Combining Yoga Rehabilitation with Physical Therapy to Find the Root Cause of Pain

By Ali Malkin, MSPT, PYT at Therapeutic Inspirations

Finding What Causes Pain is the First Step in Treating It

If someone bangs you in the head with a hammer and you are diagnosed with a headache – the diagnosis is correct.  However, it isn’t at all possible to cure the headache without addressing the hammer. The same holds true for Physical Therapy intervention aimed at the symptoms and not unearthing the root cause.

• Runners are frequently diagnosed with Iliotibial band syndrome. This causes pain during and after a run on the side of the leg.  Orthopedic surgery is common. 
• Cyclists (indoor spinning and outdoor) often complain of knee pain on the inside of the knee.  They are commonly diagnosed with bursitis. ACL surgery happens. 
• Workaholics commonly have low back pain or sciatica that is experienced when attempting to stand after prolonged sitting posture.  For them, back surgery may be necessary.
• The aging population regularly complain of unsteadiness on the feet or fear of falling. 

Would it surprise you to know that all of those above ailments could have a common “Hammer” or root cause? 

All of those symptoms can be an expression of hip muscle (gluteus medius) weakness. The hip muscles have to work in collaboration with the abdominals and low back muscles. This stabilizes you during common motions that occur in daily living or in exercise.  If there is an imbalance of the length and strength of certain muscles, a cascade of symptoms can occur. Depending on your age and activity level the symptoms manifest differently from the same root cause. Some patients even need hip replacement surgery to fix their issues.

So how do we unearth the root cause and discover the best exercises to strengthen hip joints?  

How Does Yoga Help?

Yoga postures offer a terrific way for a physical therapist to efficiently evaluate for postural muscle imbalances and asymmetries.  Through yoga rehabilitation therapy, a pose created with a proper foundation serves as a screening tool of a person to determine “the hammer”, or root cause, of their particular cascade of symptoms.  Specific poses highlight certain issues. They include:

• Which muscles are too tight
• Whether or not muscles are too weak
• Which muscles are compensating – and therefore, overworked

Then, apply exercises for strengthening hip muscles once the root of the problem is diagnosed.  

As an extra bonus, patients used yoga rehab and poses to treat identified muscle weakness and or tightness.  Yoga rehabilitation therapy involves a wide range of poses. Depending on the severity of the impairment, physical therapists prescribe them as a progression to achieve pain-free status.  Sometimes, these poses are all that patients need. Other times? They’re implemented after another intervention – like shoulder replacement surgery – is performed.

In the case of hip weakness as described above 4 yoga poses to progress through as exercises for strengthening hip muscles include:

Horizontal Yoga Positions

1.    Bridge: Lay on your back with your knees bent and feet flat on the floor. Engage your abdominal muscles and push through your glutes to lift your hips off the ground. Do this until your knees, hips, and shoulders form a straight line. Hold for 1-2 seconds and slowly return back to your starting position.
2.    Single Leg Bridge: Lay on your back with your knees bent and feet flat on the floor position. Extend one of your knees so that only one foot is flat on the floor. Engage your abdominal muscles and push through your glutes. Then, lift your hips off the ground until your knees, hips, and shoulders form a straight line. Make sure that your hips stay level and you don’t let one side drop down compared to the other. Hold for 1-2 seconds and slowly return back to your starting position.

3.    Chair Pose: Start standing upright. Inhale as you raise your arms above your head perpendicular to the floor. Exhale as you bend your knees bringing your thighs parallel to the floor. Continue to reach your elbows back toward your ears as you elongate/extend your upper back. Hold this pose with good form for  15 seconds to 1 minute and then return to your starting position.

Standing Yoga Positions

4.    Tree Pose: Start standing upright with good posture and form. Shift your weight to one side. Then, lift the other leg to place your foot alongside the inner part of your thigh. Make sure your hips are level and your center of gravity is directly over the foot you are standing on. Lengthen your tailbone towards the floor. Press your palms together in a prayer position at your chest with thumbs resting on your sternum. Inhale and exhale deeply and with control. Hold for 15 seconds to 1 minute and then return to your starting position.

As no two “hammers” or root causes of pain are the same, a thorough evaluation is always recommended.  

Physical therapists employ yoga rehabilitation techniques to evaluate and treat each patient’s specific pain and dysfunction. Combining these with the best exercises to strengthen hip joints provides the most effective treatment individualized to each patient’s needs. Yoga poses also impact surgery recovery from elbow and knee surgery, back and neck procedures, and much more. 

Though yoga is difficult to master, it is a low-impact exercise type that easily slots in with other exercise methods and recovery tips.  Ideally, those that practice yoga understand the mindset needed to truly benefit from the exercise. Though suitable for men and women, this is a common choice for those recovering from breast surgery, since it does not involve a lot of movement. It’s also ideal as a follow up for cardiopulmonary surgery recovery. With these scenarios, a gradual return is activity is necessary – as is a patient mindset. 

Ali Malkin, MSTPT, PYT is a Physical Therapist who has naturally integrated yoga into her professional work drawing from years of experience as a yogi.  In Sanskrit, yoga means “to add”, “to join”, “to unite”, or “to attach”. Ali’s evaluations and treatments demonstrate this union.

You can find Ali Malkin at Therapeutics Inspiration in addition to hundreds of other quality clinics in your area. Use the BetterPT clinic location tool website or download the BetterPT mobile app. You can now request/book a physical therapist appointment with ease and convenience. For more simplicity, make it a virtual visit with BetterTelehealth.

Make sure to find out what your “hammer” is and start feeling better soon!