my knee joint bends in an anatomically normal manner. If they found a Baker's cyst or damaged meniscus maybe that wouldn't explain the problem.

If you cannot put your finger on it, then it is more difficult.

Yes, when I went to Osaka yesterday, that was the most walking I had done in a couple weeks and all of a sudden I was having pain around the top of my left kneecap as well, something I hadn't experienced before. Another different problem, or all part of the same? Who knows? But at the moment I am really only concerned with getting into seiza. The head instructor told me I can stand to bow in and out, but it feels very conspicuous and invites pity. Plus, I can't participate in any suwariwaza or shikko exercises.
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Old 01-31-2013, 09:07 AM   #18
lbb
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Re: unusual seiza problem - pain in BACK of knee

Quote:
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Thanks again for all the replies.

If you have intense pain you stop immediately. Nothing helps like a break.

Yes, but two problems: (1) "intense" is subjective--if a doctor said there was nothing wrong, I would be inclined to think I just need to try to force myself lower and get over the pain (maybe I'm just weak); (2) whatever else might be wrong, there is underlying inflexibility in the knee, which needs to get stretched out in order to do seiza properly, so I can't just stop training for every discomfort.
Well, arguably that's true, but:

(1)Yes, "intense" is subjective, but that doesn't mean it should be ignored. It's telling you something; the trick is to figure out what the thing is. It's more nuanced than the simplistic extremes of, "If it hurts, stop" and "Pain is weakness leaving the body, RAWR!" Personally, I like to use the word "discomfort" rather than "pain": the latter has baggage, and people tend to ignore feelings of discomfort that are alerting them of problems because they feel they don't deserve the label of "pain".

The average sedentary person avoids discomfort and does whatever they can to alleviate it -- they don't have much experience in enduring it. Some discomfort should be endured, and some should be cured. It's knowing which is which that's the tricky part. Note that "endure" is not the same as "ignore". Any discomfort you feel is telling you something. Don't ignore it; do make an intelligent decision about whether to endure it.

(2)Inflexibility may be part of the problem, but from what I know of stretching and flexibility, if you're feeling intense discomfort, you're not improving flexibility. In other words, for you, right now, the action of sitting in seiza is not helping with whatever flexibility issues you have.

One thing that my sensei recommends (never tried it myself) is to spend some time sitting in seiza at home, but supported by a cushion such as a zafu or maybe a folded-over pillow. This may be helpful for you -- but not if you do it to the point of intense discomfort.
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Old 02-07-2013, 01:38 AM   #19
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Re: unusual seiza problem - pain in BACK of knee

Doctor's answer: bone spurs rubbing on tendons and other soft tissues.

I went back to the Osaka Chuo Byo-in knee clinic yesterday with the help of a bilingual Kyoto University student from their Good Samaritan Club.

The doctor in the knee clinic x-rayed my knees and did a short physical exam, then pronounced that my pain is from bone spurs. I apparently have them around the top of the tibia (as well as "many behind the patella"). One was clearly visible in the x-rays he showed me. It appears like a small devil's horn sticking out of the lateral side of my right tibia bone. The pain is worst in my lateral right hamstring tendon, so that fits. I couldn't see any other spurs in the x-ray, but I'm not trained in radiology, so maybe they were there.

His recommendation is, of course, to stop training. Don't do things that make it hurt. In the case of bone spurs, "making hurt" also means "inflaming and worsening the condition." He didn't mention surgery, although I think you can also get the ends of the bones shaved to take away the spurs.

His diagnosis fits okay with the x-ray and physical exam he did. It doesn't quite explain to me why the problem comes from seiza--why do the spurs rub so badly in an essentially immobile position of extreme flexion but not when riding bikes or lifting weights? Also, if the problem is rubbing, it seems like it would get worse with more activity. E.g., the end of an aikido class should be more painful than the beginning, but that doesn't seem to be the case; if anything, it's the opposite of that.

I was a little disappointed that the doctor didn't seem to be interested in the course of the problem or in examining me in attempting to perform seiza. He asked me basically no questions. So when he said that if I didn't stop, I could develop inflammation that might lead to effusion, I said, "yes, I know, my knees were swelled up like this [hands around knees] a week ago," he gave me a wide-eyed look and said, "oh, really" (he spoke a little English). I had hoped that he might take a look at the joint while it was flexed in seiza to see if it looked normal, but no such luck.

Thanks again for all the replies. I have to decide now what to do. I suppose I will just keep training and see if the pain goes away.
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Old 02-07-2013, 08:19 AM   #20
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Re: unusual seiza problem - pain in BACK of knee

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I suppose I will just keep training and see if the pain goes away.
Hm. Well, I hope that "keep training" doesn't involve seiza. Otherwise, I don't know about bone spurs, but given the explanation of the mechanism of injury, I don't see how it's possible for the pain to just go away when you're doing something that actively aggravates the problem.
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Old 02-07-2013, 09:50 AM   #21
Janet Rosen
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Re: unusual seiza problem - pain in BACK of knee

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Hm. Well, I hope that "keep training" doesn't involve seiza. Otherwise, I don't know about bone spurs, but given the explanation of the mechanism of injury, I don't see how it's possible for the pain to just go away when you're doing something that actively aggravates the problem.
Yep. Too many of us have seen small problems turn into big ones or acute problems turn into chronic ones, because we were too proud or too short-sighted to adapt our training to the very clear needs or limits of our bodies. Some things that are NOT improved by stretching or repetition.

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Old 03-19-2013, 12:41 AM   #22
ChrisMikk
 
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Re: unusual seiza problem - pain in BACK of knee

Quote:
Mary Malmros wrote: View Post
Well, I hope that "keep training" doesn't involve seiza... given the explanation of the mechanism of injury, I don't see how it's possible for the pain to just go away...
Quote:
Janet Rosen wrote: View Post
Yep. Too many of us have seen small problems turn into big ones or acute problems turn into chronic ones, because we were too proud or too short-sighted to adapt our training to the very clear needs or limits of our bodies. Some things that are NOT improved by stretching or repetition.
Under normal circumstances I would ask for an exception to be made for my limitations. However, as I'm in Kyoto for Jacques Payet's next kenshusei course, I think that is simply impossible.

As of the current date, Mary's intuition seems to be correct. The pain has not really improved, and has in fact gotten somewhat worse.

The best thing seems to be classes of about half suwari-waza. After some, but not too much, suwari-waza the knees are more flexible the next day. Plus, performing suwari-waza does not seem to hurt the patellas.

On the other hand, performing tachi-waza does not feel so bad when I'm doing it, but after a class with a lot of kihon doza (especially hiriki no yosei ni) my knees get stiffer and also the patellas feel like they're going to explode, which is sort of new since I originally started this thread.

Thanks for your concerns. I hope I am able to complete the course.

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Old 03-19-2013, 07:31 AM   #23
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Re: unusual seiza problem - pain in BACK of knee

Quote:
Christian Mikkelson wrote: View Post
On the other hand, performing tachi-waza does not feel so bad when I'm doing it, but after a class with a lot of kihon doza (especially hiriki no yosei ni) my knees get stiffer and also the patellas feel like they're going to explode, which is sort of new since I originally started this thread.
sounded like you put a lot of lateral torque to your knees, usually happens when doing the turn/tenkan. see if you can do tenkan without putting lateral stress to your knees.

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Old 03-19-2013, 01:21 PM   #24
lamech
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Re: unusual seiza problem - pain in BACK of knee

For what it's worth I had pain in the back of the knee a few years ago. It got worse over the course of a few months. In particular I could sit in seiza for extended periods of time, but it hurt every time I tried to stand up after being in seiza. I eventually went to see a sports medicine specialist who diagnosed it as a problem with my popliteus:

http://en.wikipedia.org/wiki/Popliteus_muscle

A few weeks of good massage and (medical) acupuncture improved things tremendously and I haven't had the problem again since.

I certainly wouldn't presume to say that you're having the same problem; but I can't say enough good things about going to see a sports medicine doc when you have long-term problems!

Definitely get it checked out.

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