We’ve seen a sharp rise in those interested in practicing mindfulness and meditation as an effective way to reduce stress and improve our general health. Sometimes, however, we are seeing an unintended consequence of meditation practice: an increase in back and knee pain.


This week, one of my patients had asked me how I could help her alleviate back and left knee pain she was experiencing while sitting in her crossed-legged seated meditation posture. It was an interesting inquiry, and I was anxious to help. I asked her to duplicate her meditation posture for me, and I took a close look at her sitting position on the floor. Her hips were raised slightly on a small pillow, and she was sitting up very tall. So tall, in fact, that her middle and lower back position was causing her to over-activate her back muscles. Her back muscles were in a constant state of contraction. No wonder she had back pain. I also noticed that she was asymmetrical. Her left crossed knee was much higher than her right crossed knee. That signified that her left hip was not moving as well as it should. Although she did not have hip pain, it was definitely something to work on.


First I took pictures of her current meditation posture so she could see how she was actually sitting as opposed to how she perceived she was sitting. She perceived herself as sitting up straight but there was actually too much back and neck extension and she was working too hard.. way too hard for what should be a relaxed meditation posture, especially if she wanted to maintain this position for any length of time. Once she could see and feel a neutral spinal posture where she could actually relax in the sitting meditation position.

After performing a musculoskeletal exam, I observed that she had less passive external rotation of the left hip than of the right hip. Also, her hip capsule was tight. Her hip muscles that internally rotate the left hip were tight as well. I was able to stretch or mobilize her left hip, giving her increased passive motion. I also reviewed an effective stretch to do at home, a pigeon stretch. This stretch, which can be done in different ranges, expands all rotation motion of the left hip.

We then went back to her seated posture and, with a more open hip, her left hip angle was much better, almost as good as her right, and there was an immediate decrease in her knee pain. She was also able to find her neutral back position, which provided relief to her lower back.  Sometimes, your hip will refer pain to the knee. With home exercises to maintain better mobility of the left hip, she should be able to independently control her pain, and with one or two more visits, I’m confident that we should have her left hip positioned normally and will no longer add strain and refer pain to her left knee.

I was happy that I could help her find a much more relaxed, natural posture for sitting. These adjustments and exercises will make her meditation practice the positive pain-free experience that it’s supposed to be. 

Physical therapy is not just about sports, anytime a patient feels body pain during a favorite or necessary activity, we can identify the cause and through treatment and home exercises, provide solutions and pain relief.