Practicing Yoga & Hip Pain
Yoga is a wonderful way to improve mobility, flexibility, and strength for the whole body, including the hip joint. The hip joint is involved in nearly all daily movements; it provides support in loaded positions and allows for a huge range of motion needed for bending, walking, running, sitting, squatting, and the wide variations of yoga poses. Because the hip is involved in such a wide variety of movements, it is not uncommon for hip pain to develop. A common hip pain pattern is femoralacetabular impingement syndrome (FAIS). FAIS is more common in females due to common anatomy variation pattern at the acetabulum ("the socket") and at the angle of the femoral head and neck ("the ball").
For people with hip joint bony anatomy that puts them at risk for developing FAIS, repetitive flexion and rotation motions can cause irritation or tearing of the labrum. Pain from FAIS can occur in yoga poses that require deep bending (i.e. forward folds, yogi squat, knees to chest), end range rotation (i.e. pigeon, figure 4 stretch), and loaded rotation (i.e. revolved triangle, wild thing). If you are experiencing pain in the groin area in any of these poses it may be a sign that your labrum is irritated. Reducing the motion and avoiding end range stretching is a great first step to reduce pain and protect the labrum. Pushing through the pain to stretch deeper can further irritate the labrum and lead to more pain.
Conservative treatment options to encourage labral healing include hip and core strengthening, activity modification, physical therapy, and/or dry needling. If conservative treatments don't help, surgery to repair the hip labrum is an option with very positive outcomes. According to the study, High Rate of Return to Yoga for Athletes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome (Rachel M. Frank), 93% of people are able to return to yoga following hip surgery for labrum tears! Participants in this research study completed 16 weeks of formal physical therapy rehabilitation to improve soft tissue quality, gait, strength, mobility, and neuromuscular control. The average time to return to yoga following surgery was 5.3 months with no significant differences due to gender or age.
Following recovery from hip surgery, yoga is a great way to help keep the hip mobile and healthy. Gluteal, core, quadriceps, and hamstring strength are important muscles that help support the hip joint. Yoga poses to target these muscles include planks (and all the variations!), bridge, tree pose, and all warrior poses. Stability exercises focusing on rotational control help promote proper joint mechanics. Yoga poses to promote rotational control include transitioning from warrior 3 to half moon, revolved chair pose, and eagle pose. Stretching exercises help maintain mobility for the hip joint. Yoga poses to promote mobility include high/low lunge, butterfly, and half splits. Following hip labral repair some yoga poses may need to be modified as mobility and strength may be initially restricted.
Not all people that experience hip pain need surgery - but if you do, be confident that outcomes are positive and your yoga practice will continue!
If hip pain is limiting your ability to practice yoga it doesn't have to! Many poses can be modified to not only reduce pain but improve healing. Email for a personalized consult: Jessica@physioyogaandwellness.com