Shift your focus from openness to stability. By Tiffany Cruikshank
IN YOGA, THERE IS A tendency to assume that we can stretch our way through perceived problems. Consider the ever-elusive “hip opening.” We aspire to use this practice as a panacea for all our aches and woes. We imagine that open hips will allow us to wrap our legs into fancy postures like Padmasana (Lotus Pose). But it’s possible that at a certain point, the coveted range of motion begins to work against us.
Enter “hypermobility,” a general term that refers to an excessive range of motion in a joint—with a lack of stability to support that mobility. It may be something you are born with or something you develop through regular stretching. Hypermobility in the hip joint can also stem from weak hip stabilizers—the gluteus medius, gluteus minimus, and other muscles—from prolonged sitting or decreased activity. This can happen to anyone, especially in the yoga world where we focus so much on long, deep stretches to get that feel-good release.
Consider a classic hip opener like Eka Pada Rajakapotasana (One-Legged King Pigeon Pose). Some people consider it a resting pose, so they continue to seek a deeper stretch in variations or harder modifications. Yet stretching those areas that are already flexible makes hypermobility more pronounced. This may not initially seem like a problem—deeper stretching feels good, and you get the release you crave—but the surrounding cartilage and ligaments also take on the impact of your movements, which can overtax and reduce their strength and stability, diminishing the support that is so key to the integrity of the hip joint.
Instead of pushing deeper into flexible areas, notice spots where you are tight or weak. Then, look instead for poses to challenge the strength of your hips, thus shifting your focus from hip opening to hip stability. You don’t need to over-analyse this; the only thing required is mindfulness to honour what you feel.
To comprehend the effects of hypermobility on the hip joint, we need a basic understanding of its five main layers, moving from deep to superficial. First, the bony structure of the joint is found where the ball-shaped femoral head fits into its socket, called the pelvic acetabulum. It is surrounded by articular cartilage and a labrum, or lip, made of fibrocartilage and dense connective tissue to help hold the ball in the socket. The joint capsule is a thin, fluid-filled sac surrounding the joint, held by ligaments—those tough but flexible fibres that connect bone to bone. Finally, atop these structures are the many tendons and muscles that affect movements.
Each of the deeper structures of the hip plays an important role in stability. The labrum deepens the socket and makes it more difficult for the femoral head to slip out. It also plays a vital role in decreasing contact stress on the joint and in ensuring lubrication between the femoral head and its socket.
The joint capsule adds another layer of stability, and it secretes a lubricating substance that reduces friction. Meanwhile, the ligaments that surround the hip limit how much the joint can move, preventing dislocation and wear to the deeper layers of cartilage: The ligaments also hold the bones together. However, ligaments aren’t elastic, so once they have been overstretched, they remain that way, and their ability to support the joint is compromised.
Finally, closest to the surface, the many tendons and muscles control the hips’ motions and stabilize them when they are balanced (in terms of strength and flexibility).
These five layers work together. When any one layer is not functioning, the rest have to work harder to pick up the slack. If your ligaments are overly stretched, your muscles must labour to stabilise the joints. And if your muscles are weak or not firing properly, the deeper layers of your ligaments or labrum must compensate by absorbing the impact of your movements.
The trouble is, you can’t always tell when one layer is falling down on the job. The cartilage and ligaments have less sensation and deteriorate over long periods, meaning you may not feel pain or notice any problems until the damage is done. As you get more flexible or “open” in your hips, it becomes even more important to create strength in your hip muscles to help stabilize that mobility.
A good way to practice is by focusing on your standing leg in balancing poses. Gluteus medius and minimus are critical for hip stability any time you stand upright. These muscles help to position the femoral head in the hip socket—to keep you from sinking into, and wearing down, the labrum, cartilage, and ligaments. A pose like Virabhadrasana III (Warrior Pose III) is a challenging opportunity to practice using the gluteus medius and gluteus minimus in order to stabilize the hip of your standing leg and strengthen those muscles so that they support you in all of your standing poses.
How to Activate the Hip Stabilisers
Here are three easy steps to activate the hip-stabilising muscles—the gluteus medius and minimus—to prepare for a balancing pose like Virabhadrasana III (Warrior Pose III). The key to each step is to keep the movement subtle rather than aiming for large contractions. When we stabilize the joint, we simply need a gentle engagement—not a huge action that can create tension.
1 Stand in Tadasana (Mountain Pose). First, imagine hugging your outer hips into their sockets by drawing them toward the midline of your body. Though the movement is subtle, you will feel your outer-hip muscles gently turn on to support the joint.
2 Next, visualize riding higher in your hip socket instead of sinking in the joint. This boosts integrity in the muscles that support the joint, helping to protect the deeper structures.
3 Finally, gently engage your lower abdominals to help support your hip joint with your core. Once you achieve all three steps, slowly lean forward at the hip crease of your standing leg to come into Warrior Pose III. Don’t lose that support as you raise your lifted leg straight behind you. Your arms can extend forward, come to your heart, or reach backward. If you get tired, come out by returning to Tadasana.
Tiffany Cruikshank, founder of Yoga Medicine, specialises in sports medicine and orthopaedics, and has been teaching yoga for more than 20 years and seeing patients for more than 12 years. She fuses traditional yoga with Western medical anatomy and physiology to train teachers all over the world to apply the practice of yoga more therapeutically. For more info, visit yogamedicine.com.