Friday Practical Pointers: Who Should Avoid Certain Hip Movements?

by Baxter

Wendy Sansjo, Age 55, of Adaptive Yoga Scandinavia
 (photo by Lars Iverson)

Today let’s take a look at who needs to avoid certain movements of the hip, more specifically the way the upper leg bone (femur bone) moves within the hip socket. The hip has six basic movements, which can be combined in various ways as you do yoga poses, sports, or movement arts, or simply move about the world:

1. Flexion: Moving your leg in toward the front of your lower torso or bringing the front of your lower torso toward your leg (a forward bend in your hips). For example, lifting your leg up in Standing Hand to Foot pose (Hasta Padangustasana) or Reclined Standing Hand to Foot pose (Supta Padangusthasana), stepping one leg forward and bending that knee as in Warrior 1 (Virabrdrasana 1) or tipping the hips forward over the leg Pyramid pose (Pasvottanasana). 

2. Extension: Moving your leg back toward the back of your lower torso or bringing the back of your lower torso toward your leg (a backbend in your hips). For example, when you step your back leg back into Warrior 1 or lift your legs up in Locust pose (Salabasana). 

3. Abduction: Moving your leg to the side, away from the midline of your body. For example, when you step both legs out to the sides from Mountain pose (Tadasana) into the wide-leg stance for a standing pose such as Triangle pose (Trikonasana).

4. Adduction: Moving one leg across the other, as in Eagle pose (Garudasana), or moving a leg that was out to the side back toward the midline of the body, such as stepping back into Mountain pose from a wide-leg stance. 

5. External Rotation: Turning your leg out within your hip socket so the leg turns away from the midline of your body. For example, when setting up your front foot position for Triangle pose, you externally rotate your front leg as you turn your front foot out to 90 degrees before entering the full pose. This movement is almost always combined with one or more of the others listed above.

6. Internal Rotation: Turning your leg in within your hip socket so the leg turns toward the midline of your body. For example, when you are setting up your back foot position for Triangle pose, you internally rotate your back leg as your turn your back foot slightly inward. This movement is almost always combined with one or more of the others listed above.

Cautions

Now let’s look at who should avoid or minimize certain hip movements. Keep in mind, however, that we want to maintain as much of our full range of movement of the hip joint as possible. So, in many instances, my caution will not mean “don’t” or “never,” but rather approach cautiously and stop if the movement worsens pain. In general, you should avoid or minimize any hip movement if you have:

1. Acute painful injury to the hip area that gets worse with that movement.
2. Chronic issues that flare with that movement, such as those with hip arthritis, joint replacement or surgically repaired hip fractures, or labral tears of the hip joint.

Now for the specific movements. Who should avoid or minimize the following movements?

Flexion (Forward Bend)

1. Those with certain types of hip replacement (check with your surgeon) may have to avoid flexion beyond 90 degrees from standing position.
2. Those with acute hamstring tears, especially those at the attachment at the sitting bone, at least for several weeks.

Extension (Backbend)

1. Those with acute tears of the uppermost part of quadraceps muscle (the rectus femoris), acute strain of the psoas, iliacus, or the other front groin muscles (as in a “groin pull”).

Abduction

1. Those with acute muscle strain to the inner thigh muscles (the known as the adductors), which get stretched via abduction.
2. Those with separation of the pubic symphysis, a rare situation sometimes seen in post-partum women or cases of severe trauma to the pelvis.
3. Those with acute trauma or surgical repair to the perineum/pelvic floor.

Adduction

1. Those with acute bursitis of the outer hips (greater trochanter area).
2. Those with large hernias in the groin area if adduction causes pain.
3. Those with a hip replacement that could become dislocated by this movement (check with your surgeon) or a history of dislocating hips. 
4. Those with painful compression of the soft tissues caused by scissoring of the legs past one another (more common for men than women)

External Rotation

1. Those with a hip replacement that could become dislocated by this movement (check with your surgeon) or those with a past history of dislocation with this action.

Internal Rotation

1. Those with an older, posterior approach method of hip replacement (check with your surgeon) or those with a past history of dislocation with this action.

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Differences Between Male and Female Pelvic Structures

by Shari

This is the second part of my response to William Broad’s assertion that women—because of their inherent flexibility—are more apt to injure their hips in a “dangerous” yoga class or perhaps during a home practice. I think it is important to understand that whether or not women are more inherently flexible than men, there are significant physiological and anatomical differences in the male and the female pelvis. Have a look at these two pictures!

Female Pelvis

Male Pelvis

As you can see here, the female pelvis is typically larger and broader than the male pelvis, which is taller narrower, more compact and stable. The female pelvis is thinner and it is more mobile partly due to hormonal changes that a woman cycles through and partly due to inherent structural attributes. There is also a difference in the size of the pelvic outlet specifically due to the reproduction capacity of the female The weight-bearing surfaces of the pelvis are larger and more irregular in the male, whereas the female pelvic joint surfaces are smaller and flatter. This structural difference is specifically important in how the sacroiliac joints “lock down” to form a stable weight bearing arch linking the legs with the torso.

The way weight is transmitted through the pelvis is different with the male pelvis having a more vertical weight-bearing loading and the female having a more posterior weight-bearing load. Of interest, male pelvises are often fused after the age of 50 in 50% of males whereas only less than 1% of women’s are fused at or after the age of 50.

The acetabula are wider apart in females than in males. In males, the acetabulum faces more laterally, while it faces more anteriorly in females. Consequently, when men walk the legs can move forwards and backwards in a single plane. In women, the legs must swing forward and inward, from where the pivoting head of the femur moves the leg back in another plane. This change in the angle of the femoral head gives the female gait its characteristic swinging of hips.

So if we really want to be anatomically correct, it becomes obvious that women need to do their standing poses differently than men specifically because of our anatomical differences in our structure. In particular, it is wise to leave room for your hips in your standing poses by changing your stance. In poses such as Triangle pose, Extended Side Angle pose, Warrior 1, 2, and 3, Revolved Triangle pose, Pyramid pose (Parsvottanasana), instead of aligning your feet as we are typically instructed to (with your front heel aligned with your back arch), try widening your stance a bit by aligning your front heel with your back heel. Otherwise, if your base of support is too narrow side to side, a lot of accommodations will occur with torqueing and twisting of various body parts that could lead to injury over time.

In addition, these differences in our morphology are important because this—not just inherent flexibility as William Broad claimed—may possibly lead to more injuries for women and therefore they need to be especially careful. A post from me on Healthy Hips, which applies both to women and men, will be coming soon.

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