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Yoga Injuries Again: Healthy Hip Joints

posted by Charlotte Bell on November 5, 2013 |

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yoga injuriesYoga Injuries Again:  Healthy Hip Joints

Five years ago my sacroiliac (SI) joint was so completely, chronically out of alignment that at times I literally could not walk. After many trips to a chiropractor, neuromuscular therapist and many extremely uncomfortable acupuncture treatments, my chiropractor suggested I have X-rays taken so that he could see what was at the root of the issue. The X-ray showed an amazingly healthy spine with symmetrical spacing between vertebrae, healthy discs and beautiful spinal curves—qualities I attributed to a longtime asana practice. My SI joint didn’t look half bad either. My SI problems were due to ligament laxity, not joint damage. But I was shocked to see that there was significant deterioration in both my hip joints, especially on the left side.

How could this happen? My hips are extremely flexible. My supple quads, hamstrings, inner and outer thigh muscles allowed me to do just about anything with very little stretching sensation. As it turns out, that “exemplary” flexibility—exemplary in the Western yoga world anyway—was probably the culprit. This revelation has completely changed my practice.

Here We Go Again

On Sunday William Broad, author of the controversial book, The Science of Yoga, an excerpt of which made a humongous splash in the yoga world almost two years ago, contributed a much smaller, less sensational article to The New York Times. The article draws a correlation between natural flexibility—mostly among women—and hip joint wear and tear that has led, in many cases, to hip repair or replacement. Broad explains that because of ligament laxity in some women, the neck of the femur bone is able to directly articulate with the acetabulum (socket) of the hip joint in a way that can’t happen in less flexible people. Over time, the contact causes wear and tear that includes loss of joint-protecting cartilage. This is exactly what has happened in my flexible hip joints.

Once again, the yoga world has jumped up to defend yoga against Broad’s supposedly spurious claims. While his theory has a few defenders, most are outraged that Broad would dare express an opinion that goes against the idea that asana practice could ever be anything but beneficial.

The Gift of a Yoga Injury

After more than 30 years of practice, I’m absolutely committed to Yoga (not just asana, but yamas, niyamas and meditation). I hope to be practicing in my 90s, if I’m lucky enough to make it that long. But I’m also aware that my practice will probably look very different from the way it looks now. At 58, my practice looks very different from what it did 30, 20 or even 10 years ago. I have my unstable SI joint and my sensitive hip joints to thank for this.

Believe it or not, despite the sometimes debilitating discomfort in my hip/SI area, as a teacher I’m grateful for the humbling opportunity to learn a healthier way to engage with these now-sensitive parts of my anatomy. When I felt nary a sensation in hip openers, hamstring stretchers and quad lengtheners—or felt compelled to push myself beyond what’s healthy just so I would feel sensation—I was completely ignorant as to the effect my asana practice was having on my joints. These days, my hip joints and SI joints give me instant, sometimes excruciating, feedback. As a result I’ve learned how to forward bend, back bend, twist, extend laterally—all of it—in a way that keeps my hip joints and SI joints happy. This gives me the understanding to teach my students how to keep their own hip and SI joints happy. I’m a much better teacher because of my injuries.

For the record, my mother had a hip replacement in her late 60s and my younger, non-yoga-practitioner, far less flexible sister tells me she thinks there might be a hip replacement in her future. We do come into the world with particular propensities. At least some of my hip joint problems are genetic. But I chose to ignore the signs when I’d feel a stinging compression in the fronts of my hip joints in forward bends, especially Gomukhasana. I could usually adjust out of it, but a lot of the time I just tried to relax around it the best I could. I was listening to my body just fine. I just chose to ignore it.

Listening to Your Body is Great, But There’s More

Encouraging students to listen to their bodies helps them become more intelligent practitioners. I’ve said “listen to your body” countless times over the past 27 years of teaching. But I don’t think it’s enough. Here’s why:  When I was doing the things that destabilized my SI joints—trying to align my pelvis between two imaginary plates of glass in standing poses, trying to keep my pelvis aligned straight forward in twists among other things—it felt just fine. The kind of injury Broad is describing—and I’m testifying to—is not traumatic, maybe for years. It happens over time. We don’t necessarily feel it in the moment, no matter how diligently we’re listening to our bodies.

So what’s the solution? In a word, it’s complicated. Despite what I just wrote, teaching students to listen carefully to their bodies, and to be aware not only of stretching sensation, but also of compressing sensation in a joint, instills healthy habits that will serve their asana practice over the long term. Slowing down the practice would be a huge help. It’s really difficult, if not impossible, to feel anything subtle when we’re only in a pose for a few short seconds. There’s no time to figure out how to adjust to protect our joints.

More comprehensive yoga teacher education is crucial. Five hundred hours are a start, but it truly takes years of observing, refining, and most of all practicing, to learn how to practice in a way that’s healing and sustainable. Then teaching someone else who’s living in a body we can never experience for ourselves is a whole other ballgame. The requisite 10 hours of anatomy in Yoga Alliance’s 200-hour requirements do not even scratch the surface. I’ve taken three semesters of university-level anatomy and plan to do another sometime soon and I’m well aware that I know only a tiny fraction of what there is to know about the amazing human body. It’s incredibly important to understand how our structures are designed to move and how they’re not designed to move, and to learn how to apply that to asana practice.

Most important though—and this takes a whole lot longer and requires much more of us than taking a course and calling it good—is shifting our understanding of what asana practice is meant to accomplish. Throughout most of yoga’s long history, asana was a means to more comfortable sitting, a way to prepare the body—mostly the nervous system—for meditation. Making yoga about accomplishing fancy poses is a very recent invention, and in my opinion it’s the most common cause of injury. This paradigm shift also involves an ego shift. It takes time. It just does.

Here’s one more thing that would go a long way toward developing a more healing practice: Stop looking at asana photos. Or at the very least, stop believing that asana photos and videos are what asana practice is about. The people in those photos are not living in your body. Your asana will never be quite the same as theirs. And another thing: Asana photos freeze a living practice in time. They turn asana into a concept instead of a process. Asana unfolds in each moment. There’s no moment of an asana somewhere out in the future when we look like a Yoga Journal cover photo, that’s more important than this moment. Yoga happens in this moment, in your unique body, right now. Be with the process.

And if it hurts, please stop!

 

Post By Charlotte Bell (207 Posts)

Charlotte Bell discovered yoga in 1982 and began teaching in 1986. Charlotte is the author of Mindful Yoga, Mindful Life: A Guide for Everyday Practice, published by Rodmell Press. Her second book, Yoga for Meditators (Rodmell Press) was published in May 2012. A lifelong musician, Charlotte plays oboe and English horn in the Salt Lake Symphony and folk sextet Red Rock Rondo, whose DVD won two Emmy awards in 2010.

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2 Responses to “Yoga Injuries Again: Healthy Hip Joints”

  1. Maggi Nimmo Says:

    thank you for your comments. With over stretched ligaments the only thing you can do is strengthen your support muscles and tendons, activate the posterior chain of postural muscles.
    I too have learnt this lesson from being overly stretchy and not doing enough sheer strengthening movements.
    As a yoga teacher I now encourage natural movements that are not forced and emphasise, especially with young flexible women to pull back into movements that challenge them mentally, for example, someone with an easy forward bend I ask them to execute prone floor back lifts like Cobra with the hands off the floor and held for long periods or repeated with the breath for up to 50 breaths.

  2. Kathleen Talmadge Says:

    Excellent! If only we could let go of the competitiveness an return to learning gentle stretches. Thanks.

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