Frequently our visitors to Hip Pain Help ask, “Does yoga help hip pain?” and if so “Which yoga poses help hip pain most?” In our first blog in this series, we looked at yoga poses that might contribute to your hip pain, why and which hip and pelvic conditions may need to be treated with caution in certain poses. Yoga is a form of exercise that can enhance wellbeing and it can be extremely beneficial to those with hip pain with some key guidelines around general practice and some alterations to particular yoga poses. In this way yoga can help rather than hinder your hip pain.
Does Yoga Help Hip Pain? Move But Modify
At Hip Pain Help, we aim to keep people active and doing the exercise they love to do. For this reason, we suggest that instead of thinking about which yoga poses to avoid with hip pain, you try to modify your yoga poses before considering removing them from your yoga practice or stopping yoga altogether. After all, there are lots of benefits to yoga practice.
In this blog we will review the 3 poses we looked at in our first blog “ Yoga poses to avoid with hip pain” and suggest ways you can alter them to practise comfortably. If the specific pose you are concerned about is not listed below, then review the tips we have suggested for a specific hip position and apply this to similar hip positions in other poses.
In addition to the modifications suggested below, there were 3 key strategies we outlined in our previous blog that are worth thinking about throughout your practice:
Strategy 1: Don’t push yourself too far or let yourself be pushed further than you are comfortable
Strategy 2: Focus on technique and getting the pose right, from the start to the finish of the pose. Don’t progress to a more advanced pose until you have the basics perfected.
Strategy 3: Practice like no-one is watching. Being overly competitive or simply trying to keep up, can led to people pushing themselves too far. Run you own race, keep yourself safe.
Now let’s take a closer look at some specific yoga poses.
1. Practicing yoga to help hip pain – Warrior Pose.
This is a pose focusing on strength and power. It is a pose that opens up the front of the body. There are 5 variations, but we will focus on Warrior Poses 1 and 2. In these variations the back leg is extended backwards to open up the front of the hip and body, with the back foot turned outward from the hip.
Ways to alter Warrior Pose to help hip pain
Lunging is a fantastic weightbearing exercise that can be beneficial for the lower back and legs, as well as contributing to bone density and balance amongst other things. So our aim is to alter rather than stop this pose entirely.
Here are some simple strategies you could try, to make the Warrior Pose more comfortable for your hips:
- Don’t lunge as deeply
This will help to reduce the closing-down or impingement forces that can occur at the front hip
- Take a smaller step
This will reduce how much extension occurs at the back hip, reducing excessive stretching forces across the front this hip
- Lift the back heel and bend the back knee slightly
Similar to the above tip, this will reduce hip extension and the forces through the back hip. You could even place a small lift under your back heel to help maintain this position and with better balance, and therefore more control in this position.
- Turn the toes of the backfoot more towards the front.
This will help reduce the amount of rotation, or twist, that the back hip and pelvic region is subjected to. Reducing this rotation, together with reducing extension with the above tips, substantially reduces irritating loads on hip joint capsule and labrum.
Reduce your hold time and repetitions
Sometimes just doing a little less can go a long way.
2: Practicing yoga to help hip pain – Tree Pose.
Tree pose is a standing pose used to improve balance as well as for calming and relaxing the mind. It is a pose often used with beginners to help gain postural and body awareness. The pose focuses on balancing on one leg, whilst placing the opposite foot on the inside of the stance leg and turning the knee outwards away from your midline.
Ways to alter Tree Pose to help hip pain
For all the reasons this exercise can be an issue for your pain, if may also be a help. Standing on one leg requires a lot of hip and pelvic control. The deep gluteals at the side of the hip should workto stop the hip from shifting or dropping too far out to the side. The hip flexors and abdominals work to prevent the pelvis from shifting too far forwards , where you would feel your weight is more through the ball of your foot than your heel – we discussed this in more depth in our first blog – click here to read more (link).
Standing well on one leg can really work the muscles on the outside of the hip (gluteus medius), the muscles at the back of the hip (the deep hip external rotators) and reduce the stress that can be placed on the muscles at the front of the hip (the hip flexors). This good standing posture can also change the pressures placed directly through the hip joint, in turn reducing pain resulting from hip joint issues, including hip dysplasia and labral tears. (link to these condiitons). However, if you are not performing Tree Pose with an ideal technique, the hip can suffer.
Here are some key things to think about as you perform the Tree Pose:
- Think tall
- Keep your hip on the weight bearing leg tucked in – don’t let it stick out to the side
- Keep your weight 2/3rds on your heel and only 1/3 through the ball of the foot
- Don’t force the knee of your non-weightbearing leg back so far. This will reduce stretching force at the front of the hip.
- Use a little bit of support for balance initially – either with a stick or a fingertip on the wall, preferably on the non-weightbearing side
- Where pain is more difficult to control, possibly rest the toes of your non-weightbearing foot on the ground to reduce the balance challenge initially, while you work on gaining the hip strength and endurance required for sustaining this pose.
- Reduce your hold time and repetitions.
Remember, as we said above, sometimes just doing a little less can go a long way.
3: Practicing yoga to help hip pain – Twisted / Revolved Lunge Pose.
This is a standing pose that requires you to drop down into a lunge position, lean the body forward and then twist the spine. It is a pose that opens up the front of the trunk and rotates and lengthens the spine. However, the position of deep flexion and rotation at the front hip can cause some challenges for those with hip pain.
Ways to alter the Twisted / Revolved Lunge Pose
The deep flexion, where the body comes close to the front thigh, and rotation, where the body and pelvis twists towards front thigh at the front hip puts the front hip in an extreme closed position, a position of bony hip impingement. The opposite occurs at the back of the hip, that is then in an extreme open, or stretched position. For those with certain hip conditions, this can be irritating to the joint. You can read more about this in our previous blog.
Therefore, the modification is actually quite simple, don’t bend forward or rotate the pelvis as much.
In addition, you might want to try
- Keep the body upright
Keep the body upright to rotate, rather than rotating in a bent over posture. This will still allow a good spinal mobility but in less aggressive hip positions.
- Use a block under the hand
If you are using a variation where one hand reaches to the ground, use a block under the hand to help reduce the amount of bend at the hip. This will also reduce the amount of twist that occurs in the hip joint in this position.
- Reduce your hold time and repetitions
We have said it the whole way through this blog: sometimes just doing a little less can go a long way.
So, does yoga help hip pain?
In answer to your question as to whether yoga helps hip pain, yes, yoga has the potential to build strength and balance around the hip and pelvis, particularly the standing poses. Weakness and poor muscular control of your pelvis and femur (thigh bone) are much more likely to be underlying issues for those with hip pain, rather than lack of flexibility. Often the reduced range that comes with hip pain is due to joint inflammation and muscle guarding to protect the joint. Forceful stretching usually does little to address the real underlying issues and may make symptoms worse. When practising yoga with hip pain then, focus on control and balance through your movements and don’t force or sustain your hip in any uncomfortable end-range position. Work with your hips to improve your strength and muscle support during dynamic poses, making the simple alterations covered in this blog to ensure that your yoga does help your hip pain.
We hope this blog has helped you to understand ways you can alter your hip positions in yoga poses where you are required to:
- Sustain an extreme ‘open’ or stretched position of the hip, or
- Sustain or repetitively move into an extreme ‘closed’ or compressed position, a position of hip impingement.
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We have aimed to bring you thought provoking blog with plenty of tips, but it will be no means provide all the answers for every individual. If you have ongoing hip pain during or after yoga, even after trying these tips, we strongly suggest you get in touch with a Hip Pain Professionals. The Professionals on our Hip Pain Help Directory know hip and pelvic pain – get in touch now – click here. And remember – video consultation is an excellent alternative if the professional you think would be best for you is located too far away for a face-to-face visit. Make sure to give it a try.
This blog was written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists who have over 50 years of combined professional clinical experience, dealing with patients suffering from a wide range of hip and pelvic conditions.
Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of Physiotec Physiotherapy, an Australian Sports Physiotherapist and Adjunct Senior Research Fellow at the University of Queensland, author and global educator.
Kirsty McNab BSc Hons, MPhty(Sports), is Practice Principal of Physiologix and a highly experienced Sports and Exercise Physiotherapist having worked extensively with elite athletes, the Olympic Winter Institute of Australia, and Tennis Australia.
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- Wiese, C., Keil, D., Rasmussen, A. and Olesen, R., 2019. Injury in yoga asana practice: Assessment of the risks. Journal of Bodywork and Movement Therapies, 23(3), pp.479-488.
- Denham‐Jones, L., Gaskell, L., Spence, N. and Tim Pigott, 2021. A systematic review of the effectiveness of yoga on pain, physical function, and quality of life in older adults with chronic musculoskeletal conditions. Musculoskeletal Care, Jun 14. doi: 10.1002/msc.1576. Online ahead of print.
- Campo, M., Shiyko, M., Kean, M., Roberts, L. and Pappas, E., 2018. Musculoskeletal pain associated with recreational yoga participation: A prospective cohort study with 1-year follow-up. Journal of Bodywork and Movement Therapies, 22(2), pp.418-423.