Hip Injuries: Why So Prevalent?
After recent news about Kino MacGregor’s hip injury, I did a little research. She’s a major voice in the yoga world, and a role model to thousands of young women. I wanted to learn more about her, and her injury, since it represents what I see as a risk in the modern yoga world – injuries to the lower back, hips and hamstrings.
I watched MacGregor’s “Hip Opening” YouTube video. In the opening scene, she plunks herself into a deep version of pigeon pose, making it look easy, correcting people who might have their lower leg tucked in close, as opposed to parallel. Then she plunks herself even deeper into the pose and says this is an “intro to surrender.”
Surrender, let go, relax.
These common verbal cues are frequently heard in yoga classes, particularly in passive poses, such as the pigeon pose, considered to be the classic hip opener taught in most yoga traditions. Kino uses the pose at the beginning of her “Hip Opening” video to prepare the body for more hip openers.
You’ve probably done the pigeon pose many times. It is ubiquitous in modern yoga classes, and is often taught instead of half or full lotus because it is considered to be an excellent preparatory pose, and is thought to be safe for most people.
Imagine you are in the pose and the teacher says: “Relax, surrender, breathe.” This probably sounds familiar, over the years you’ve become quite good at this, you can let go and feel a deep stretch in your hips without any effort at all.
Sooner or later you may begin to notice sensations before and after practice that don’t seem right.
Have you overstretched your hips and lower back. These are some of the symptoms:
- Clunking sounds in the joints.
- Aching at the top of the hamstrings, near the sitting bones.
- Pain in the groins, sacroiliac joints or lower back.
- Weakness in the lower back area.
- Loss of resiliency and elasticity.
To surrender or not to surrender? That is the question.
Surrender into sensation, be aware, breathe into sensation, create a state of equanimity, stay calm, relax. These verbal cues imply that every student should stay in the pose as long as possible and deal with the sensations that come up.
This attitude is part of the problem. Yoga students are encouraged to ignore pain, surrender to sensations, and at the same time, pay attention to their bodies and do what feels right. The messages conflict and it’s hard for students to know what is right.
The truth is, different body types and different anatomical structures mean that each person should approach pigeon pose differently. And many students don’t need to stretch their hips this way at all.
Repeating the pigeon pose in a passive way for many years can result in over stretching and eventual weakening of the muscles around the hips. These students, instead of doing pigeon pose again and again, should be doing hip-strengthening exercises instead, or do an active version of pigeon, one where all the muscles in the hips are engaged, instead of relaxed.
What’s the solution?
I believe that the yoga community will eventually acknowledge the long term implications of yoga asana, and redesign the practice to meet the needs of an aging population.
In my own teaching practice, I have been doing one-on-one sessions, teaching about the Body Braid and how to continue to practice yoga safely, while considering each student’s unique anatomy.
People come to me because they are unsure about sensations they are experiencing and want to know how to avoid injury. I usually suggest a strengthening practice that avoids the passive stretches they love.
Some students are shocked at how much harder it is to do poses with full muscular engagement. Their remarks are revealing:
- “But I like the feeling of letting go.”
- “This is so hard.”
- “It’s too much work.”
I know, I tell them. I’ve been there. But with time, I managed to adapt my practice and get used to the new sensation of strengthening my muscles, rather than stretching them.
If a student has pain in the lower back, hips or hamstring insertion, I suggest:
- Replacing forward bends with squats and more back extension (backbends)
- Replacing hip openers with hip strengtheners.
- Practicing with the Body Braid, which will provide resistance creating dynamic stretches.
The yoga of the future will reflect the changing needs of the population, either that, or it will become a passing trend.
The benefits of yoga far outweigh the risks. The imbalances that lead to injury in modern yoga classes can change if the yoga community can find a sense of humility and be open to evolution.
Interested in adapting your practice to your changing body?
Contact me at email@example.com to set up a private session.
Part of the problem is the compass heading that many people seem to be following in their “yoga practice”. It becomes a journey towards “an extreme”, in which “the more flexible, the better”, rather than a journey towards “balance” in which yogis (and their teachers) examine where they, as individuals, are starting from and what can bring them to greatest “functional health”.
I don’t think hip openers are bad. There are a LOT of tight people out there who NEED to open up, who are physically restricted in their functional mobility and store all kinds of stuff in their hips and need a way to “let it go”. But for somebody like Kino (who doesn’t seem to need ANY additional flexibility), I would hope they were doing a good amount of proper strengthening and stabilizing too.
I think there’s a lot more integration of sound bio-mechanical principles being practiced “out there” in the yoga-sphere these days. At least, that’s increasingly what I see predominantly in the circles that I’m in. And I can only hope that this is the trend playing out outside of my immediate community as well.
Thanks for your reply, yes of course there are lots of people who can benefit from hip openers,
but when are hips open enough, when there is always another pose that can open them even more. We were all lead to believe that the progression of poses was good for us, I believed in that. Now I realize my belief was blinded by the yearning for sensation in my practice, once we get stretched out, we have to go deeper to feel anything. This is the problem we are facing right now in the yoga world. I always say yoga is fantastic the first year or two, or even five, or part of an overall fitness program, but so many people only do yoga now a days, and that’s not a good thing, unless the way in which is taught changes. Being open to the discussion is important, beginning to actually change what we teach people to teach is the next chapter. I hope we can collaborate on this at some point in our futures. I have some simple solutions that could fix at least 50% of the problem. Let me know if you would like me come and do a workshop at Ahimsa.
I have taken part in and enjoyed thoroughly, Yoga classes, on and off through the years but have never made it an ongoing practice. I have friends now in their 60’s who have practiced, or even taught Yoga, who have had hip surgery due to worn hip joints and/or stretched ligaments. We must be aware of the changes in our bodies as we age. Maintaining health and physical ability are priceless, but however healthy we stay, as the years progress, our physiology does change and we lose elasticity. Joints should no longer be pushed beyond their designed flexibility to hyperflex positions. Be gentle with yourselves.
Thanks for your reply, sounds like your approach was very well balanced, some yoga with other activities mixed in is a good plan. Repetitive strain injuries that are at the root of most yoga injuries are the result of too much of the same thing.
I am one of those people who are very tight through the hips and in the hamstrings. Would love to know safe ways to decrease this tightness. Cause I think is a lot of spinning and other cardio without enough counterbalancing yoga and stretching. I’m trying to correct that.
I would suggest going to yoga 2 times a week, sounds like you need it. And don’t let your yoga teachers convince you to stop doing the other things you like to do, mix it up and keep it balanced.
I don’t do pigeon (tastes like chicken hehe…).. I don’t do it in my own practice, nor do I teach it. Why? In my case it’s less about the hips and more about the knees. If you have someone with tight hip rotators to begin with, they’ll end up placing all that external rotation into their knees, causing ligament laxity and instability.. There are certainly healthier, modified, ‘stressless’ alternatives.. Due to injuries and an aging body I’ve had to re-learn a lot of my practice as well as how I approach my teaching. As difficult as the process has been (more ego than anything else), it’s essentially saved my body from further harm, and has led me on a path of greater stability, mobility and strength. I hope to be able to do and teach yoga at 90 in a still mobile, chronic pain-free body..
Congratulations! Sounds like you’ve done your practice and listened to your body. Where do you teach? Sounds like a class i might like to attend.
Gee I’d be honoured, Diane! I teach yoga at Ryerson University’s Athletic Centre, so come by anytime!
Did not know where to post after I heard the sad news that Diane past away. She was influential to me which has helped my life journey …when I was injured and couldn’t sleep on came this slow pace yoga show with basic instructions, something I could do and gave me breathing space and confidence to heal. I am forever grateful!