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No Strain: No Gain - how to deal with hip injuries

 
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Bernie



Joined: 23 Sep 2006
Posts: 1039
Location: Vancouver

PostPosted: Tue Jul 08, 2014 3:47 am    Post subject: No Strain: No Gain - how to deal with hip injuries Reply with quote

I recently receive the following question about a student with hip problems due to injury:

My question is about a new client that will be attending my Yin class this week. Her first experience with Yin. She emailed me saying she had an injury and wanted to try yin. I wrote her back wanting more information about said injury and told her that this practice was not for injured tissues. The following paragraph is what she wrote back to me. I lead my Yin classes using your Goldilocks position and offer many options/props for each pose so that every student can find their appropriate edge.

"This is not a major sort of injury, e.g. I can run and do lots of the Ashtanga practice, but have some specific problems with lower back and glutes which are more in the realm of chronic "myofascial dysfunction", according the sports medicine practitioner I have seen recently. I have some trigger points/ areas of local spasm in low back and glutes/piriformis, which I think have been long-standing but not really preventing any activity. What really aggravated the situation was a layoff due to a minor surgical procedure (unrelated to any of this) and overenthusiastic resumption of my usual routine. I developed some really bad spasm in my right butt and have been working my way out of that."

Any thoughts on poses she should maybe avoid or poses that might help more than others? I was thinking shoelace and sleeping swan could go either way. I had planned to do a sequence that includes half shoelace, swan, sleeping swan, and deer twist. I know you're not a doctor and cannot offer a lot of advice in the medical realm but if she walked into your class, how would you advise her? Thank you so much for any advice. Christy.


Hi Christy, thanks for your question: it is a good one.

An article that I posted a few months ago about about dealing with injured tissues (called Yin Yoga or Restorative Yoga?) has a good graphic that may help you with your new student. In it you will see that the Goldilocks position does apply to damaged areas as well as healthy areas. All our tissues need some stress in order to remain or regain health. However, damaged or injured tissues can easily be over stressed. This does not mean that the solution is to have no stress, but we have to find the appropriate amount and that can be tricky.



You would be wise to advise your student that you are not a therapist and you lead general classes, not one-on-one yoga therapy classes. You can say that you are willing to help her to the degree you can but she really should seek specialized therapy if she wants the best results. Having said all that, there are a few suggestions you can offer. The key, though, it to teach the student how to sense for herself whether the postures are working, too little or too much. Train her to pay attention to sensation: both while in the postures and for the next day or two after class. In this way, she will be able to build her own mindfulness practice which will tell her whether she is on the right track or not.

Given all this preamble, I think your idea of stressing her injured area is good - just do so gently. Half Shoelace is probably a good idea. Ideally you would want to put her hips through the full range of movements. Half-Shoelace will give you adduction, external rotation and flexion. She could also add Half-Butterfly as well as a gentle flexion for the hips along with some abduction. If you do Swan and Deer you are getting these movements again, which may be okay but you might want to, instead or in addition, move in the other directions: Reclining Half-Saddle will provide extension and internal rotation to the hip. Offer her lots of props to make Half-Saddle available to her. If it is not available, try reclining windshield wipers on one side then the other, or reclining, twisting Deer resting on a bolster. For her lower back issues, perhaps finish with Sphinx, Childs Pose and reclining twisted roots.

There are many possible poses to choose from that will move her hips in all directions: just start with the gentle versions, teach her how to sense the effects of these postures and insist that she come out at any signs of pain. For the first few weeks, shorter holds may be better holds (1~3 minutes) and she can work up to longer holds over time.

Let us know how it goes.
Cheers
Bernie
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