Recalibrating Yoga for Hip Preservation
Yoga is, inarguably, a popular contemplative science, enjoying 36.7 million practitioners in the US alone, up from 20.4 million in 2012.1 A 16 billion dollar industry, yoga is one of the most widely utilized methods of complementary and integrative medicine in America today. In 2008, the editor of Yoga Journal declared “yoga as medicine” as the next great wave. That was right in the middle of the Great Recession, when the last thing on the collective healthcare industry’s mind was yoga.
What happened during the same time frame as the interest in yoga surged?
Our expanded knowledge of hip anatomy, physiology, and pathophysiology exploded onto the medical scene, providing more information than ever about how to address, preserve, and otherwise attend to the hip joint. Prior to this new age of research, the hip was relegated to a joint worthy of no more than a tendonitis, bursitis, or osteoarthritis diagnosis. A person was simply a hip replacement candidate or not. There was no other option once a hip joint had prematurely degenerated. Now, that has all changed, thanks to technological advances in diagnostic testing and investigation.
Yet, the worlds of hip preservation and rehabilitation and yoga have yet to join hands. 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. Some suffered injuries in yoga class during a single traumatic injury, and some injuries were drawn out over years of accumulated microinjury to capsuloligamentous, bony, or cartilaginous structures.
Hip labral injuries (HLI) have vastly increased over the last 10 years, perhaps making HLI the newest orthopaedic diagnosis of the 21st century. This discovery also makes surgical and conservative management of HLI uncharted territory. Conservative therapy includes nonsurgical and post-surgical rehabilitation, and since the average time from injury to diagnosis is 2.5 years, there are many people with hip, pelvic, back, or sacroiliac joint pain that have undiagnosed hip labral tears.
I should make myself quite clear, however. I am not out to demonize yoga or fear-monger the practice of yoga or how it may wreck a person’s body (to use recently controversial language).
My purpose is two-fold: To clarify 1) “what” and “how” yoga can be a safe, effective form or physical therapy and rehabilitation for the hip and pelvis, as well as to 2) underscore the areas where yoga posture practice should be evolved to prevent injury.
To that end, I have written and will be presenting a new 4-hour workshop entitled, Hip Preservation: Yoga Reconsidered, at the Montreal International Symposium on Therapeutic Yoga (MISTY) this weekend in Canada. The lecture is relevant for yoga teachers, yoga enthusiasts, yoga therapists, and health care professionals who are interested in learning how to prevent hip injury in yoga practice.
The workshop will introduce identification of imbalances that could contribute to HLI, as well as understand the common mistakes made in yoga practice that could increase HLI or hip impingement. Understanding the pain patterns that surround HLI are also critical to safe and therapeutic yoga practice and will be discussed. Discussion of structure, function, ability and “dis”ability of the hip, including their major substrates, will help identify the “red flags” in yoga practice, identifying high risk populations and those who need postural modification(s) and/or outside referral to physical therapy.
I am looking forward to instructing a high energy, action-packed hands-on learning session at MISTY on March 19-20, along with my presenting a 2-hour lecture on maximizing public speaking impact through Vocal Liberation: The Voice as Therapy.
- The Voice as a Linking Science for Clinical and Business Efficacy
- Hip Preservation: Yoga Reconsidered
- Ginger’s lecture overview – Montreal International Symposium for Therapeutic Yoga
Want to learn more?
Yoga in America 2016 Survey. Yoga Alliance and Yoga Journal. January 2016. https://www.yogaalliance.org/2016yogainamericastudy.