Today’s pose of the week is about how to know your hip motion limits for hip preservation in yoga. In short, it’s about hip preservation over hip opening, folks. I want to teach you how to know your hip range of motion boundaries through to beginning to understand how to screen your own hip morphology.
Why is this important? It will help you know what your healthy hip motion should be in yoga poses, and all movement! Let me explain…
Determining Your Hip Motion Limits
There are multiple types of angles that are important to measure in the hip and pelvis, some of those include acetabular version, lateral-central edge angle, and others. But for this post, we are going to single out femoral version angles, because in the literature they correlate to available range of motion when compared to CT scans (which is important, because you want your clinical tests to be confirmed reliable and valid when compared against gold standard diagnostic testing and surgery).
The most easily accessible screen to understand your hip motion limits, without invasive diagnostic testing, is called the Femoral Version Screen, otherwise known as the Craig Test. There are 2 types of femoral version:
- Femoral Anteversion
- Femoral Retroversion
Femoral Version: Why It Matters for Hip Preservation
Have a look at the illustration below (Figure 4.25) from my text yoga in rehabilitation. In the figure, you can see a person lying on their stomach (prone-lying) with their knee bent (flexed) to approximately 90 degrees. A measurement is taken by palpating (touching) the greater trochanter (the part of the hip you can feel from the side of your pelvis) and centering it up in the middle of the upper thigh by internally and externally rotating the femur until the “centered” position is achieved.
The angle you see, as is demonstrated in the photograph, is called the femoral version angle and can be taken with a digital or manual goniometer from the vertical axis of the tibia or a horizontal level line drawn between the two distal femoral condyles. A “normal” range for femoral anteversion, which is what the normal hip needs, is between 8-15 degrees from the vertical, where the femur is slightly internally rotated. Anything above that measurement (greater than 15 degrees), is considered excessive femoral anteversion, and anything less than roughly 8-15 degrees (I typically use 15 degrees as a cutoff) is considered femoral retroversion.
Watch my Femoral Version Screen Test below, which will make it far easier to understand. In it I demonstrate two variations on how to pull an accurate measurement.
Femoral Version Determines How Far You Should Go in Yoga Postures
It means that, through CT scan studies, femoral version can be correlated with a loss of normal physiological osteokinematic range of motion. That is to say, if a person is found to have excessive femoral anteversion, he or she will likely have limited external rotation. If a person has femoral retroversion (any amount is considered excessive) then she or he will have limited internal rotation. This has profound implications for the practice and prescription of yoga, whether when used by a yoga teacher, yoga therapist, or healthcare provider in clinical or wellness practice.
Your Hip Motion Limits dictate Protection, Performance, & Hip Preservation in Yoga
Nobody wants a hip replacement under any circumstances, but it is especially heartbreaking when you need a hip replacement due to pushing yourself too far in yoga postures for years, or decades. Some of my good friends and colleagues in the yoga world, like Jill Miller, for example, can attest to how important it is to honor your hip range limitations. Jill has suffered through the pain of premature aging and joint degeneration in the hip due to decades of extreme yoga posture practice. But it isn’t her fault. She has boldly shared her story and journey through recovery, and I applaud her for it.
She, like many others, was encouraged to lean into her flexibility, not knowing that every hip joint has a natural limit. This is why I am a STRONG proponent of not using the phrase “hip opening.” Instead, replace it with the term “hip preservation.” Read more on why here. Hip Openers in Yoga? Please Let’s Stop the Madness
You can also listen to my interview on moving from Hip Opening to Hip Preservation – and get a FREE DOWNLOAD here:
Dr. Ginger Garner: From Hip Opening to Hip Preservation- Why Yoga Can Predispose You to Hip Injuries & How to Avoid Them
The femoral version screen is done by a licensed healthcare provider, so today’s pose of the week is a screen that is available to everyone.
Today’s Pose of the Week is a start to screening your hip range of motion so that you can begin to personalize not just ONE yoga pose, but your entire yoga practice.
Follow the links below to learn how to address hip preservation in these postures.
Yoga poses that require hip external rotation can include, but are not limited to:
- ✅Warrior II
- ✅Extended side angle
- ✅Tree pose
- ✅Cobbler’s pose
- ✅Child’s pose
- ✅Wide angle forward seated bend
Plus yoga poses that require hip internal rotation (there are far less of these) include but are not limited to:
triangle pose is an example of where both internal and external range of motion in the hip are needed
I can’t list ALL the yoga poses here but hip rotation is required for most yoga poses. Yoga postures really lean toward LOADS of external rotation (aka abusing hip external rotation), which is super difficult for those who don’t have a lot of this motion available.
The abuse of hip external rotation in yoga is a big reason why I DO NOT LOVE the term “Hip Opening.” Simply put – a good deal of the population, especially woman, may not have this range fully available in their hip.
For this reason, I really discourage yoga teachers, therapists, and all healthcare providers from using the term. Why? It’s not as simple as just “opening” the hip.
Words matter, and we cannot be inclusive of everyone’s impairments, limitations, and/or disabilities if we continue to use the phrase “Hip Opening.” Further, if you are still using the word “Hip Opener,” you are making a dangerous assumption that the students in your yoga class or session actually have that capability in their hip joint.
Inviting random people off the street to do a “hip opener” class is like insisting that all fish can ride a bicycle or climb trees – if only they try hard enough. Continuing to insist on using the term “Hip Opener” is not only insensitive to a person’s needs and limitations, it’s also bullish and ignorant.
Everyone has a different available range of motion in the hip. Instead of using the term “Hip Opener”, let’s evolve our language to be person-first friendly and start using the term Hip Preservation!
Know Your Hip Motion Limits for Hip Preservation in Yoga
I want to emphasize that this screen is just one small part out of a comprehensive physical examination and evaluation I do as a pelvic PT. This screen is not a replacement for a physical therapy evaluation nor does it constitute physical therapy. If you have hip pain or feel like you need to be seen for hip issues, feel free to reach out and connect.
About the Author
Ginger is a passionate, unapologetic advocate of improving access to healthcare, a mother to 3 sons, & a 20+ year veteran in Integrative & Lifestyle Medicine in women’s health physical therapy & athletic training. She is the author of Medical Therapeutic Yoga, founder of Living Well Institute, owner of EudeMOMIa Integrative PT & Lifestyle Medicine, and most recently uprooted to Greensboro, NC with her family after 21 years of beach living, where they and their rescue pup Scout are wildly joyous about their new hometown.
PS HERE ARE 3 MORE WAYS I CAN HELP YOU!
2. Take courses with me at Living Well Institute and Yoga U Online!
3. Take advantage of the Free Medical Therapeutic Yoga Basic Video Library.
DISCLAIMER: These movements are for protection and preservation, as well as maximizing, pelvic girdle function (hip, SIJ, low back, pelvic floor). This and any other videos I instruct do not constitute physical therapy or a patient-provider relationship. User assumes risk in performing this or any video. Finally, you need to get the approval of your healthcare provider before doing this or any instructional movement video. Assessment and evaluation of the hip & knee should only be done by a licensed healthcare provider.