Assessment question

Yoga Discussion Structural Yoga Therapy
#1

I have an assessment to ask you about, he is a regular in yoga class. He is very stiff in his hip external rotation (27 degrees both sides ? 45 is normal) (I think psoas and gluteus minimus are implicated) and hip abduction (adductors and gracilis implicated). In yoga class when he attempts Sukhasana, his legs are way out and can just cross his ankles. When he is supine and I flex his knees, he gets a slight discomfort in his sacrum, as well as when I lift his leg for hip extension. He had his lateral meniscus of his left knee removed, thus his knee flexion is very limited (118 degrees) on that side, but the right side is limited too (130). Note: 150 are normal. I was thinking weak psoas, so I. MMTed it and it was negative except that he reported some soreness in sacrum again, I totally forgot to do the sacrum test on him… Abductors MMTed negative as well. Should I call him in again and MMT his gracilis and sacrum test? (I think) psoas, adductors, and quads are tight and hamstrings are weak so far. His hip flexion was limited, but is that just because he could not flex his knees? I want to be helpful with his knees (bridge pose only)?

This past summer I had a similar assessment (pain in sacrum with knee flexion) and I believe you said it might be tight external rotators. Would you think that as well for this case? His ROM in hip internal rotation was very good… Looking forward to your Kripalu workshop.

Peace, A

#2

A. is in my Structural Yoga Therapy course in Boston, so this is a more technical question. Yes retest him. Especially look at the sacroiliac motions to be sure they are even as if they are not all other tests will be reflected in that imbalance. His weakness sounds most attributable to the tightness of hip flexors and quadriceps. Because of this his limited quadriceps would also prevent full knee flexion. Bridge is a good choice and progressively moves his feet closer to his buttocks in the resting pose so that the repetitions will increase hip extensor strength and knee and hip flexor stretch. Also see if he can do frog pose (on belly pulling heels toward buttocks), without a strain in low back. If the stretch stays in quadriceps that can make progress for him. If not then he should not do it.