Pose of the Week: Half & Full Lotus Pose

Question: 

What is happening to the knee and hip in half and full lotus pose? 

Answer: 

This is a GREAT question! I’ve seen this pose hurt many people – and my mission as a therapist is to help people heal – and avoid getting hurt, especially in yoga. So my answer is multi-faceted.

1. First, I would like to kindly suggest that from my 25 years of experience, I have seen little to no therapeutic benefit for half or full lotus. This is especially when it comes to hip and knee joint preservation. The pose imposes extreme ranges of motion in the entire lower extremity from the ankle to the hip.  
2. Second, nearly 100% of the friendly folks I see with hip and knee issues aren’t going to benefit from an extreme pose like half or full lotus.  
3. Third, for those of you who can do DO lotus and half lotus…

Just because you can (do half or full lotus), doesn’t mean you should. 

BUT – If you are bent on doing half or full lotus pose (no pun intended), then I gently suggest you consider these recommendations before launching into the pose: 

DO THESE THINGS to help decide if half or full lotus is right for you: 

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✅ Use the Vector Analysis to guide your decision-making about whether or not this pose is right for you or someone else*: 

These 4 variables make up the Vector Analysis. The Vector Analysis is how I teach therapists and doctors to use yoga postures and breath work diagnostically and therapeutically. The Vector Analysis includes:

1. Optimal kinematics – Do the joints move safely and fit together well? This includes measuring: 1) osteokinematic (gross) range of motion – think flexion and extension, rotation, and abduction/adduction. 2) arthrokinematic (accessory movements) motion – think spin, glide, and slide movements.
   
2. Efficient motor patterning – Does the “Snarky Psoas” try to dominate the movement pattern in this pose? If so, that’s a recipe for disaster. You’ll impinge the hip and create unsustainable motor patterns in the hip flexors which can create pain, impairment, and even injury.
   
3. Stress response – Can you be mindful in the pose? What does your interception and proprioception look like? Are you afraid of this pose? Does this pose cause anxiety?
   
4. Tissue extensibility and sensorimotor integration – Is the fascia happy and responding well? How about muscle, nerve, and vascular integrity and mobility? Does the person integrate sensory and motor information well or do they have problems with safe movement, processing environmental surroundings or even processing how they are feeling relative to what they are wearing or touching?  

USE the Vector Analysis to evaluate the following hip and knee range of motion: 

✅ Osteokinematic range of motion – especially hip external rotation, flexion, and abduction and knee external rotation

✅ Arthrokinematic range of motion – especially the movements which would facilitate healthy ostekinematic range of motion listed above

✅ Femoral Version Screen – Here is a post on it, and the video below explains the test in full. 

✅ Also screen the ankle motion if the above motion is adequate to perform the pose. 

Now there are other variables, like pelvic movement, that can also limit your ability to do half or full lotus. However, today’s video is a surface dive into what is happening to the knee and hip in half and full lotus. 

DO NOT do half or full lotus if you have: 

❎ excessive femoral anteversion (see the Femoral Version test above)

❎ increased internal rotation with lacking external rotation (see the screen I use in the video for this)

❎ a hip labral tear or repair 

❎ hip impingement

❎ hip or knee osteoarthritis. Advanced arthritis is associated with increased knee external rotation and posterior translation at the knee joint. And, increased translation/rotation is associated with laxity in the medial collateral ligament.

Your yoga practice should CREATE JOINT STABILITY, NOT contribute to premature joint aging and joint instability.

❎ You have hip or knee pain. Please see an orthopedic PT for an evaluation to help you decide what yoga poses are BEST for YOU. To find a therapist trained in MTY, visit this link. 

❎ You have pelvic pain. Creating MORE tension in the hip is NOT helpful for pelvic pain. Please see a pelvic PT to help decide a best way forward. To find a therapist trained in MTY, visit this link. 

❎ You haven’t done any of the screening above. 

What is happening in the hip and knee in half and full lotus pose?

I hope this helps you in your journey toward a sustainable yoga practice, or what I like to call “Yoga 2.0.” 

If you DO have hip or pelvic pain, you may want to join my community Facebook Group, Hip Labral Physical Therapy Network. 

PS Here are 3 more ways I can help you!

1. Free Phone Consult – Not sure if your yoga practice is on target? I offer free phone consults on a weekly basis to see how I can best help.

2. Take courses with me at Living Well Institute and Yoga U Online!

3. Take advantage of the Free Medical Therapeutic Yoga Basic Video Library.

A Final Word

DISCLAIMER: YOU CAN DO ANY YOGA POSE however you feel is best for you. However, these poses are for protection and preservation, as well as maximizing, pelvic girdle function (hip, SIJ, low back, pelvic floor). This and any other videos I instruct do not constitute physical therapy or a patient-provider relationship. User assumes risk in performing this or any video. Finally, you need to get the approval of your healthcare provider before doing this or any instructional movement video.

*Assessment and evaluation of the hip & knee should only be done by a licensed healthcare provider. A physical therapist or orthopaedist would be most suited. An orthopaedist is trained in surgery and drug prescription. A PT is trained to evaluate, rehabilitate, and prevent injury.