A team from the University of Arkansas for Medical Sciences (UAMS) have gone where few orthopedic researchers have dared to go.
Up With Downward Dog? Yoga and the Hip
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Their work, “Position of the Hip in Yoga,” appears in the July 2018 edition of The Journal of Arthroplasty.
Co-author Simon Mears, M.D., Ph.D., professor at UAMS, told OTW, “I became interested in this as I have practiced yoga now for five years.”
“Yoga is a fast-growing sport and many older people participate. Many people who are participating now have had a joint replacement or want to get back to doing yoga after they have their hip replaced.”
“It became clear that there is very little to guide the hip surgeon as to recommendations for patients who have a hip replacement. Many of the poses in yoga involve stretching the hip in ways that are not standardly recommended after hip replacement.”
“The study examined a group of 20 people who regularly practice yoga. None of whom have a joint replacement. We put them through 11 poses that are commonly practiced and that stress the hip. Using motion analysis, we looked at the range of motion of the hip in these positions to see what people are standardly achieving.”
“We found that certain positions stress the hip in flexion and others do in extension. In flexion, forward fold and pigeon pose stress the hip. Warrior 1 and 2, crescent lunge, and pigeon stress the hip in extension.”
“Hopefully this helps surgeons discussed with her patients which poses may stress the hip after hip replacement surgery. Many surgeons may be totally unfamiliar with common yoga poses and I hope that this study helps joint replacement surgeons understand what their patients are expecting to do after their surgery.”
C. Lowry Barnes, M.D., the Carl L. Nelson, M.D., Distinguished Chair in Orthopaedic Surgery at the University of Arkansas for Medical Sciences (UAMS) Department of Orthopaedic Surgery, told OTW, “We are pleased to have the research facilities and team members at UAMS to help our orthopaedic partners answer questions like this that are important to them and their patients.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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