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THR and Yoga:
Under Active Construction!
These web pages are for people who want to practice yoga after hip surgery. However there is a serious diescussion to be had about whether yoga causes hip damage.
Click here for more on that discussion

 
BKS Iyengar To the left you will see a photograph of the revered yoga teacher B.K.S. Iyengar doing a posture that most THR patients will never be allowed to do. He is simultaneously flexing, internally rotating and crossing his leg across the midline. Most surgeons have used these three motions to dislocate the leg before replacing the femur head and thus the patient will always be vulnerable to dislocation with this action in the future, even after the joint capsule has healed.

This is not true for everyone. What you are allowed to do once the hip has healed depends on what surgical approach was used. Factors include whether the incision from the front, side or back, what structures were disrupted, i.e., were there muscles or tendons that were severed and were they repaired, and was dislocation involved. The new MIS "2-incision" technique, for example, is done without dislocating the hip, so that fewer movement restrictions may apply.
 
In developing a yoga practice it is vitally important that each person consult with the operating surgeon to get personalized range of motion instructions.
My orthopedist, for example, has a special interest in the hip problems of dancers. He is careful to reattach the external rotator muscles, therefore his surgical approach allows for full external rotation after the hip capsule is healed. Thus a person could do a full lotus (and turnout in ballet). Also the back leg can be turned out in triangle pose.
 
I brought Erich Schiffmann's book, Moving Into Stillness, with me to my 2 month check up. I selected illustrations of the various asanas I hoped to be able to practice to show the surgeon, and to get his approval. He was concerned about extreme forward flexion. He forbad anything that caused intense internal rotation as in reverse triangle pose, or any posture in which the operated leg crossed the midline.
 
In contrast, someone with an anterior incision may be restricted from doing any back-bending postures.
CLICK HERE to read the experience of a yogini with bilateral anterior hip replacements.
 
Remember, your post-op restrictions may differ from the person on the next mat!
 
UPDATE: (May 2011) I have added a new page of personal observations on yoga practice.
Click here to read more.
 
Literature
A good article from Yoga Journal that addresses the question of which asanas are appropriate for different surgical approaches can be found here:
http://www.yogajournal.com/practice/596_1.cfm
 
A helpful book before and after surgery is:
Recovery Yoga by Sam Dworkis published by Random House's Three River Press, 1997. Dworkis, a yoga practitioner and teacher for more than 20 years, developed multiple sclerosis. In this book he uses his personal insight and experience to guide others to a gentle and healing practice, no matter what the physical limitation.
 
Links:
Moving Into Stillness The website of Erich Schiffmann. Includes yoga community message board.

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