Yoga therapy assessment of hip rom

Yoga Discussion General Yoga
#1

Hi, I WOULD BE GRATEFUL FOR ANY HELP WITH THE FOLLOWING;
In response to a question on assessment of hip ROM on yoga forum in 2005, Mukundu Stiles talks about measuring external and internal hip rotation; he says that external rotation should be 45 degrees and internal 35 degrees and that the safest way to measure internal rotation is to get client to lie prone, knees bent, feet in the air and widen feet towards wall; for external rotation, reverse so that the feet ate crossed with knees wider than hips; in both cases assess angles.

  • WHAT I am a little unclear about is where you measure from - is it the distance of feet from floor in internal rotation and the knees from floor in external rotation. I am also a little unclear as to how to specifically determine the angle- any help would be most appreciated.
#2

The floor represents a 180? horizon. The measurement is the amount or degree of movement expressed by the position of the shin bone relative to the floor. The shin is the needle of the gauge, like your gas tank.

If the student is prone and the legs are together, pointing straight up with knees bent, then they are both at the 90? mark (approximately). If the instructions you are referencing state a certain degree of movement, the legs (from keens to feet as a result of thigh bone rotation) move away from each other in an arc toward the floor on their respective sides. If they go half way to the floor they have moved 45?.
It’s usually measured with a protractor.

Speaking personally, I’ve not actually bothered with a measure beyond my own visual assessment, would do that using our Beginning Hip Opening Series where the student is supine rather than prone, and probably would not predetermine a “should” of 45? and 35? respectively.

#3

[quote=dee;35698]Hi, I WOULD BE GRATEFUL FOR ANY HELP WITH THE FOLLOWING;
In response to a question on assessment of hip ROM on yoga forum in 2005, Mukundu Stiles talks about measuring external and internal hip rotation; he says that external rotation should be 45 degrees and internal 35 degrees and that the safest way to measure internal rotation is to get client to lie prone, knees bent, feet in the air and widen feet towards wall; for external rotation, reverse so that the feet ate crossed with knees wider than hips; in both cases assess angles.

  • WHAT I am a little unclear about is where you measure from - is it the distance of feet from floor in internal rotation and the knees from floor in external rotation. I am also a little unclear as to how to specifically determine the angle- any help would be most appreciated.[/quote]

Hello Dee and welcome to the forum,
If you would, please copy and paste the post you are referencing above into a reply here so that I may reference it before offering you a reply.

Also, is your only reference to Mukunda’s Structural Yoga Therapy (SYT) range of motion assessment through this website, or do you also have the SYT book and the SYT training manual? This will help me offer you clarification that relates directly to where your question is arising from.

Gordon has offered you a perspective outside of Mukunda’s training, that is likely within his own training of Purna Yoga and his other athletic training. I am going to speak directly to Mukunda’s teaching and specifically to SYT, as this is my certification.

In SYT, we are not trained to use a protractor, we are trained to use an assessment instrument called a gonimeter. It is a tool used by physical and occupational therapists to determine an individual’s specific range of motion as to evaluate it against a standard range of motion (ROM) that has been established for each joint of the body.

Mukunda too is careful about “shoulds” and “should nots.” With my own Yoga therapy clients, I am additionally careful to avoid using “ab/normal” or “un/usual” when addressed my client’s ROM. I say “standard” and then speak to the specifics of that person as standard, hyper- or hypomobile, as well as symmetric or asymmetric.

I will watch for your reply and add more then if you would like.

All the best to you,
Nichole

#4

Hi Gordon and Nichole, Thank you both for your very helpful replies.

Nichole, I found that question in a structural yoga therapy paper by Sarah O’ Hare in which she includes some of Mukundu’s yoga forum Q&As - I have just checked the forum and can’t seem to locate it there. The question which is posed relates to a client who has had a hip replacement 6 years previously and has been fairly inactive since. the therapist asks the question: "What is your knowledge regarding hip replacements and what approach should I take in assisting her in developing more mobility and freedom of movement?"
Mukundu replies “there are valid cautions to be concerned with; they are external hip which is crossing the legs and/or ankles. In general these mild motions need little caution if the ROM is measured first and found to be near normal. External hip rotation should be 45 degrees;internal hip rotation 35. Safest way to assess this is with cllient lying prone and knees bent, feet in air, ask them to widen the feet towards wall(internal hip rotation) and assess angles - then reverse so feet are crossed with knees wider than hips width(external hip rotation). By doing these tests first you can see what they are capable of without pain.”

Any Further thoughts would be great.

#5

As my esteemed colleague from Colorado points out, we have different lineage and training and therefore different viewpoints to offer.

For the physical practice (in Purna Yoga) for those students with a hip replacement, it depends on what muscles have been cut in the surgical process. Further, there are new procedures being employed. However, generally speaking, with the previous methods of hip replacement, I would not do any open-pelvis postures for that student who’s had the hip replacement surgery. That means avoidnig or modifying trikonasana, parsvakonasana, vira II, vrksasana, baddha konasana, sukhasana, et al.