Note from the editor: These are general recommendations for yoga teachers and practitioners. These are not meant to replace the advice of a qualified health professional. Yoga teachers must stay within the scope of their practice. This means they should not attempt to diagnose or treat students or give medical advice.
How do you feel about your hips during or after yoga practice? You may feel a pinching sensation a few inches below your frontal hip bone, along with clicking or popping sounds or discomfort in your hamstrings. femoroacetabular impingement or hip impingement is a movement-related cause of hip pain. It can affect the mechanics of your joint and lead to joint issues. Only some people in the yoga community are familiar with the acronym FAI, despite the importance of the term to our practice.
FAI was recognized as a hip-pain cause in the 1990s. In a 2003 report, it was proposed that FAI is a cause of hip degeneration. However, recent evidence has linked it to hip cartilage damage and labral tears.
According to Dr. Shante Coffie, aka ” the Movement Maestro, a physical therapist and digital business coach, this term is exactly what it implies. Cofield explains FAI as “the femur (the thighbone) and the acetabulum” (the cup-shaped hip joint).
Dr. Ariele Foster, physical therapist, founder of YogaAnatomyAcademy.com, creator of the online course “Way of the Happy Hips,” and multi-disciplinary yoga teacher since 2001, took the time to explain FAI to me and to point me in the direction of some helpful research. Foster explains that FAI is when bone grows extra around the hip joint.
The extra bone growth around the hip joint can be on the femur or the socket. According to Foster, there are three different types of FAI: “[There may be] a thickening or deepening the rim around the hip socket (pincer type) or the neck of femur.”
Pincer impingement is more common among women than cam impingement in men. However, the majority of FAI sufferers have both. FAI can affect people without symptoms. According to some studies, FAI affects 31 percent of the population. A study showed that athletes were likelier than the general population to have an asymptomatic deformity.
FAI: Causes and Symptoms
Why is FAI more common among athletes, and what causes it? Hip abnormalities that are linked to FAI may be genetic. Our bones can change throughout our lives depending on how we treat them. Cofield summarizes Wolff’s law which describes how the bones adapt to the stress placed on them: “You rub something, you get bone development.”
Researchers have pointed out repeated hip flexion and internal rotation (knees bent inward and turned inward) can lead to FAI.
Internal hip rotation and hip flexion may trigger symptoms in FAI.
One way to diagnose FAI is through a Clinical Exam, where the hip affected is rotated and flexed to determine if it causes symptoms. Another sign of FAI is a reduced range of movement, such as a loss in internal rotation or difficulty flexing your hips beyond 90 degrees. Hip clicking or popping could also signal FAI, as might a distinctive pain pattern–discomfort at the front of the hip, perhaps extending to the outside of the hips in a “C-shaped” (which can be shown by someone cupping their hips with their thumb and finger). The discomfort can occur after a vigorous activity or after long periods of sitting.
FAI AND YOGA
Yoga poses and movements can cause hip pain and bone growth. Many yoga poses require repetitive motions of the hip.
Certain yoga poses can cause the hips to be in flexion or internal rotation. This position may pose a problem for people who are susceptible to FAI.
Understanding how yoga can affect FAI is essential, but it is hard to pinpoint the usual suspects. Some yoga practitioners attribute yoga injuries to incorrect alignment, underlying damages, wrong or no instruction from yoga teachers, excessive intensity or improper cueing. However, FAI can occur even when alignment is correct, there is no underlying injury, the teacher gives accurate and thorough instructions, or when yoga is practiced gently.
In addition, while we may think that yoga injuries are more common among beginners, FAI can also occur in students who have been practicing for a long time. older people are more likely to suffer yoga injuries, but FAI is most common in men and women who are athletic in their 20s. Foster points out, however, that this statistic is misleading. Even if young and active people are initially diagnosed as having FAI in their 20s and 30s and 40s respectively.
The disorder is both subtle and gradual. It is possible to not notice FAI for many years after practicing yoga. Foster says that “it’s why yoga instructors cannot rely on the phrase Listen To Your Body as their best injury prevention strategy.”
Treatments include physical therapy and anti-inflammatory shots. If damage to the hips progresses further, An arthroscopic procedure may be required to repair cartilage and the labrum of the hip and smooth out any bone growth. It is not certain that FAI or yoga will worsen.
Foster says that noticing early symptoms and changing your movement strategy can “absolutely prevent” minor signs from worsening. “Especially when working with a physical therapy who understands your practice and has treatment experience for hip conditions.”
Getting a medical diagnosis for hip discomfort is essential. There are also general explorations that can be used as a starting point for yoga students who have hip discomfort resulting from various conditions, such as FAI. Foster says the first stage of recommendations would be similar to initial general recommendations made for FAI.