“Could we work on some hip openers?” I hear this request almost weekly during prenatal yoga check-ins. Having open hip joints has become the proverbial holy grail in both general population and especially in prenatal yoga. But when I investigate further what a student means when they say hip openers they nearly always indicate external rotating actions, where the knee moves away from the midline. While yes this action is one that can be helpful during the birth process, and yes we do need some access to external rotation for hip health in life, focusing exclusively on outward rotation not only misses the dynamic action of the pelvic/femur relationship. It has actually created a damaging imbalance in our physiology; particularly in female physiology!
Look at any book on “yoga for women” and you will find an over focus on poses which outwardly rotate the femur bones. Think Baddhakonasana, Supta Baddhakonasana, Ankle to knee, Upavista Konasana, Gomukkhasana, Jaisana (Goddess squat) and multiple variations there in. It’s almost as if yoga for women is meant to have us constantly splaying our legs open and stretching the butt and hamstring muscles. Let’s not even start down the road of the social implications of having women constantly practice spreading their legs…Um hello?
But when we focus excessively on outward rotating movements, two things happen. We begin to develop an imbalance in the possible movements within the pelvis, and maybe just as troubling- especially for birth preparation- we miss connecting with the posterior half of the pelvic floor!
Let’s dive in a bit deeper.
We all know the kids song “The hip bone’s connected to the knee bone, the knee bone’s connected to the shin bone…” well these bones have the ability to influence one another, and also the connective tissue (yes I’m back on fascia) and musculature attached to them. The hip socket is made up of the articulation of the acetabulum (the socket encased within the wing bone of the pelvis), and the femoral head. These two move in concert with one another as we twist, turn, walk, sit, and stand throughout our day.
But wait, you might be saying, I know the thigh bone moves, but how does the pelvis move? Well, we might first think just of how the whole bowl of the pelvis can rotate on the femurs. Try tilting and tucking your pelvis when standing. The action of forward and backward rotation shifts the position of the pelvic bones relative to the femurs, increasing the crease of the hips (your underwear line).
But stay with that pelvic action, and focus not on the hip crease but on the sitting bones- the ones at the base of the pelvis. As you rotate forward (navel towards the floor), the space between those bones begins to spread, and when you rotate backwards (tucking the tail) the distance between the sitting bones narrows. Not by much, but it does change. Not only that but focus on the thigh bone as the pelvis moves, during the tucking action, the thighs will want to spin outward a bit (external rotation), and during the tilting action the knees want to knock towards one another (internal rotation).
That’s with movement from the pelvis, but now what if we initiated the movement from the femur bones. Try standing with the legs turned out. As a recovering ballet dancer I literally have hours of practice in this position. In order to outwardly rotate the legs, the glutes (and other external rotators) engage. This action draws the knees out, and closes the back of the pelvis, drawing the pelvis into a slight tuck position, narrowing the sitting bones and tailbone towards one another. Reverse the action to bring the toes in and heels out (Oh my ballet teachers would cringe!), and we get strong internal rotation of the thigh bones, accompanied by the butt sticking out and the sitting bones flaring.
If you want to check this for yourself you can try this simple measurement exercise- I do this with all our teacher training students. Grab a piece of paper and a pencil. Sit down on the paper and feel for your sitting bones. Place the soles of your feet together and make a mark on the paper underneath each sitting bone. Then, on another piece of paper, sit so your knees are together and your feet are apart (Virasana position in yoga). Lean forward and again mark where your sitting bones are on the paper. Then compare the two papers. I’ll bet the Virasana one is wider.
So what does all of this have to do with yoga over focusing on external rotation and this poorly affecting female bodies and birth preparation?
Well between the sitting bones rest the muscles and tissues of our pelvic floor, which guide the process of labor. And half of those muscles lie between the sitting bones and tailbone (the ones that get compressed during external rotation). If you read my post about the Cardinal movements in labor you know that during birth the baby needs to be able to spiral through different levels of the pelvis, and if those levels can’t move or are locked in one direction, then the birth pathway isn’t as pliable or responsive as we would like it to be. So if we truly want balanced hip joints and pelvic movement, we need not just external rotation, but INTERNAL rotation as well! In fact, because our culture tends to be so focused on outward rotation and tucking the tail under, I would suggest we need even more internal rotation than external these days.
What does this mean for our practice? It means when doing stretches and movements we need to balance external rotation postures with internal rotation ones as well. For every Baddhakonasa, we need to find time for a Virasana, which really is the more neutral position for the female pelvis than Sukkhasana (sitting cross-legged) or Dandasna (staff pose). Being able to find internal rotation helps to both spread the back triangle of the pelvic floor, and also allows for better opening of the sitting bones. It places the pelvis in an easier upright position, which helps align the pelvic floor for better connection to the abdominal diaphragm, and ultimately makes it easier for the spine to undulate upwards in it’s supportive curvatures, rather than having to strain against gravity.
So should we only do internal rotation postures for hip openers? Well as usual the answer is, it depends. The truth is for both birth and life preparation we need a balance of different pelvic and body movements. So yes practice your Baddhakonasanas, but maybe practice twice as many Virasanas for a while. And when sitting on the floor, try kneeling, or sitting on a block instead of striving for sitting cross-legged. Your pelvis just might thank you, and so will your pelvic floor.
Ways to practice internal rotation for hips:
Virasana Pose:
Get a block and kneel on your mat (or a rug). Bring your knees together and separate your feet slightly wider than your hips. Using your fingers, gently pull the muscle back from the back of your knees and sit back. Place the block between your heels if your hips don’t touch the floor. This pose should not create pressure in the knees- so if it does raise the support. Sit feeling the inner thighs descend towards the floor and the weight rest on the front of the sitting bones. Breathe throughout the body.
Cow pose: This one often gets overlooked because of the focus on the spinal movement, but when we pay attention to the pelvis and legs, this can be a great practice in balancing internal and external rotation. From all 4’s position, tilt the pelvis forward, so the pubic bone draws back through the legs and the top of the sacrum tilts forwards.
Wide Legged forward fold with internal rotation:
Stand with the feet 3-4 ft apart in front of a chair or tall height blocks. Turn the toes to point slightly inward. Tip the pelvis forward (increasing the hip creases), resting the hand on the chair or blocks. (Important-this pose is not about how far forward you fold. Less is actually more here!) With the spine in a straight line, and as level to the floor as possible gently press the sitting bones back feeling the pelvic floor and high hamstrings spread. Stay for several breaths.
Clam/Reverse Clams:
A more active way to find your internal rotation and strengthen the internal as well as external rotators. Lie on your side with the hips stacked and the knees bent. Keeping the pelvic stable and the feet together, lift the top knee as far as the thigh can rotate (don’t be shocked if it’s not much!), then with the hips remaining stationary, reverse the position of the knee and foot, so the knees touch and the heels separate. Go back and forth slowly between these two actions. Practice 5-10 on one side, then switch.