Many people turn to yoga as a way of healing hip injuries that they acquired elsewhere. Some people find that their injuries improve with mild stretching and strengthening, but others find that their symptoms get much worse.
Hip injuries that are caused by traumatic events like car accidents or bad falls have a profound effect on overall physical alignment because of the fact that our centre of gravity is located in the hips. When the Sacroiliac joints become misaligned, body alignment shifts to compensate and can be the cause pain of anywhere from the head to the feet. Broken pelvic bones can deform the hips and change alignment permanently. Surgery in the hip area or damage to muscle structures after serious trauma can also alter the function of muscles at the hip.
As we recover from either a bone or a soft-tissue injury, the muscles in the hips tend to alter their natural usage patterns, resulting in muscle imbalances. Correct usage habits need to be retrained or they will persist and this is why a strenuous yoga practice can make symptoms worse – compensatory muscle usage habits are strengthened, not corrected. It is often very frustrating to deal with this kind of pain, because every doctor that a sufferer consults has a different opinion and treatment method.
Soft-tissue injuries can improve with the correct remedial exercise although with old injuries the body’s natural alignment may have changed after the injury and will need to be assessed and monitored. Body alignment can be very difficult to correct and requires perseverance and patience, or sometimes simple acceptance of limitation.
In yoga practice, excessive stretching can be counter-productive. Even if hips feel tight, intense hip-opening asanas should be avoided if they cause pain. Constant pain and tightness indicates that muscles are working incorrectly – it is not a sign that they need more stretching.
Rehabilitation specialists find that balancing on one leg is helpful to retrain hip stabiliser muscles to work correctly. Exercising on unstable surfaces like wobble-boards or a Bosu ball stimulates the hip stabilisers neurologically. Standing balancing asanas like Utthita Hasta Padangustasana variations and bending the knee to squat without holding the big toe strengthens the hips. Practising standing balancing asanas on an unstable surface is a very effective way to correct muscle imbalances.
More work needs to be done on the weak or dysfunctional hip, rather than just doing asanas once on each side. Lifting up onto the toes in Vrksasana can also be very helpful, if you take care to practise with good form and alignment. Good alignment habits for the hips will be looked at in my next post.
Reading sources: De Franca, 1996, Pelvic Locomotor Dysfunction Cook, 2003, Athletic Body in Balance