Is Lotus Pose Anatomically Possible?

Christine Wiese Anatomy, Lower Limb, Yoga Postures Leave a Comment

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Do you really need 115 degrees of hip rotation to do lotus pose?

Is Lotus Anatomically Possible?If you’re having trouble with lotus pose (padmasana), or it just seems like full lotus is something that’s completely impossible, you’re not alone. Full lotus pose is challenging and it does require a considerable range of motion from the joints in the kinetic chain of the leg (hip joint, knee joint, and even some movement from the ankle joint). But, is lotus anatomically possible?

A student wrote in with this question:
“I have a question regarding safety of padmasana. I saw this [guy] on YouTube. [The guy] quotes the AAOS (DK note here: This is the manual for the American Academy of Orthopaedic Surgeons), who says the ROM (Range of Motion) of external hip rotation is 0-45 degrees. [He says] padmasana requires ~115 degrees [and] he says that this has to come also from knee rotation and [would] damage ligaments (in the hip and knee).”

So, is lotus pose (padmasana) anatomically possible?

The short answer is, it depends. There are, as there are with any physical posture, many variables that go into the potential to create the shape. The more towards the ends of range of motion that a posture asks for, the more those variables come into play. With a posture like full lotus we need to recognize that the question: is lotus anatomically possible, isn’t that simple.

The influence of genetics on range of motion

Bodies are different and the activities we do with them are different. My teacher, John Scott, has often pointed out that yoga practice comes out of Indian culture. It’s relevant that the daily activities of many Indians include movements that often far exceed the range of motion of daily activities common to those living in North America and western Europe. Lotus, or at least sitting on the floor with the legs crossed in some way, is part of the culture (at least, it used to be).

An awareness of these differences in what we do with our bodies in regular daily activity has become particularly important to those working in the field of orthopedics, specifically hip and knee replacements. Hip and knee replacement patients from India, Japan, and other countries in Asia have been providing the orthopedic community with valuable feedback in recent years that the prosthetics designed with the range of motion requested by North Americans and western Europeans do not meet the range of motion needs required for many common activities of daily life in other countries, where squatting and sitting cross-legged are not considered the extreme, but instead are the norm (Han et al., 2015; Hemmerich et al., 2006). Research on Indian populations (Hemmerich et al., 2006), Japanese populations (Han et al., 2015), and others indicate many people in other areas of the world routinely demonstrate a much larger range of motion in hip, knee, and ankle movements, when going about their daily activities,  than is considered “average” in North American and western European populations.

That’s not to say that North Americans and western Europeans cannot do lotus, but only to point out that genetics do play a role in the potential that we’re working with. Travell and Simons, 1993, note that women as a group tend to have greater flexibility than men. Recent research supports this as well (Han et al., 2015; Kouyoumdjian et al., 2011; Soucie et al., 2011). Travell and Simons, 1993, also report that men of Asian heritage as a group tend to be more flexible than those of African American heritage, and men of African American heritage tend to be more flexible as a group than men of Caucasian heritage. These are of course generalizations. But, it does point out that there is not one genetic range of motion. There is a spectrum of range of motion.

Genetics interact with our activity history. In North America and western Europe, that daily activity history often looks like a lot of sitting in chairs from an early age and very little movement in daily activities that would keep the muscles around the hip joints open, like squatting and sitting on the floor in a cross-legged position. When you throw in an activity history of sports, particularly those that involve a lot of running, we have more challenges to a comfortable lotus pose due to the tension around the hip joints from various athletic activities. Genetics and activity history also interact with age, as current research demonstrates that range of motion does decrease with age for both genders (Soucie et al., 2011; Kouyoumdjian et al., 2011; Stubbs et al., 1993).

So what is necessary, anatomically, to place the body in full lotus position?

In order to move into a full lotus position, the body has to allow the necessary range of motion in both the hip joints and the knee joints. And how much range of motion is that? No one has reported thus far that they have actually measured the required joint angles necessary for lotus position in a lab, so we don’t actually know the answer to the question: what hip range of motion is needed to do full lotus

Normal range of motion in healthy adults, even in more mundane movements than full lotus position, is rarely studied (Soucie et al., 2011; Roaas and Andersson, 1982), particularly with respect to hip rotation (Kouyoumdjian et al., 2011). Contributors to Yoga Journal and Yoga International have suggested that 115 degrees of external rotation is necessary in the hip joints for lotus, if you don’t allow the knee joints to rotate at all. But, firstly I have not seen any research that has verified 115 degrees as the necessary external rotation in the hip for lotus, and secondly I question the idea that the knee joints shouldn’t rotate at all.

I do understand that the knee joint is significantly more susceptible to injury than the hip in a posture such as lotus. I would guess that this is where the suggestion not to rotate your knees comes from. I have written about this particular issue multiple times over the years. Most knee problems within lotus do come from too much tension in the hip. You have to look at the leg as a functional chain of joints, not as individual joints.

In addition, consider how the spine and pelvis respond to the position of lotus. Remember that hip joint movement is either created by the pelvis being fixed and the femur moving OR by the femur being fixed and the pelvis moving. If the pelvis tilts in a posterior direction, it is reducing the required external rotation. You’ll probably have to think about that one for a moment.

Hip external rotation range of motion

Let’s talk more about the hip range of motion in lotus. Researchers in the field of orthopedics, who studied an Indian population, have measured the range of motion of the hip joints that was necessary for a simple cross-legged position to be 40.3 degrees +/- 18.4 degrees. This is in the range of what the AAOS lists as “normal” range of motion for external hip rotation, which is up to around 45 degrees. 

Kouyoumdjian et al., 2011, measured passive hip external rotation when subjects were seated with both hip and knee flexed at 90 degrees. They found that hip external rotation averaged 40.7 degrees. Other researchers have reported normal hip external rotation to fall in the ranges of 36-42 degrees (Hallaceli et al., 2014) and 26.8-40.4 degrees (Roaas and Andersson, 1982). This does suggest that full lotus would require an amount of openness in the hip joints that is towards the more open end of the spectrum, but obviously not impossible.

What about those knees in lotus pose?

Now let’s talk about those knees. Do the knees rotate? Yes, the knees do rotate in normal, healthy movement. But that rotation ONLY happens when the knee is in a flexed position. The greatest amount of rotation is available when the knee is flexed between 30 and 90 degrees (Zarins et al., 1983). When the knee is flexed between 30 and 90 degrees, and you are doing passive rotation (this is when the leg is relaxed and someone else is moving your leg, or when you are using your own hands to move the tibia at the knee joint, as you would to put your legs in lotus), 45-50 degrees of lateral rotation is possible (Chaitow and DeLany, 2011; Zarins et al., 1983). Lateral rotation is the direction needed for lotus.

Is lotus anatomically possible?

So we come back to the question, is lotus anatomically possible? Yes, if there is sufficient flexibility in both the hip and knee joints to allow for the necessary external rotation in both joints. Whether or not full lotus posture is anatomically possible and whether it is a good idea, however, are two different questions. The research that has been done suggests that a full lotus posture approaches the ends of range of motion for some people, specifically those whose combination of genetics, activity history, and age, don’t easily allow for that range of motion.

That said, it doesn’t mean that lotus pose is inherently impossible or something you should never explore. It just means that some caution is advised. Start with preparation postures to explore the range of motion that is truly available to you. Maintain an awareness of how preparation postures and external hip rotation, in general, feels in your body. Go slow. Accept where your body is at in each practice. Also keep in mind, that yes it is possible that when you mix your particular combination of genetics (bone shape) and activity history (maybe a runner), lotus is not advisable. If you push into genetics that don’t lend themselves to the posture as well as tight hips from activities such as running, your knees will most likely pay the price.

For more ideas on preparing your body for exploring lotus, you can check out my How To Practice And Teach Lotus Workshop and my video on A Simple Preparation For Lotus Posture.

References

Chaitow, L. and J. DeLany. 2011. The Hip. In Clinical Application of Neuromuscular Techniques. Volume 2 (Second Edition).

Hallaceli, H, V. Uruc, H.H. Uysal, R. Ozden, C. Hallaceli, F. Soyuer, T. Ince Parpucu, E. Yengil, U. Cavlak. 2014. Normal hip, knee and ankle range of motion in the Turkish population. Acta Orthopaedica et Traumatologica Turcica. 48(1):37-42.

Han, H., A. Kubo, K. Kurosawa., S. Maruichi, and H. Maruyama. 2015. Hip rotation range of motion in sitting and prone positions in healthy Japanese adults. Journal of Physical Therapy Science. 27(2):441-445.

Hemmerich, A., H. Brown, S. Smith, S.S.K. Marthandam, U.P. Wyss. 2006. Hip, knee, and ankle kinematics of high range of motion activities of daily living. Journal of Orthopaedic Research. 24(4): 770-781.

Kouyoumdjian P., R. Coulomb,T. Sanchez T. 2012. Clinical evaluation of hip joint rotation range of motion in adults. Orthopaedic Traumatology and Surgery Research. 98: 17–23.

Roaas A and G.B. Andersson. 1982. Normal range of motion of the hip, knee and ankle joints in male subjects, 30-40 years of age. Acta Orthopaedics Scandinavia. 53(2):205-8.

Soucie, J.M., C. Wang, A. Forsyth, S. Funk, M. Denny, K.E. Roach, and D. Boone. 2011. Range of motion measurements: reference values and a database for comparison studies. Haemophilia. 17:500-507.

Stubbs, N.B., J.E. Fernandez, and W.M. Glenn. 1993. Normative data on joint ranges of motion of 25- to 54-year-old males. International Journal of Industrial Ergonomics. 12:265-272.

Travell, J.G. and D.G. Simons. 1993. General Issues. In Myofascial Pain and Dysfunction —The Trigger Point Manual. Volume 2.

Zarins, B., C.R. Rowe, B.A. Harris, and M.P. Watkins. 1983. Rotational motion of the knee. American Journal of Sports Medicine. 11(3): 152-156.

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