Our knowledge of the hip joint has progressed tremendously over the past ten years, notes yoga therapist and physical therapist Dr. Ginger Garner in this free download.
This progress is particularly great news for the numerous people whose hips are structurally “unique,” who until now had little recourse other than a hip replacement as the joint wore out. We now know that in many cases, hip replacement can be avoided through early intervention, including physical therapy.
However, what has not changed, notes Ginger, is the way we use movement for fitness, including yoga. People with different hip structure or other congenital or developmental changes require a different approach to movement and fitness.
Yoga practitioners with a different hip structure are at higher risk for permanent damage to the hip if their yoga practice does not modify activities according to their unique structure. This applies not just to yoga, but to any type of exercise that is repetitive or emphasizes end range of motion.
Most yoga postures are biased toward hip flexion, abduction, and external rotation. This means yoga postures, as they historically stand and are currently taught, are inherently imbalanced. Unless this changes and modifications are made to accommodate all types of hip joints, yoga injuries of the hip will inevitably be on the rise, Ginger notes.
Ginger points to the need to take more steps to protect the hip in our yoga practice and teaching. “Many of my patients and colleagues have suffered from unnecessary hip injuries, from labral tears, all types of impingement, and compounding secondary diagnoses such as torn hamstrings, sports hernias, gluteal tendinopathy, to pelvic pain, all due to yoga practice,” she notes.
She goes on to discuss some of the steps we can take to introduce greater safety in our yoga practice, including learning observational skills that will enable yoga teachers to spot students who may be at risk.
It is also important, she notes, to modify our language to avoid phrases like “hip opening,” which implicitly encourages pushing against the end range of the hip joint. Hip safety in yoga is entirely possible, she notes, but more education is needed in light of the increased understanding we now have of the hip joints and the mechanics of injury.
You may also be interested in Ginger’s course, Save Your Hips! Asana Evolution for Hip Preservation.