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Generally speaking: Students from a "chair sitting" culture, who have never sat on the ground, will have a hard time adapting to "low to the ground" postures, if the have lived 30 years or more.
For low to the ground supports you have bolsters, blankets, blocks, and stools, but sometimes the best thing to do with Lotus is give students the option of half lotus. The same can be said for any leg folding posture. You can give them the option to leave one leg straight.
Any form of joint pain is a serious warning from the body. Although, we can get away with "pushing" our muscles, a bit, especially when we are young, we cannot force a joint into position.
There are many causes for joint pain. However, in Yoga practice, joint pain is often caused as a result of two reasons. In some cases, the joints above or below the afflicted area are not correctly aligned. Resulting in the soft tissue of the weight bearing joint being forced to make up the difference. Over the long-term this will lead to premature wear.
The most common cause of joint pain, in Yoga practice, is when students force flexibility from within a joint where that level of mobility does not exist.
As a result of force, torque will travel to the next most malleable or weakest joint. In the case of Lotus posture (Padmasana) that particular torque travels into the knee.
In Lotus posture, once the hip has improved in flexibility, and the lower leg bones (fibia or tibia) can remain fully aligned with the upper leg bone (femur), as the hip is externally rotated, the ankle is the next potential location, which bears the burden of the pressure.
This is why some students experience pain when initially performing Marichyasana (seated twist). As the hips continue to open, the pain will disappear.
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