Pinching sensation in the Anterior Hip

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heidikeithyoga
Posts: 4
Joined: Mon Sep 26, 2011 4:21 am
Location: Los Angeles, CA

Pinching sensation in the Anterior Hip

Post by heidikeithyoga »

Hi All,

The last time I posted, you all were so helpful, I figured I would try again. I am working with a professional football player to help him gain more flexibility, specifically in his hips. He is a big guy - 6'3 300 lbs but all muscle so while he is bulky it is not inhibiting his ability to move. He has pretty good range of motion in all directions of his hips, however, when we work on poses that get him in external rotation / flexion / abduction - like butterfly, thread the needle, and supine swan, he experiences a pinching sensation in his hip crease when we have him flex further. What's interesting though is he is fine folding forward in straddle pose and if I put him in simple cross legged up on a couple of bolsters, he says he feels the pinch mildly but it goes away once he flexes past a certain point. I have been researching everywhere if this is a muscle thing, or a ligament or joint thing. I can't tell if it's compression or tension related. He says it's almost like something is getting caught in the crease. When I put him in warrior 2 he says he also feels tightness in the same area, so I'm thinking it might be muscle related but I'm not sure!

Has anyone come across this with clients? .

I also experience the same issue from time to time myself but I never thought much of it because it didn't hurt and I have really tight hips. Anyway, I bring that up because I don't think it's his size or bulk that's the issue because I'm 5'4 120 lbs.
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

A pinching feeling in the hip when folding forward

Post by Bernie »

Hmmm...as I am not a doctor nor a physiiotherapist and haven't seen your student, so I can only speculate what might be happening here, so here are my 2 cents worth:

Since the sensation is felt in the direction of the movement into the posture, it sounds like he is experiencing compression: something is getting pinched between other body parts. Normally students find it easier to come into external rotation of the hips when they come into flexion because flexion helps to move the neck of the femur and greater trochanter "out of the way" of the hip socket and ilium, allowing more room to move. In your student's case, when the hips are externally rotated he finds flexion a challenge because he has "a pinching sensation in his hip crease." My suspicion: iliopsoas impingement (IPI).

What is IPI? Check out this article for a picture of what might be happening. This condition is rarely diagnosed and usually only when there is pain in the hip socket, probably due to a labrum tear caused by the impingement. In this case however, I suspect that the tendon of the iliopsoas may be riding up over the head of the femur and getting "caught" between the neck of the femur and the ilium as it folds forward. This is more likely the case when the legs are adducted as that may draw the tendon more laterally towards the neck of the femur. External rotation can also slide the tendon more laterally.

All this is speculation but if I am right your student might find the pinching goes away if he changes how he comes into the postures. Start with flexion first, go to an edge and then add the adduction/external rotation. This is certainly not the normal way to come into a pose like Butterfly, but by flexing the hips first, this will loosen up the psoas and it may not need to slide laterally when you add the adduction/rotation. For example; try Caterpillar, to Straddle to Butterfly all while staying flexed. See if that helps him get around the pinching points. He can experiment with other entry approaches too.

Hope this helps.
Cheers
Bernie
heidikeithyoga
Posts: 4
Joined: Mon Sep 26, 2011 4:21 am
Location: Los Angeles, CA

Post by heidikeithyoga »

Bernie, thank you so much for your response! I think this may be the culprit! I noticed you are in Vancouver and teach training modules. Do you have any recommendations for trainings available in Seattle or will you ever offer one here? I am really interested in taking a yin course toward my 500 cert.
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

teaching

Post by Bernie »

I only offer courses up here in Vancouver, but there are 5 offerings each year. Semperviva, the studio that hosts me, does credit my Yin Yoga hours towards their 500 hour program. I am not aware of any 500 hour programs in Seattle. You may want to ask some of the other Yin teachers there (see their listings.) Or you can head down to Ashland, Oregon and study with Paul Grilley.

Cheers,
Bernie
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