Shift your focus from hip openness to hip stability.
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 our hip-opening 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.
Hypermobility of the Hip Joint
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 can be something we are born with or something we develop through regular stretching. In the hip joint, it can also stem from weak hip stabilizers—the gluteus medius, gluteus minimus, and other muscles—from prolonged sitting or decreased activity. Hip hypermobility is something anyone can develop, 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). It can seem more like a resting pose for some people, so they continue to seek a deeper stretch in variations or harder modifications. Yet stretching those areas that are already flexible makes the hypermobility more pronounced. This might not seem like a problem initially—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.
So, 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 the hips, thus shifting your focus from hip opening to hip stability. You don’t need to over-analyze this; the only thing required is mindfulness to honor what you feel.
The Five Layers of the Hip Joint
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 boney structure of the joint is found where the ball-shaped head of the femur fits into the 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 fibers that connect bone to bone. Finally, atop these structures are the many tendons and muscles that effect 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 head of the femur 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, plus 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 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.
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, the muscles must labor to stabilize the joint. And if your muscles are weak or not firing properly, the deeper layers of the ligaments or the 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 longer periods, meaning you may not feel pain or notice any problems until the damage has already happened. As you get more flexible or “open” in the hips, it becomes even more important to create strength in the 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 are standing 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 gluteus medius and minimus to stabilize the hip of the standing leg, and strengthen those muscles so that they support you in all of your standing poses.
How to Activate the Hip Stabilizers
Here are three easy steps to activate the hip-stabilizing muscles—the gluteus medius and minimus—to prepare for a balancing pose like Warrior III. The key to each step is to keep the movement subtle rather than aim for large contractions. When we stabilize the joint, we simply need a gentle engagement rather than a huge action that can create tension.
1. Stand in Tadasana (Mountain Pose). First, imagine hugging your outer hips into the sockets by drawing them toward the midline of your body. Though the movement is subtle, you will feel the outer-hip muscles gently turn on to support the joint.
2. Next, visualize riding higher in the hip socket rather than sinking in the joint. This creates the integrity of those muscles that support the joint, to help protect the deeper structures.
3. Finally, gently engage the lower abdominals, to help support the hip joint with your core.
Once you achieve all three steps, slowly lean forward at the hip crease of the standing leg to come into Warrior III without losing that support, as you raise the lifted leg straight behind you. The arms can extend forward, come to your heart, or reach backward. If you get tired, come out by returning to Mountain Pose.
ABOUT OUR EXPERT
Tiffany Cruikshank, founder of Yoga Medicine, specializes in sports medicine and orthopedics, and has been teaching yoga for 20 years and seeing patients for over 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, go to yogamedicine.com.