Transcript of: How do I work with hip impingement in yoga?
Hey everybody! Welcome to this month’s question of the month. If you’ve got a question that you want me to answer, just go to yoganatomy.com/myquestion and I’ll do it for you. So how do you work with hip impingement in yoga? This month’s question comes in from Justin.
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“I came across your video on hip pinching during twists. I’ve been diagnosed with hip impingement and have severe tightness in the TFL [tensor fascia latae], gluteus medius, and [my] iliopsoas. Have you come across this and have you seen success in avoiding surgery through yoga practice?”
First, confirm the hip impingement
Alright! This is a good question. So, with a diagnosis of hip impingement, this would mean that you have some type of bony deformity. So, you said you got a diagnosis, but you didn’t say from whom. Like, was an MRI taken, an X-ray, that kind of thing, right? That’s just so we’re clear that there is a bony impingement. I know that there are functional tests that are done where I think you flex the knee to 90 degrees and then you adduct and then do a rotation and that tells you if you have a hip impingement. I would trust that less than I would trust an image that shows that you have the type of bony deformity that is associated with hip impingement. You might. You might not. I honestly don’t know.
Is the pinch coming from bone or soft tissue?
Having said that, remember that the severe tightness that you have in the tensor fascia latae, gluteus medius, and iliopsoas—those can all be a response from the body trying to protect you because you’ve been doing too much movement at that hip joint. So, this is a little bit complex, but it’s something to remember. You know we always assume that, well we have a tendency to assume, that when we come across this muscle tightness, it is the cause of something, which it can be. But sometimes, it is a response to something. It’s an effect, not a cause.
So, that is the first thing that you need to figure out before you consider working with a hip impingement in yoga. Are the muscles tight because I have a bony deformation and my body’s trying to prevent me from moving that joint so much that I cause more problems? Or, is the muscle tightness the only problem, and there is no bony deformity that’s stopping me from doing particular movements?
This is hard to figure out. The best way to figure it out is where I started. That is, do you have an image from inside? I know a lot of people get nervous. They don’t want to go to the doctor because they’re afraid that the doctor is going to tell them something that they don’t want to hear. Yes, that is possible. But, we need to remember that doctors and the tests that they do, provide information. It’s not a requirement that you do whatever the doctor says after that point. But no one should ever be scared of just going to the doctor and taking in more information so that you can make a better decision for yourself.
Hip impingement and yoga
So I don’t have quite enough information here to go beyond what I’ve gone to regarding a hip impingement and yoga. But if you have the opportunity, go get an image if you haven’t already, to confirm that it is an actual hip impingement as a result of bone deformity. If it’s not that then you can go back to the muscles and work on releasing those muscles. And that might not be accomplished as quickly through just doing yoga postures. Probably the intervention of a good massage therapist or neuromuscular therapist, or something like that would help. If you go to the PTs they’re going to make you do exercises, which is only going to tighten already tight stuff. So, just be mindful of that as well. Alright, if you’ve got a question that you want me to answer, go to yoganatomy.com/myquestion.