Yoga’s good, but watch out for hip injuries

November 26, 2013

Orthopedic surgeons at the Mayo Clinic say they are seeing an increase in hip injuries among women.

The injuries, known as femoroacetabular impingement, or FAI, stem from repeat grinding of the hip socket by the upper thigh bone. Women are disproportionately affected, due to their wider range of motion and elasticity, and often need more attention from their instructors, said Jill Abelson, an advanced certified Jivamukti Yoga instructor, teacher, trainer and author of the book “Extra Love: The Art of Hands-on Assists: Hips, Twists, and Forward Bends” ($35).

Poses causing the injuries appear to be Paschimottanasana (seated forward bend), Uttanasana (standing forward bend) and Anjaneyasana (low lunge), Abelson said.

“If done in the extreme over a period of time, the poses can cause the upper femur bone to rub right against the rim of the hip joint,” she said.

Abelson said in her trainings and workshops, she emphasizes safety for hyper-flexible students.

“Too much flexibility leads to instability and increased risk of injury, especially to the joints like shoulders. The converse is also true. Too much strength leads to rigidity, which often causes soft tissue or muscle strain,” she said. “Hyper-flexible students tend to over-do their poses and push past safe range of motion. I commonly see this in downward dog, back bends and twists.”

Fifteen million Americans practice yoga, according to statisticbrain.com, and nearly 73 percent are women. Although hip injuries are on the rise, Abelson said there are other problems associated with yoga.

“There are progressive injuries, which happen over a long period of time, and immediate injuries occurring on the spot,” she said. “I sustained three neck injuries from teachers and assistants who didn’t know how to help me correctly in class. One injury sent me to the emergency room. From another injury, I had to have MRI and MRA scans of my head and neck to rule out vascular damage. A third injury left me with a pinched nerve that gradually resolved.”

The best way to prevent injuries, Abelson said, is to thoroughly warm up before you start.

“We know from yoga anatomy that the hip is a ball and socket joint. It can, and will, wear out,” she said. “We should regularly ask, ‘Is this my normal range of motion or am I jamming the joint?’ When nicely warmed up, normal range would move like a well-oiled door hinge. Jamming would feel pinched and the joint would simply grind. The feeling would literally be bone on bone.”

Abelson said yoga has many beneficial sides. The key is to know your body, flock to a highly skilled trainer and know when to stop and call the doctor.

“Renowned teacher Sandra Sommerfield-Kozak always taught that you have to have a sense of responsibility toward your own body first,” she said. “You have to look out for yourself. Listen to your body and ask your teacher for extra help if needed.”