Student with one foot rotated outwards

Yoga Discussion General Yoga
#1

Hi

I have a new student who has an unusual body structure and I’m not sure how to teach this. In one of their ball and socket joints(femoral head), the ball never formed - the body instead has compensated by forming a kind of ligament/muscle structure in the ball’s place. This leg is weaker and the foot externally rotates. The person manages ok in day to day life. I an hesitant to approach poses that involve standing, eg warriors, tree, standing forward bend because I’m not sure whether I should be straightening the externally rotated foot, or going along with the way the body has compensated for lacking the femoral head. The muscles in the legs and hips will have formed in such a way that supports the foot externally rotating, so adjusting the feet to both face forwards may cause damage.

Does anyone have any thoughts on this?

Thanks

#2

Since this person does not have an actual joint where the femoral bone meets the acetabulum I would not think it wise to try to increase the movement here. Most likely this person needs the stability that the ligaments and muscles provide. I think it wisest to strengthen the muscles around the area but refrain from any range of motion that does not come naturally.Just my thoughts.

#3

Thanks very much for your time. Yes this sounds right, I also asked a physiotherapist today and they suggested the same thing. Building up the muscles strength around the hip/leg area. I think best to avoid poses like triangle, warrior 2. I think things like boat and similar exercises that work on hip flexors plus abdominals, side leg raises, locust variations, cobras, maybe tabletop or east stretch build up to, dandasans, tadasana ect.

Thanks again!

#4

Hello Jo-Ann,

I have several thoughts and since you’ve not specified I’ll simply outline them all and you can take what resonates.

First, when there are significant therapeutic issues faced by a yoga teacher anm opportunity is presented to connect with their lineage. This may involve contact hours with the person or person who trained them in a sort of consultation capacity. Peers from teacher training may also be a helpful resource in such situations. Of course if that is not available AND the teacher is not completely comfortable addressing the student’s issue, then the student ethically should be referenced to a senior teacher with therapeutic expertise. At very least the student should be made aware of the choices so that they may mindfully choose.

In the early part of my teaching life I told several students that I was not a pre-natal teacher, that they would be best served studying the practice with someone who was, and then they opted to remain in my classes anyway. But I was clear and clean in that process and did what was needed to maintain my ethics. All too often we pretend to know something when in fact it is perfectly okay to say “I don’t know”.

Specifically to your A&P question, internal and external rotation of the foot can either come at the ankle or at the hip. If the rotation is on the ankle then working at the hip would be less than profound. So it is critical for the teacher to look at the entire alignment of the leg and see where the rotation is originating. In this case however it is more likely to be malalginment in the hip.

For this student I would want to make certain they had clearance for physical activity from their healthcare provider. Additionally I would want far more intake form them than “the person manages in day to say life”. It’s simply too vague for a focused assessment and subsequently, an effective protocol in Yoga.

Generally I would avoid open pelvis poses - Vira II, Trikonasana, Parsvakonasana Vrksasana, as well as Baddha Konasana. Use extreme care and apply a gentle asana practice exploring the student’s capabilities within the framework of their current healthcare paradigm.

These are the thoughts I can provide without seeing the student and having much more information.

Warmly,

gordon

#5

Thanks very much for your time Gordon.

Yes I enquired at my TTC place, it was in another country but they have a place where I am. I am waiting for their reply as I havent had the chance to go there in person yet. I am also connecting with other teachers in my area.

Sorry, my explaination was probably a bit vague, I didn’t want to give to many details over the internet of this student’s situation, or of how I know them. They gave me alot more info that just “managing from day to day”. I took a very detailed record of how this hip happened from birth and the kind of activities they do on a daily basis including exercises.

I have made it really clear that I am not qualified (I know this student personally and they know my abilities) but they still want to learn some yoga. Plus they will not go another yoga teacher or a therapist. I requested they get clearance from a doctor or other healthcare provider.

The rotation comes from the hip, I’ve assess their both whole legs up to hips, their range of motion, the way the hip rotates out when they rotate the foot out and in.

Yes I agree, I am avoiding the triangles, warriors, standing angles, ect any anything that takes the hip out of its usual range of rotation or that puts pressure on the hip area. Any hip/leg exercises that I do with them will be on the floor and really gentle - such as gentle leg raises, side leg raises, or on a chair. They like the shoulder/upper body releases / gentle twists that I give, with variations to suit them.

Thanks again