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Hip Impingement Tips for Yoga

Updated: Oct 17, 2023

Hip impingement (FAI) and labral tears can be very painful and limiting conditions. FAI occurs when the femoral head (ball of the hip) pinches up against the acetabulum (cup of the hip). There is a combination of structural changes in the hip morphology (CAM or Pincer lesions) plus symptomatic hip/groin pain and stiffness related to activities like walking, standing after long periods of sitting, hip twisting, or getting in/out of a car.

There is usually a gradual onset of symptoms that occur slowly over a period of time, often associated with alignment issues, prolonged sitting or activities involving hip flexion and internal rotation.

I love Yoga and I think it is a fantastic form of exercise for a number of reasons. It is often valued for its ability to improve flexibility. That’s probably why a lot of people with hip dysfunction believe yoga will be great to improve their hip mobility. Unfortunately that’s not always the case. There are some stretches and postures that can actually make the pain worse.

If you have been diagnosed with FAI or labral tear, your symptoms will be aggravated by compressive anterior hip load - bending and crossing your leg past 90 degrees, and excessive anterior translation of the femoral head - end range of hip extension.

So how do we modify our yoga practice to avoid irritating this hip impingement further?

The most important thing is try to avoid any deep hip stretches, which are essentially any postures where you take your knee too close to your chest and towards the opposite shoulder, or pushing the hip forward when having your leg behind you, into extension.

Making some changes to your practice can help relieve discomfort and prevent further hip damage. Eliminating mechanical triggers of pain and optimising muscular activation will make your practice comfortable and consistent.

So let’s have a look at some yoga postures and how to modify them:

  • Crescent Lunge

Maintain a gentle pelvic tilt Keep your knee right under hip

  • Maintain a gentle pelvic tilt

  • Keep your knee right under hip

  • Do not sink into the hip joint

  • Avoid hip hyperextension

  • Eagle Pose

  • Don’t hook your toes behind your standing leg shin

  • Only squat as deep as your hip feels comfortable

  • There is a lot more anterior hip compression by trying to hook your foot behind standing shin and going into deep squat

  • Pigeon pose

  • Maintain a gentle pelvic tilt by using your core muscles

  • Don’t sink into your hip join

  • Trikonasana

  • Keep your hand closer to the knee to avoid deep hip flexion

  • Another option is to rest the hand on a block

  • Avoid bringing the hand too low as that increases the compression in the hip joint

The movements and poses that may cause problems in yoga are:

Type of movement example of poses modifications:

  1. Repetitive forward bending: poses that involve the chest being close to the thigh.

Low lunge: triangle and pyramid poses: use blocks under your hand to avoid deep hip flexion.

Chair: just go as deep as it feels comfortable, try to shift your hips back, avoid over-tucking your pelvis.

2. Combination of deep hip flexion, hip adduction and internal rotation (such as wrapping one leg over the other).

Eagle: avoid going too deep on your squat and avoid wrapping your toes around the opposite calf.

Cow-face pose: only cross your legs at the inner thighs to a comfortable range

Revolve triangle: rest your hand on a high block on the floor 3. Hip hyperextension: Poses that potentially allow the hips to go into hyperextension are:

Crescent lunge and Warriors 1 and 2: find a neutral pelvis and avoid sinking into your extended leg

Pigeon: place a block under the bent leg, don’t sink into you hip that is extended

Camel: keep your thighs perpendicular to the floor while bending back

I hope those tips will help you continue to enjoy your yoga practice!

The pain can be very limiting, but research shows that specific strengthening exercises can help you manage the symptoms.

If you are experiencing groin pain, it is a good idea to see a Physio with a special interest in yoga to provide you with an accurate diagnosis, identify contributing factors to your symptoms and develop a long term solution.

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