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| My right hip flexors have been hurting (discomfort and moderate pain) when I bend forward in standing as well as sitting poses. It's really stopping me from bending forward. I ignored it at first but it's been almost two months. I does help when I massage and also I did stop yoga for 2 weeks to help it heal and it was fine for 2 days and then started hurting again.
Not sure what to do. I went to PT but he just gave me electric simulation which helped very little so I stopped it. Exercises he gave me are all basic yoga poses. So not sure what to do next. Any suggestions?
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| An ashtanga teacher may have a different reply.
For me a student in your situation would need to be assessed first. Said assessment is in-person.
Therapeutics based on guesswork (without assessment) are "nice" but rarely anything more.
It is unusual for hip flexors to act up in forward bending since the muscle insertion is moving closer to the muscle origin. So as a yoga therapist I'd want to look at this very carefully. Presuming then that it is a hip flexor issue, which of the three are we dealing with?
Since you have not mentioned the location of the pain or it's nature (sharp, dull, throbbing, radiant) it is all the more difficult to guess.
Others who may be more familiar with the ashtanga practice may advise you on the do's and do nots. Seems to me your choices are three. Continue on as you are and hope this will pass, amend your practice and hope this will pass, stop your practice and rest, or find a yoga therapist, get an assessment and develop a practice that will assist your body in healing whatever is "up" for you.
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Location: London, England | Eteraz - 2008-05-02 2:01 AM
My right hip flexors have been hurting (discomfort and moderate pain) when I bend forward in standing as well as sitting poses. It's really stopping me from bending forward. I ignored it at first but it's been almost two months. I does help when I massage and also I did stop yoga for 2 weeks to help it heal and it was fine for 2 days and then started hurting again.
Not sure what to do. I went to PT but he just gave me electric simulation which helped very little so I stopped it. Exercises he gave me are all basic yoga poses. So not sure what to do next. Any suggestions?
Hi Ellie,
Would you mind if I asked how you or your physiotherapist diagnozed the hip flexors as being the source of pain? I'd like to clear that up first, because you mention that massage helps, and not to many massage therapists would attempt to massage the psoas-it goes from the lumbar spine to the femur, and passes behind the abdominal contents-so a masseur has to know how to massage through the abdominal muscles and abdominal contents-you can cause all kinds of nasty things if you don't know what you are doing-the abdominal aorta also is close by-risky.
I think that the ability to use bandha in astanga yoga is particularly important-crossing the legs and bringing them to the chest when you lift forwards or lift back is an example of a strong hip flexor action. If used properly, bandha can amke it so that the abs and pelvic floor remove the need for such a strong hip flexor contraction-something's got to contract, and if it isn't bandha, then it's almost certainly the case that the hip flexors have to contract more strongly.
This is also the case in all the forward bends-the hip flexors have to be tempered by using bandha. perhaps try to do upward dog with really good form-people often just skate through the vinyasa and sun salutes, and lose the benefits of all the back bends.
Nick |
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| HI Nick, well I told my PT that part of my upper leg hurts (groin area when I bend forward) and he moved my legs around a bit and said it's not joints or bone related so he diagnosed it as hip flexor . today I went to an Iyengar workshop and the teacher told me it's because I scoop my tail bone in too much and therefore the muscles in that area have become stuff.
Both he and another female teacher told me to use my bandhas and we did some uttanasanas where she took my thighs and pulled them in and away and as she was still holding it told me to move forward and down towards my feet while holding all the bandhas (I surprisingly felt no pain).
Afraid of having a sway back I'd been scooping in my tail bone too much and apparently that had something to do with it. I will try to do these things and see if I can do it on my own without anyone helping. |
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| Nick one more thing, It helpswhen I massage it myself. It is the area right above my groin. I push in really hard when I'm half way down and that area is really soft and I immediately feel a relief. I'm guessing that's my psoas. Maybe I shouldn't be doing that. |
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| Since you already have tension in this area, your hip flexors will almost automatically want to tighten up whenever you try to activate the lower bandhas. Work with your teacher to keep this at bay, he/she may notice the muscular activation before you do. Your teacher may also be able to recommend specific poses to help stretch the affected area passively. Any place in the body where tension already exists, tension will tend to want to show up and hang out.
A teacher of mine just gave me a great piece of advice while I was experiencing back pain during a week-long Ashtanga workshop: don't do anything you hate. Life is too short!!! Enjoy the asanas that feel right to you, and they may just reveal ways that your body can work with a hip flexor imbalance. If forward bends are hurting you right now instead of helping, DON'T DO THEM! Modify your practice to bring peace to your body, instead of feeding the imbalance.
On a more practical level, I especially enjoy a very relaxed Pigeon pose. I lay face-down with one leg beneath me, then take the rear straight leg and bend it, possibly taking that foot in the opposite hand while still relaxing on the mat. Feels GREAT for the hip flexors! I tried it on one of my Pilates clients (she is a big tailbone-tucker) and she just loved it. I hope my description made sense at all! Best to work with your teacher for the best pose for your body.
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| Two additions to the flow of this thread thus far.
First, if you are palpating the psoas (touching it) you would almost certainly know it. For a variety of reasons it it very reactive to contact. I really am not fond of writing text on how to find this or that or do this or that pose. So I'll skate around it. If someone else feels comfortable directing you you to palpate the psoas then so be it. My point is that in most people pressing that muscle hurts and intensely so.
Second is the concept of bandhas which I acknowledge varies quite a bit from one yoga person to the next, one style to the next. I presume however that it would be agreed that there are three bandhas and that they are "locks" in the body. Further more I presume it would be agreed that they are Mulha (or mula), Uddiiyana, and Jalandhara, AND that they correspond to the root of the body, the abdominal cavity/diaphragm, and throat or neck.
So are you saying that you were holding all three of these bandhas going into and out of uttanasana? |
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Location: London, England | Hi Ellie,
I'm still not sure we are talking about psoas-according to 'anatomy and human movement':
"It is almost impossible to palpate this muscle as most of its bulk lies within the abdominal cavity. It appears near the surface in the groin, but is still quite difficult to feel as it is covered by other structures."
Try this-a resisted leg raise-sit on a chair, put your hands over your knee and lift the knee towards your shoulder a few inches, now push down with your hands at the same time as you try and raise the leg. If psoas is in trouble, that should make it hurt  You're welcome
Nick |
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Location: London, England |
Edited by Nick 2008-05-03 5:09 AM
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| Hi Nick, I tried it but nothing hurt. Last year I was going to a great PT for back pain and she used to massage my psoas. She said from experience and study she could go down deep and feel it from my abdomen and massage it. She kind of showed me how to push deep into the abdomen lying
hat's why I thought it was indeed the psoas.
However I did not feel any pain when I did your exercise below. So maybe it's not. I did what the Iyengar teachers told me to do today in my regular ashtanga class in forward bends and it really helped. I've also been rolling that area on a tennis ball and I got the exact spot where it's hurting and I've been pushing on that and it's really helped. |
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| I had the muscle palpated by others and I have palpated it myself.
Tricky, yes. Impossible no.
If the student, and thus the abdomen, are resistant there is absolutely no way to get into it.
But I've "allowed" at least four different massage therapists in there and I can assure you it was more painful than an ACL repair but with less duration :-) |
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Location: London, England | Hi Ellie,
Well, maybe you are right and it is your hip flexor-here's a picture of the iliopsoas:
http://tinyurl.com/6b7sza
I don't think that you could get to the psoas by massaging through the abdominal wall and contents, not on yourself. To get to it, you basically have to use pointed fingers and go in right beside the rectus abdominus, at navel height, where the belly of the psoas muscle is-and like Gordon says, if you find it and you need work on the muscle, it will feel like you are trying to dis-embowel yourself with a food processor
Nick |
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| Update:
Hi everyone. I've been going to a great Chiropractor who pracites ART (Active Release Technique) which was recommended to me by someone. He massages my posas (last) and also presses on then tendon of inserstion points in my groin (while moving my legs all the way back ) but all are soft-tissue techniques, where illiacus and psoas meet and that is exactly where it hurts (as well as the psoas near there). He also massages the back of my hips and it helps. My pain is almost 100% gone. I have only one more session. He also gave me some PT excrcises to stretch my quads (apparently quads are effected by tightness of hipflexors as well and contribute to the pain).
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| I see that this is an old thread but am adding to it anyway because it lands high on a Google search of hip pain and forward bends, which I also get. I think it's not uncommon.
I found this Pilates explanation REALLY helpful: http://pilates.about.com/od/technique/a/Hip-Flexors.htm
I've never taken a Pilates class, but I hear they focus a lot on core strength and even use some Ashtanga-like moves. (Interestingly, Ashtanga was not in my Google search but happens to be the kind of yoga I do.) Apparently the Pilates folks often say "stay out of your hip flexors" because it's easy to over-use them when you should be using your abs - for instance, I think, when you feel navasana in your groin and hips instead of your belly.
Maybe everything falls into place naturally if you're taking the lower bandhas correctly, but simply engaging the muscles wasn't fixing my hip pain in forward bends. (Or, it was weird: I would go for long periods with no problems, and then the hip pain would come up again. I think my body sometimes forgets proper alignment, even if it came naturally before, and then it's difficult to rediscover it.)
If you watch the video of The Hundred, a Pilates exercise (http://video.about.com/pilates/Pilates-Exercise--The-Hundred.htm) you won't get spiritually enlightened from it, but you WILL get a demonstration of what almost seems like tucking the tailbone while lying on your back with your knees bent and feet flat on the ground.
If you try to do this "tuck" -- rolling your hips forward and up a little -- and THEN take your forward bend, with abs engaged and the bandhas and all that, it might solve the problem. Did for me!
Actually, I tried several of the exercises they suggest just to see the difference between over-using my hip flexors and, well, not doing that. That's how I discovered that this was definitely my problem.
Hope this is helpful to someone else, too.
Cheers,
Tabby
Edited by tabby 2009-10-10 12:49 AM
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| @Tabby. I looked at the pilated video and also go to pilates class. Have been doing that pose the way they suggest and it really helps. BTW, I went to a chiropractor who is also a physical therapist and he massaged the psoas and some muscles that comprise the hip flexor muscles (groin muscles?) as well as my quads and after each session the pain completely went away. After several sessions I was totally fine. The massaging was very intense though but it worked. |
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Hip flexor pain forward bend
