Activity of Periarticular Hip Musculature during Yoga in Patients with HipPain: A Descriptive Study of a Case Series

Abstract

Objective: Yoga is a popular form of exercise that promotes mind-body wellness and has recently been touted as a modality that may be well tolerated by patients with orthopaedic conditions. Paradoxically, yoga may exacerbate pain and dysfunction in certain populations, as poses often require prolonged activation of periarticular hip musculature to optimize stability, balance, and posture. The purpose of this study was to evaluate muscular activation patterns in subjects with hip pain during select yoga poses, hypothesizing that yoga participants with hip pain demonstrate poor ability to maintain muscular contractility necessary for pelvic stability. Methods: Women with and without hip pain, who regularly participate in yoga, were evaluated using surface electromyography (SEMG) while performing common yoga poses. Each participant performed 30 s holds of three poses. To introduce the element of fatigue, the three poses were repeated in the original order, immediately following 20 repetitions of side-lying hip abduction. Results: Subjects with hip pain demonstrated decreased muscular activation of the Gluteus Medius (p=0.0008), Gluteus Maximus (p<0.0001), Adductor Longus (p=0.0003) and External Obliques (p<0.0001). In healthy subjects, EMG activity of these muscles during yoga did not change (p=0.6387, 0.9954, 0.9740, 0.4878 respectively). Baseline amplitudes between groups were not significantly different (p=0.1725), although the Gluteus Medius amplitude was suggestive of a difference as it approached significance (p=0.0707). Conclusion: Patients with hip pain undergo more rapid periarticular muscular fatigue than control subjects. They demonstrate increased muscular dysfunction when performing weight bearing yoga poses, therefore, should be appropriately counselled regarding the potential risk of symptomatic exacerbation and possible counterproductive effects of participation.