Anterior Central Labral Tearing

Yoga Discussion General Yoga
#1

I’ve been working sometime with an individual who was recommended by one of the doctors of the clinic I’ve been teaching at. She has been diagnosed with Myofacial Pain Syndrome and besides yoga, she has been seeing a PT & having craniosacral. The pain was located around the right hip joint since a minor car accident. About 2 or so years ago she had an x-ray and nothing was too conclusive except for a backwards tilting of the hips. She recently finally had another x-ray done and followed it with an MRI which turned up a Anterior Central Labral Tear. How long it has been going on is anyone?s guess.

Both the doctors and her both wish to keep pursuing yoga and we have been taking it easy (working at a 70% effort level and avoiding postures when they are felt in the joints) but I was wondering if any of the experienced yoga therapist had recommendations as to postures that would be productive. I’m fairly familiar with postures that should be avoided.

PS. It’s been such a long time since I’ve been on the board! Greetings everyone! OM Shanti!!!

#2

Hello Bridgette,

The myofascial pain syndrome seems related to fibromyalgia, which I am familiar with through some of my students. You can do a great deal with yoga therapy for pain reduction. The recipe is vata balancing. An approach like Mukunda Stiles’ joint freeing series is appropriate. Gentle movement in harmony with the breath. Or the similar Bihar School of Yoga pavanmuktanasana series. Or an approach like restorative yoga. Always include a long savasana and a guided meditation like yoga nidra. Gentle pranayama (ujjayi, alternate nostril breathing, simple abdominal breath) is a great pain control technique as well. Yoga can effectively break the cycle of pain —> stress --> pain and improve sleep for these students.

For the hip, the gentle movements of the joint freeing series can work. Always stay within the pain-free range of motion.

It may be worth investigating [U]with the doctors[/U] whether is would be appropriate to correct the backward tilting of the hips. Would that shift the load away from the labral tear? I assume that you mean that the pelvis is tilted. Or are you referring to the shape and angles of the upper part of the femur? To correct pelvic tilt you would first need to assess your student for tight and weak muscles. Once you have identified these, you could devise a very gentle program to work on those muscles - stretching and toning, respectively. Angles in the bone itself cannot be corrected.

Best wishes.

#3

Since this sort of topic could evolve very quickly into a very involved discourse I’ll simply answer what you’ve asked Bridgette.

I would have to first look at the student’s MRI to determine a course of action.

Postures that would be beneficial would be ones that traction the head of the femur away from the acetabulum. Since the hip lives in a compressed state due to our bipedal nature, additional jamming of the thigh bone into it’s joint could place pressure on the tear.

Obviously if there’s inflammation that could also be a source of pain or discomfort and then asana would not be the remedy but rather a protocol designed to reduce inflammation.

#4

It may be worth investigating [U]with the doctors[/U] whether is would be appropriate to correct the backward tilting of the hips. Would that shift the load away from the labral tear? I assume that you mean that the pelvis is tilted. Or are you referring to the shape and angles of the upper part of the femur? To correct pelvic tilt you would first need to assess your student for tight and weak muscles. Once you have identified these, you could devise a very gentle program to work on those muscles - stretching and toning, respectively. Angles in the bone itself cannot be corrected.

Discussions with the doc. have already been had and they seen no issue with it. And I have already done a muscle assement and and figured out areas to really focus on.

Postures that would be beneficial would be ones that traction the head of the femur away from the acetabulum

Thanks for the input. I don’t have the full details of the MRI on hand but from what the docs. have been able to inform me, it is considered 3rd degree. Any postures in particuler, do you think would be really helpful?

#5

Hello Bridgette and welcome back. It is great to see you again! It sounds like you on course so far.

I have a few questions before offering recommendations. I understand the term of the tear is presently unknown, but has the doctor or PT established the origin of the tear? Is it due to a previous (known or unknown) injury, instability or an abnormality? Has your client undergone a debridement procedure before coming to you or has this been recommended by the MD? Are there any repair strategies that are going to still be explored or required? Is the tear currently evaluated as a III or has there been come healing to get to this point?

Also, if you would, please share your tools for assessment and describe what this process entails.

Your own,
Nichole