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Yoga Hip Injuries Attributed to Women’s Flexibility (Read: Listen To Your Body)

in YD News

hip-pain

We’ll start this post with the closing line of William J. Broad’s latest New York Times piece about the safety/hazards of yoga: “Better to do yoga in moderation and listen carefully to your body. That temple, after all, is your best teacher.”

Bill Broad, not a stranger to controversy in the yoga world, nor backlashes sprinkled with words of praise followed by the mellowing out of a discerning, yet generally peaceful yoga community, is back with some more criminalizing evidence.

Smarter than before, this time Broad begins his article by stating that, hey, he practices yoga and thinks its generally good with all it’s nice benefits and stuff. So don’t go getting all mad at what he’s going to say, ok?

“In short, the benefits are many and commonplace while the serious dangers tend to be few and comparatively rare,” he prefaces, and we accept his peace offering. That said, Broad brings up some real issues that we ought to get hip to (bad pun).

As it turns out, many reported injuries that people attribute to yoga practice come from males, either because they go aggro and push themselves too hard, or they’re due to lack of flexibility, or a potent combo of both. But what Broad warns is that women, because of their typically more flexible bodies, may actually encounter more risk of tearing and injuring their hips.

So Bill got to doing some research, calling around to doctors and orthopedic surgeons (whom, in all fairness, are surgically biased). To whittle it down to a sentence, he found that people are getting surgery and hip replacements and a lot of these people happen to be women and happen to practice yoga.

One orthopedic surgeon he spoke with, Bryan T. Kelly, shared that 50 to 75 of his patients who danced or did yoga underwent operations at the Hospital for Special Surgery in Manhattan. And most of them were women. And so it seems that dance is also a threat to our hips’ livelihood because, like yoga, it makes our hips work extra hard.

“If that’s done without an understanding of the mechanical limitations of the joint, it can mean trouble,” Kelly said in an interview.

See: Lady Gaga. See also: running, walking, climbing stairs, sitting. We’d be extremely interested to see a comparative chart.

What we do like about this article is that it brings to light (even though it’s been pretty glaring already), that there is potential injury in yoga when we don’t pay attention to individual bodies, and frankly, when we as practitioners don’t listen to our own bodies.

Meanwhile, scientists and doctors are still studying and researching the real causes and contributing factors to hip issues like bone misalignments, excess body weight and subtle joint deformities that differ from person to person, as Broad notes. One of our favorite sentences in the article is this one: “Hip scientists are exploring such factors, but the variations make it hard to predict who is most likely at risk.” Because it admits to the lack of having a clear and cut answer to this problem.

Injuries in yoga is an ongoing discussion, and was even before Broad unleashed his The Science of Yoga: The Risks and the Rewards on all of us. As yoga grows exponentially, so do the amount of teachers (maybe not with sufficient training/various bodies experience?) and the amount of students looking to receive these promised gifts of improved flexibility and increased relaxation. But, being humans of the modern age, when everything is wanted and expected to happen NOW, we can be a bit hasty in trying to achieve said gifts, students and teachers included. (Remember that Bikram student who blamed his teachers for “breaking his back”?) Is it maybe that slowing down could be a key to finding the answer? Isn’t it one of the core lessons of yoga to listen to our bodies? Or maybe the real answer is that it’s different for everyone and there is no one defining answer. News flash: “Yoga”, bundled in all its varied styles and methods, is not a panacea.

We’ll close with a thank you to William Broad for taking the time to investigate this and present it with less sensational fanfare than preceding events, and with this quote from Dr. Jon Hyman, an orthopedic surgeon in Atlanta which seems to sum up what we find is the take away message:

“People need to be aware,” he said. “If they’re doing things like yoga and have pain in the hips, they shouldn’t blow it off.”

image via chronicbodypain.net

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19 comments… add one
  • Natasha Harhold

    I agree that we all need to listen to our bodies, but I also wonder if maybe we see more hip injuries in women than men because our bodies are different? Our whole pelvic region is different than a man’s. IOW, it has nothing to do with how we’re more flexible, but rather, with our physiology.

  • Donna

    While it’s true that yoga, like any other form of exercise/movement, can cause injury, I wonder how many of these women may have sought out yoga as a therapy for hips that were already troublesome. I see this as a chicken/egg type of deal more than a clear-cut cause and effect.

    • diana

      exactly what i was thinking, donna – my hips hurt before i started practicing. so the fact that i do yoga and also have hip pain does not mean that i have hip pain because of my yoga. opposite, actually – because i do yoga, i can still move – before i began practicing, my body was locking up all over.

  • paymaneh

    With greetings and cheers. I long ago one of the sports blog I read something about the relationship between lymph nodes with heavy exercise , but unfortunately it is quite where I do not remember What . If you have information on whether exercise with heavy and painful swelling of the lymph nodes , or you can send me . Because it is a part of the body involved and still no evidence that the infection does not exist . I am grateful to you if you answer this message! Maybe we can not see the public posts . Thank you.

  • Laurie

    As a hypermobile female, who has chronic SI joint issues that I need to keep under control, I agree almost 100% with this article. Where I disagree is the whole “listen to your body” part. Because- if you, let’s say, like myself- have elbows that overextend so much that when I get to the feeling of “straight” arms, my elbows are literally bent backwards (sounds gross, and it looks gross too!). It’s hard for someone like me to gauge what the FEELING of straight-looking elbows should be, unless I’m looking in a mirror or have someone put my arm in place. Because it feels like it’s just kinda bent at a random angle. Same with my hips. I can’t feel where “square” is often times with my hips, since it feels like a really random degree in space, since my pelvis is so hypermobile. For some of us, it’s not a matter of listening to our bodies. It’s a matter of having really good teachers who don’t get sick of adjusting your wonky arms and hips and knees time and time again until somehow, your body memorizes what degree in space straight is, and what a “healthy” range of motion feels like. And train those stabilizers like crazy.

    • VQ2

      In today’s push-push-push yoga class climate, it is almost worse to have the rare problem of elbows that are incapable of ever hyperextending, along with internally rotated hips that will never sit comfortably even in easy pose, without elevated sit bones.

      This is why there are pilates classes and yoga home practice–just for people like me.

      Until things change …

    • Exactly! Could not agree more.
      Hyper mobile bodies have no edge; they stretch well past the point of functional alignment/form into the point of no return, i.e. overstretched ligaments and deep connective tissue – which is plastic rather then elastic – doesn’t not return to a state of “stability” – and hence unstable pelvis can and usually does result. The problem is that they hyper-mobile body type is “able” to do the ridiciulous cirque du soleil contortions (to a relative degree of course – be it hyper mobility or ehlers danlos) and execute postures which are impressive & “Sham Wow”. As such they are often selected to”demonstrate” in class or in workshop or in intensive or in YTT programmes and their dysfunctional ability sets the bar and establishes the standards to which others “aspire”. No one tells us this is unhealthy in the long run and we are potentially doing alot of damage to ourselves; when we get to menopause and our collagen is depleted and we can barely walk due to all the overstretching of our youth (which felt so good at the time) . Too soon old, too late smart. 😉 For the hyper-mobile body , LESS is definetly MORE.

  • Aimee

    I am a yoga instructor and damn, do I love my practice.
    I also love sharing it!
    I think that it is fair to say that Yoga has some inherent flaws and dangers and that we all have to be aware if them.
    I would hate to unknowingly hurt someone or myself.

    The fact is that there are some injuries that people are more likely to incur: sore wrists/shoulders and some which are more pervasive and take longer to develop: lower back/sacrum issue.

    Here is the most amazing website.

    Written by an incredibly knowledgeable woman, she writes specifically about YOGA INJURIES, how they are CAUSED and often how to counteract and avoid them.
    Any practitioner or teacher would be served well by reading it.

    http://nikivetten.wordpress.com/

    • Monica

      Thanks for this website recommendation!

  • Monica

    I thought this was important info, even if the scenario is a bit more complicated than WB presents as other commented. I’m glad Laurie brought up this issue of hypermobility too. So important to really see your students and their individual needs.

    Also, I wondered to whom he was referring when he said “yoga teachers too often encourage students to “push through the pain.”” What???!! That sounds like a football coach, not a yoga teacher.

    • Semper Fi

      He was referring to people with 200-RYT training.

  • Mark

    It’s seems no one is examining what the article is really saying.

    While Broad has expressed some criticism about modern yoga practice that many of us felt was off base, some of his concerns about the state of practice and teaching do have merit.

    If you dig into the article and Broad’s comments on Michaelle Edwards teaching philosophy (Yogalign), you will see that she has developed some interesting insights into fundamental structural alignment problems with many core asanas that we all take for granted. With insights gained from other body therapies and modern physiology research, she questions some fundamental asana alignment principles and offers some compelling alignment alternatives, which runs counter to what we are all taught.

    Some examples – practicing standing and sitting forward bends with straight legs appears to be pushing the hip bone too far into the hip socket, ultimately causing premature wear in the hip joint. Alternative – keep the knees bent in all bends. Other core points – in order to keep a neutral, naturally aligned spine, don’t tuck in your chin, keep it elevated, even in downward dog. Don’t tuck in your rear in any position, this can aggravate sacrum issues. Let’s face it, these are heretical assumptions! Iyengar would have these infidels burned!

    Yogalign is not the only approach to asana alignment alternatives. Viniyoga and it’s various cousins has offered similar alignment options for quite some time. John Friend’s new approach, Sridaiva, also offers similar fundamental asana alignment alternatives. As much as yoga puritans hate him for his past behavior, it’s too bad for him and us, because his new alignment approach is pretty interesting and is worth a serious look.

    As most asanas and modern yoga practice really developed in the early 20th century (Yoga Body – Mark Singleton), it’s time for a thorough analysis of body mechanics and alignment assumptions in today’s hatha yoga, in order to make sure that we are maximizing benefits and minimizing injury. Per Mark Singleton’s book, hatha yoga has always changed and evolved through the centuries. Perhaps it’s time to do a thorough reassessment. Right now, such discussions seem to be on the fringe, but it really should be at the forefront of current teaching and practice.

    • Semper Fi

      I disagree with your statements regarding Iyengar. I have been to many senior teachers who had us bend our knees and in forward extentions to gain a certain effect. Stick to your viniyoga and John Friend adherence, and we’ll see how your practice fares in 20 years.

    • Could not agree more.
      (Michaelle Edwards is doing excellent work in service to contemporary asana practice).
      From a hyper mobile practitioner, 35 years practice, looking at a hip replacement. 🙁
      I believe that part of the problem is our cultural mindset that bigger is better, and some types of yoga have become an extreme sport, way too many 200RYT teachers on the circuit with insufficient experience and training – teaching to the pose and not the person, a gross lack of misunderstanding of hyper mobility and all the inherent risks, and “doing” yoga rather then “undoing” and let the yoga be something that is internally referenced rather then externally defined ….

    • Mark, thank you for recognizing the work I am doing with YogAlign. The injuries and hip issues are clearly showing that asana needs to evolve. There used to be a lot of people who believed the earth was flat. I think there are many that regard the human body as flat and linear and compartmentalized so its hard to see the ‘global’ nature of the human body. Even fitness workouts target specific areas when clearly there is no part of the body moves that can move in isolation. The shift will happen but right now most people do not know about Mark Singletons book so they perpetuate the myths of ancient yoga poses etc. Also many yogis refused to read William Broads book on the Science of Yoga so they do not even have an understanding of what he is trying to do which is educate people about yoga.

    • Mark, thank you for recognizing the work I am doing with YogAlign. The injuries and hip issues are clearly showing that asana needs to evolve. There used to be a lot of people who believed the earth was flat. I think there are many that regard the human body as flat and linear and compartmentalized so its hard to see the ‘global’ nature of the human body. Even fitness workouts target specific areas when clearly there is no part of the body that can move in isolation. The shift will happen but right now most people do not know about Mark Singletons book so they perpetuate the myths of ancient yoga poses etc. Also many yogis refused to read William Broads book on the Science of Yoga so they do not even have an understanding of what he is trying to do which is educate people about yoga.

  • Deborah
  • I am the Hawaii yoga teacher who was interviewed by William Broad in his latest article on hip injuries with women who do yoga. As a bodyworker, and a yoga teacher, with years of experience in private sessions, most of my clients had serious chronic pain issues related to poor joint function and biomechanics. Common sense told me that the way I did yoga was not going to help them. Besides most of them could not begin to do down dog or forward bends or triangle pose. YogAlign took many years to develop but it started with the intention to give people tools that aligned their body so nature could heal it from within.
    Pain is a result of poor posture and breathing habits and that it is the wiring in the nervous system that needs to be rebooted. I created YogAlign as a way to heal my own yoga injuries and give my clients a practice that improves posture and reduces pain levels. As any hip yogi knows, we are just vibrating light particles so lets change the wiring! My inbox is now full of the sad stories of yogis with chronic pain, hip joint deteriorations, knees that wont let them run or dance and a serious lack of muscular forces that stabilize their joints.
    I am convinced that much of the compartmentalized stretching we do in yoga is unnecessary and in the longterm; can be detrimental. Asana should reflect how the body is designed to move and also support excellent posture not perfected poses. People age by going forward and yet so many yoga poses are positions that pull us forward and stretch the spine in ways it is not designed. Just watch a toddler move and it is so simple to see how we are designed. When posture is aligned, the body is peaceful and one feels connected to source. This happens not by compartmentalized stretching or performing poses but by balancing the tensional forces in the body. We are strung like instruments and not made a like a static building designed in right angles. We are designed to move and we are made of curves not straight lines. How does sitting in staff pose benefit the anatomy of the human spinal column and hip joint? It does not and there is no right way to try and do this pose. It is linear, flat and unnatural for our curving human body. Why does asana have to put the body in so many right angles? Listen to the intelligence of your body and it will tell you that it is not made of parts and that all movements reverberate through the whole body. YogAlign is a whole new way of looking at asana and all I can say is look at my website and look at the evidence. I have been photographing before and after pictures of people for many years and it is truly amazing to watch people change so dramatically and get out of pain. There are no straight lines in nature. Humans are made of curves and asana should support our natural design form.

  • As yoga baby boomers age, lack of joint stability from over-stretching will become an even bigger issue. Many will find out that years of toe touching without bending the knees has undermined the necessary ligament tension needed for stability and longevity of the joints. check out the toddlers in the video. They are the gurus I learn from.
    http://www.youtube.com/watch?v=jCXohKKyuZI&feature=c4-overview&list=UUn5J-os1wJvuhfwU7iMuq4w

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