This picture alone is why America needs to have more subways.
Yoga is supposed to be the ultimate non-competitive exercise but if you’ve ever spent time in a “serious” yoga class (or even a not-so-serious one) you’ll discover the Pose Off. I wish I was talking about lining up all the mats like a catwalk and having each yogi do their best Tyra impression. No, I mean the inevitable comparison of who can do which advanced poses and how well. Since overt bragging doesn’t mesh well with the whole yoga vibe, you have to make your stunts look calm and serene. Oh this? I always relax in a fingertip handstand. You can’t do it? Super easy – you just have to focus on tightening your core and you’ll get it!
(Side note: I swear the answer to EVERY tricky yoga pose is always “It’s all in your core! If you just hug your ribs together you’ll pop right up like a beach umbrella, easy peasy lemon squeezie!” Also, why is there no Beach Umbrella Pose?? There should be. I don’t care if beach umbrellas didn’t exist in ancient India. Neither did Justin Beiber and yet we now have yogaBiebs poses.)
Not gonna lie: I’m a competitive girl. Always have been. I try and reign it in during yoga but every once in a while that shiz comes bubbling out and last week was the perfect example. We spent the whole hour doing a series of progressively deeper hip opening poses, building up to one big doozie. Now, I have two natural God-given athletic gifts (and only two but that’s a post for another time): I’m more flexible than most and I don’t feel pressure as pain. I don’t know if all those years of gymnastics damaged my nerve endings (or brain, whatev) but I can go very deep into most poses and still not feel a dang thing. So of course I bounced right up into the pose — let’s call it Hip Replacement Pose. You know, for funzies.
Oooh! Ahh! SNAP!
I failed to mention that my athletic superpowers come with one mega kryptonite: My muscles, bones and ligaments still work like everyone else’s which just means that I have a greater propensity to stretch too far and hurt myself.
My hip snapped like Oprah interviewing Lindsay Lohan and while I didn’t think too much of it in the moment, the next day – which happened to be day one of our hiking through Arches – my hips just ached. Especially my right one. As a young (read: dumb) gymnast, I used to pop my right hip out in order to hyper-extend my straddle splits. It was a cool party trick but I didn’t realize that that actually isn’t a healthy movement until a physical therapist told me a few years ago. Oops. Turns out that flexibility can actually be a liability in strength maneuvers because your bendiness allows you to go further than your muscles, joints and bone structure would prefer. And I paid for it, hiking all day on a sore hip.
I am not alone in my ability to damage myself. Apparently yoga hip injuries of this sort are so common that they got their own write-up in The New York Times! And women, since we are naturally more flexible than men, are more prone to what is known as “yoga hip”, “dancer’s hip” or “runner’s hip” depending on your preferred sport. Or “aerial acrobat’s hip”, as evidenced by the following e-mail I got from Reader S:
Hi Charlotte,
I have been doing aerial acrobatics for about three years now, and about 6 months ago I started feeling a crackling in my hips whenever I did a straddle. The pain from this has slowly increased, and while it’s not awful, I should probably work on fixing it. I’ve been told that it is Snapping Hip Syndrome, and that it is very common for dancers, gymnasts, and martial artists to get it. I was wondering if you had ever experienced it, and if you had any advice on how to fix it.
Thank you!
First, no pictures Reader S??? You KNOW how I love aerial acrobatics! (My Great Circus Arts Fitness Experiment is still in my top 3 favorites ever and was the #1 most fun workout I’ve ever done.) It’s okay though, I understand how hard it is to hold a camera while dangling from one leg in a silk. We can still be friends.
But to answer your question: What is the deal with all this hip pain going around? Like the Times article points out, this type of hip pain is most common in women who do exercises where the hip is repeatedly extended. Gymnastics, dance, martial arts, acrobatics, yoga and even running are all common culprits from the way they require the joint to move in its socket.
For anyone who needs a refresher from high school anatomy: Behold, a healthy hip joint!
There seem to be three most common causes of range-of-motion related hip pain:
1. Snapping hip syndrome. According to WebMD, this a condition in which you hear a snapping sound or feel a snapping sensation in your hip when you walk, run, get up from a chair, or swing your leg around. The noise is caused by a ligament – most commonly the illiotibial band – moving over the top of a bony part of your hip. For most of us they say it’s usually little more than an annoyance and the only symptom is the snapping sound or sensation itself. But, they add that for dancers or athletes, snapping hip syndrome symptoms may also include pain and weakness that interfere with performance.
2. Bursitis. We have little fluid-filled sacs called bursa that are found at friction points in the body, like our hips, and when the tendons repeatedly snap over the bursa they can cause it to get inflamed which can be quite painful and become chronic. So this would be like exxtreme! snapping hip syndrome. (Everything is better with more X’s. Don’t you read fitness adverts?) And since your hips are instrumental in walking, it can become a vicious cycle of pain and inflammation, severely limiting your range of motion.
3. Femoroacetabular Impingement (FAI) syndrome. This happens when you repeatedly jam the neck of your thigh bone into the protruding rim of your hip socket. Sound hard to do? Not so much: Think your standard touch-your-toes forward bend in yoga, your split leap in dancing and your favorite “runner’s lunge” stretch after your 5-miler (or just the running part). Eventually your body builds up extra bone to try and protect itself but ends up hindering the motion of the joint and can be extremely painful.
“Women’s hips showed particular vulnerability. By nature, their pelvic regions support an unusually wide range of joint play that can increase not only their proficiency but, it turned out, their health risks. The investigators found that extreme leg motions could cause the hip bones to repeatedly strike each other, leading over time to damaged cartilage, inflammation, pain and crippling arthritis,” explains the Times piece.
So how do you treat hip pain from overuse in activities that require a large range of motion?
If your pain is mild or you’re simply bothered by the snap-crackle-pop then Runner’s World has a nifty article on some exercises to do to strengthen your hip joint which will help keep your pesky ligaments in line. My old trainer, who specialized in corrective exercises, was always adamant as well that weak glutes cause a lot of hip pain in women. So you can also try adding some glute-strengthening exercises like band walks, lunges, hip bridge raises and twerking. (What? It might get you some strange looks in the gym but it looks like it would work your buns! Not that I’d know – I can’t do it. Yes, I tried.)
The next recommendation is rest. Yes, you need to stop doing whatever activity or motion is causing the pain in the first place. How long? Here’s my old trainer’s super science-y recommendation: Until it doesn’t hurt anymore. Then once you resume your sport, try not to push so hard into your hips. Yeah it feels cool to be 35 and still able to do all my splits (woot!) but it will feel way cooler when I can walk my grandkids around the park without needing a robot hip. So REST IT. (I’m yelling at myself, not you!)
So…stop doing this. At least not every day.
However, if your hip pain is more severe and doesn’t get better with a little rest, ice and ibuprofen then you should see a doctor. They may prescribe more targeted physical therapy or do things to help reduce the inflammation. In some cases, according to WebMD, this pain may indicate torn cartilage in which case you definitely want to see your doctor. But what you don’t want to do is ignore it! Left alone long enough, these injuries can cause your hip joint to degenerate necessitating surgery or even a hip replacement. (And as Sarah pointed out in the comments, the ONLY cure for FAI syndrome is surgery as it necessitates removing the extra bone growth.) Ain’t nobody got time for that! Especially those of us who got it because we love yoga/acrobatics/dancing/running so much!
Dr. Jon Hyman, an orthopedic surgeon, told the Times his typical hip-pain patient was a middle-aged woman who did yoga or something similar, adding that he saw up to 10 a month — or roughly 100 a year. “People need to be aware,” he said. “If they’re doing things like yoga and have pain in the hips, they shouldn’t blow it off.”
Bryan T. Kelly, an orthopedic surgeon at the Hospital for Special Surgery in Manhattan, echoed the warning, saying, “If that’s done without an understanding of the mechanical limitations of the joint, it can mean trouble.”
Aaaand I feel compelled to confess that tonight, as I sit here typing this, my hips are again aching. Because did I learn from my hubris-induced injury last week in yoga? Nope! Did it again in class today. Which I feel especially dumb about because I went into class committed to being gentle and not pushing my hips deeply. But then we were working on Eight Crooked Limbs pose (WHO HAS EIGHT LIMBS?!) and it’s just so fun falling over and rug-burning my cheek that I completely didn’t pay attention to my poor hip sockets!
Anyhow. TL;DR: Just because you can, doesn’t mean you should. Don’t be me.
Any of you had hip pain like this? Have any advice for Reader S?? What’s your biggest athletic gift/talent?
I have FAI syndrome. Got it from running, not yoga, and the only way you can fix FAI is actually with surgery because you end up with extra bone that can only be removed with surgery. A cortisone injection helped a lot, but for me the WORST thing I can do for it is actually sitting too much, not yoga. Yoga seems to at least give me temporary relief, even though the problem is joint and not muscle related.
I didn’t know about the hip snapping thing, but if I had paid attention to that, perhaps I wouldn’t be in this situation now!
Ooh thank you so much for pointing that out! I updated my post with your comment in it so people will have that info! (Crediting you, of course). And I’m curious – do you still have the pain even after having the surgery?
I haven’t actually had the surgery yet, but if I did I’ve been told the pain would go away. It’s just keyhole surgery, so not too bad at all, but I am putting it off until after my PhD. In the interim, I’ve been able to manage the pain by getting a cortisone shot which took the inflammation down, never running two days in a row, not sitting for too long without moving, and just generally not overdoing things!
I have had recurring illiotibial band syndrome. It started years ago from running on a damaged and angled section of sidewalk and has recurred, I think (just guessing here) from weakened hip muscles…as it now aches closer to the hip and less near the outside of the knee, but still on the band.
My feeling about the weakened hip muscles (abductors perhaps) is because my flexibility is nowhere near yours Charlotte.
Plus no snapping noise with mine.
I do a stretch where I place my leg with soreness behind my good leg, then lower onto my good leg stretching the sore leg along the band.
I also do lunges at varying angles.
And yoga seems to help with my particular problem.
I have the opposite of this problem – I’m kind of knock kneed so any hip opening pose is really difficult for me. Even sitting cross legged properly isn’t easy for me as I can never get my knees anywhere the floor.
Conversely, when I was a kid I always found it much more comfortable to sit in hero pose rather than cross legged (http://yoga.about.com/od/yogaposes/a/virasana.htm) . Not that I knew it was a yoga position of course at the time, I just knew that it freaked some people out at school! Wish I could still do it now, I’m not flexible enough any more to do it for more than a couple of seconds.
I am the same way with hero pose and reclined hero pose! I could sit or lay down in them all day and never feel the slightest stretch. Except my feet eventually start to fall asleep…
Im LOTUS POSITION HEAD STAND McGEE—with piriformis induced hip pain.
should I take my show on the road??
That is one of my favorite pics of you:)
I’m probably the most inflexible person on the planet. Not exaggerating one bit. But, I have FAI (running) and just this past week partially ruptured my IT band at the iliac crest. Yes, that’s fun. So I think whether you are bendy or not, as females, that whole hip area is extremely susceptible. Ugh.
The closest I have to an “athletic gift” is. . .wait for it. . .flexible hip joints.
Yes, the rest of my body is tight (especially my shoulders because I’m a naturally uptight chick) but my hips are flexible. I think it’s just in comparison to the rest of my body because there are plenty of yoga hip-sy things I can’t do but of all the yoga stuff, the hip stuff comes easiest to me (and I was even complimented on my “flexible hips” once, I take any and all compliments when I can get them, even weird ones like ” you have strong hip flexors”).
I’m kind of competitive, too, and it rears its head in yoga. My show off pose is fire logs. I’ve had two instructors who couldn’t fully stack their legs and I could do it the very first time I tried. There’s something to add to my resume, huh? (ok, I’m done bragging now–really, that’s the only yoga brag I have, I’m painfully average to “needs improvement” in all other poses).
Hey I love me a good weird compliment! And I’m the same way with firelogs – I’m not even sure what it’s supposed to stretch? But yeah, give me an arm balance and I’m falling all over the room like a drunk clown… so yeah.
I have really flexible hips too. With my last pregnancy I had the worst hip pain that I chalk up to relaxin and having a baby jammed in there! I do notice an achiness in my hips when I do a lot of jumping and plyometrics now. My hips also snap and crack. Maybe I’ll back off on the stretching (I can still do splits too).
mine are def worse during pregnancy too!! And I feel like it takes forever (like 2 years) for them to properly get back into place after.
My biggest strength is being able to get up and down easily from a full asian squat: https://www.youtube.com/watch?v=y7Hh00vWd2s
I do a slow motion move I call The Vampire. Think of a vampire rising smoothly from the coffin. While lying flat on the ground with arms crossed over my chest, I bend forward at the waist to a 90-degree angle, then I draw my legs under me in a full asian squat and stand up without using my arms at all.
Yes, I love sitting in an Asian squat. It’s so funny because little kids can do it so easily (a toddler will pick up a toy by going down into an Asian squat and then standing right back up) but we seem to lose that ability as we age. Also, I had to try your Vampire move – I love it!!
PS. My fave thing about that youtube clip is that they’re actually filming something else (a drum routine?) and the guy with the mic is all “Woooooowwww look at my camera man holding his camera and squatting” ahahahh!
I’ve never heard of snapping hip syndrome until now! Very interesting! I’ve had bursitis in my hip from a tight IT band, but luckily nothing more serious than that.
I’ve got ‘probably’ got FAI according to the physio. Unconfirmed unless I have an x-ray but he said there wasn’t any point for now. I’ve danced for years and only ever had mild issues, but then I started running and that’s when the pain was suddenly very noticeable. I spend a lot of time in close personal contact with my hockey ball, massaging my hips to keep them from too much pain. The physio reckoned I probably could keep up with running as long as I continue a lot of massage, but that I might need a hip replacement in ten years. Guess which option I chose?!
I’m hoping you chose to quit running! So glad the massage is helping:)
I did quit, but marathon season on twitter is making me question that decision!
I occasionally have some pain in my hips from long (and I mean long like all day) walks but that’s about it. I try to be really careful of my hips though. My mom had a hip replacement at 48 years old due to congenitally shallow hip joints. There’s no sign I have the same issue (she had life-long problems) but it’s enough to make me try to protect them. I’m not at all flexible though so maybe that helps stop me from pushing too hard.
I had severe hip pain one summer, to the point that I would be in tears on the floor in the middle of a dance class. No one could figure it out (physio, dance chiropractor). Then a few weeks later I came down with severe acute mono.
It turns out that you have lymph nodes in your hip. Fighting off an infection can cause hip pain when they get swollen. I’ve now found that I can predict a cold using my right hip a day or so before I start feeling icky.
So interesting!! I have a bump in my mouth that swells right before I get sick. Not sure what it is – I don’t think it’s a lymph node? But it’s handy!
Very often we use our hip flexors for things our lower back should do, and vice-versa. To the point where they become almost fused. There are preventative exercises that can be done, but too often we don’t realize there’s a problem until the pain starts. (I know, collective “duh!” 🙂 )
A number of dancers have double hip replacements before they turn 40.
A good yoga and/or Pilates teacher can help with hip and joint issues, as long as your doc says it’s OK.
Good point about the hip flexors! I’ve heard they compensate for a weak core too. Thanks for the suggestion!
I have snapping hip syndrome. Felt the snapping for many years, but never had any pain until recently. I was in a long, deep lunge in yoga and one of my tendons on the front of my hip shifted and got stuck. Ouch! I couldn’t move for the second half of class. After that, I had my hip flexor and IT band get stuck a number of times resulting in a trip to the doctor. Have been seeing a physical therapist for a few months. We are working on engaging and strengthening the glutes and stretching my hip flexor and IT band. According to my doctor, physical therapist and a few trainers, many people overuse their hip flexors and underuse their glutes, causing a variety of problems.
I have hip pain. My right hip. It started right after my first pregnancy (during which I suffered from SPD), when it felt like my right hip joint never really realigned quite right. It worsened after each subsequent pregnancy, then improved greatly once I started a regular walking, running, and Pilates routine.
Then I started reexploring yoga. I too am quite flexible for a 35-year-old woman, and managed to overstretch my hamstrings in an Ashtanga class. I recovered from that, but the injury seemed to reignite the hip pain. Now I’m feeling it at some level, usually mild, but sometimes more acute, much of the time. What are my favorite workouts? Running, dance, and power yoga. It may be time to take my husbands advice and get in to see a PT.
SPD is the worst. The WORST.
Yeah… let me know what they say! I’m always super interested in other people’s medical stuff. (Seriously, I am. Plus I have a good friend who is in a wheelchair thanks to SPD and I’d love any information to pass on to her)
That used to be me when I was younger doing the splits. Now I look very similar, just the opposite way from running (90 degree angle ;D). I don’t do anything halfway!
I have FAI and bursitis. I plan to get surgery after I stop nursing. My first pain came from prenatal yoga. I stand to work and can no longer run, jump, bike or do any activity that is outside of water really without pain. It’s definitely put a damper on a more active lifestyle.
My hips pop all the time and I’m not sll that flexible…tho I do love sitting crosslegged. I found working my glutes helped, but I’m just miss pop a cracky most days. Hope when I am older they don’t give me trouble…
I’ve been diagnosed with FAI and a probable labral tear in my left hip. It’s true that the only thing that would fix it is surgery but I’m avoiding that because I’ve been told the recovery is rather long. Thankfully I’ve found that I can still run, strength train, etc as long as I avoid anything that requires me to move my knee too close to my chest (child’s pose, deep squats, etc). I also can’t do running interval speedwork every week like I used to. I don’t really mind the limitations since I can still stay active. The worst part is that sometimes I’ll try something new and feel fine while I’m doing it and then be in pain later that day or the next!
I wasn’t the active type of person on my younger years. I actually hated gym class so I have never experienced any sort of hip or any body pain. I was quite lazy but now I just started doing Pilates. Luckily, I haven’t had lingering pain problems only soreness that recovers after a day’s rest. The key is to listen to your body’s needs, that’s the essence of yoga, being at one with yourself. And stop comparing yourself to others and feel competitive all the time, it’s a tragedy waiting to happen.
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Ah, hip pain. Two summers ago after swinging a kettlebell around for half an hour, my left hip joint started *killing* me. I took some ibuprofen & called it a day. But it got so bad I finally went to urgent care. They took an x-ray, and it turned out to be three bone spurs on the ball part of the joint. Ouch! It’s the same hip that had a horrible case of sciatica during my first pregnancy.
After the inflammation in the joint went down, I did a lot of hip opening stretches, IT band rolling, rolling every inch of my legs and butt, and it helped. The only time the joint has bothered me since is when I posed for three minutes in a squat for a gesture drawing class. The joint (and I) were not ready for that!
My doctor called it osteo arthritis. It’s a ‘mild’ case, but still. Spurs in the joint! (same as the type you get on your heel)
In the article on women’s hips and yoga in the NY Times, I am the yoga teacher who urged William Broad to investigate hip injuries and yoga. The straight leg forward bending poses not only compress the hip joint but also loosen the ligament stabilizing forces of the spine and hips. These poses inhibit the back muscles and lead to a flat sacrum and weak gluteals. We need to strengthen the stabilizers of the hips and avoid hip opening which is like pulling on the seams of a piece of clothing the glamorization of flexibility in yoga poses oftentimes sacrifices joint integrity. I created YogAlign where the focus is on getting good posture not getting into poses or body positions that override natural ranges of joint movement.
Does anyone know how long I would have to wait after hip bursa removal to practice yoga again?
I have FAI as well as snapping hips. I am 30 and still taking dance classes 5 days a week. My hips are weird, in some directions, they feel super flexible, and others, I can barely move them, but I think that’s more due to tightness in certain muscles, hip flexors for example. I have excellent turnout, and could stay in the ballerina frog pose all day, but definitely couldn’t kick myself in the face doing a grand battlement.
I briefly considered the FAI surgery, but decided I would wait till I was old and not dancing anymore, as it’s not excruciating yet. I think if I did it now, I’d end up having bone start building up again as I returned to my original activities.
Keeping moving and stretching really does help me. I feel like its much harder to move around if I have a break from dance.
I’m 13 and I have been a dancer for 9 years and acro for 3 years. My back has been hurting for almost a month and so I have completely stopped doing any thing that has to do with my back but continued practicing turns and dancing. my hip has started hurting recently too but only when I’m doing splits, illusions etc. but not that much so I just ignored it. now my hip hurts very bad and the pain it spreading down my leg. I told my mom and sister but the sais its probably nothing but im still nervouse. Does anyone have any ideas on what to do?
I love your blog! Is it possible you have hypermobility syndrome? I was doing crossfit for about 6 months and discovered that I have hyper mobile hip, shoulder, and ankle joints (which basically means that those joints are “double jointed”).
While most people have very strong stabilizer muscles and have to warm up with stretches in order to be flexible, my stabilizer muscles are very weak and I have virtually no support when I do certain movements (for me its running, snatches, pull ups) which results in my joints sort of shifting out of their sockets.
http://www.tabatatimes.com/so-you-think-you-have-a-mobility-problem-hypermobility-in-the-crossfit-athlete/
I am a dancer and now that I teach yoga my hips are better than ever. I am not competitive though, my goal is to relax and get my body aligned so I can dance more. I am also into the meditation and connecting to my body. I also have a neck injury that yoga has also pretty much healed. It has been amazing for me. I love the way yoga has balanced and gently opened up my hips. I don’t strain or push things though. I think no matter what you do, if you attitude is competition and strain you will probably end up with injuries.
One day I tried to do my right splits which I had been doing for 2 weeks without problem, I heard a crack sound and my right hip hurt a little bit. I thought it was nothing so I kept doing several times more.
But later that day I felt a mild pain in my right hip and today I try to do right split again but it(my right hip) hurts so bad(the left one is still OK)! What can I do, I don’t want this to stop me from doing splits, am I having Snapping hip syndrome?