Sacroiliac Joint Problems

Sacroiliac Joint Problems

Question: A student has SI joint issues and subsequent lower back pain that makes it impossible for her to lie down on her back with straight legs without pain, so she bends her knees in Savasana. She does Sit-ups with bent knees. Is that all right?

Answer: No problem with doing the Sit up like that as long as it doesn’t bother the SI joint.

Please use this topic for further discussion about SI joint problems in hot yoga.


5 Comments

Terisa on December 13, 2013 at 6:20 pm.

Hello Team Yoga!

I have a student, Hyper-mobile SI joint. Has been practicing for 1 year… strong healthy body otherwise.

Wind removing and triangle aggravate it.

Physio therapist recommended to wear a SI joint belt frequently.

Student asked if they should wear it in class. I was thinking it would be ok for a few classes to create awareness in that area- to keep on top of form… but on the other hand if it hurts- they will be well aware of the area!

I have some thoughts related to healing this…..

let me know if Im on the right track and feel free to add more please!

I myself had some SI joint problems and doing all of the following really helped:

Butt tight. and.. like emmy says, think of closing the thighs and opening the calves.

SHTK: make sure leg is stacked straight… avoid pushing hip back, think of it more forward when rounding down, executing first postition and while kicking out as well. “Kick the Mirror”

Standing Bow: Foot over the center of the head…. making sure the foot doesnt turn out at all…(this was extremely beneficial- and helped right away)

SSLS – body weight forward

TRiangle…. hips forward, hips forward… butt tight

Wind removing- Pull the knee to the shoulder and apply slight pressure into tight grip… slight pull, little bit pushing

I could go on….

Please add any isight any of you wonderful yogi’s have!!!

Much kindness!

Reply

Petra on December 21, 2013 at 12:54 am.

When I was dealing with unstable SI joint & pain, the most important factor for me was to be very very conscious of not trying to ‘open’ my hips & pelvis so much – rather than working on spreading the pelvis wide (sorry, can’t think of a better way to put it), I focused on maintaining stability in that region. Basically, any posture where legs are separated or hips are ‘opened’ need to be closely watched.

Don’t do hip openers outside of the series – no Pigeon, no splits. Treat like low back pain in terms of forward bending. Stop well before discomfort.

Do about 50%.

This worked for me. It took months, but I have no SI joint pain now, and I can do all postures again.

1st part Wind Removing – I kept the ‘straight’ leg bent and didn’t pull very hard toward the shoulder (to minimize separation of the SI joint) or skipped it. This was a temporary adjustment while I was in severe pain. I still don’t pull ‘hard’ – I don’t think aggressiveness helps in any situation where the problem is basically overflexibility in a joint (or in any situation, really).

If it aggravates, just SKIP IT.

Triangle – I let my spine twist more by bringing the straight leg hip forward and the bent knee back, rather than ‘opening’ the pelvis – I focused on pelvic alignment over trying to open the hips wide. I think this was one of the most important adjustments I made – this alignment correction stabilized the entire pelvic area. If it aggravates, SKIP IT (eventually, fixing the alignment here will help, but doing it wrong way will make things worse).

EDIT: I mean, I didn’t try to ‘square’ hips to the mirror.

Spine Twist – I do not have a flexible, long spine; this posture is hard for me in the best of times. I focused on twisting ‘top to bottom’ – I think a lot of yogis twist bottom to top, destabilizing the low back & pelvis. I focus on on GENTLY twisting the neck, upper back, mid back, and not so much on the low back (it’ll happen when it’s ready); never ever FORCE the twist.

And the set up is so important – students just jump into this without proper foot/knee alignment & hips way off-kilter. Easy does it. Maybe there won’t be much of a twist at all – that’s okay.

ANYTHING with a twist – take it super-easy, DON’T try to twist from lower back. Spine Twist, Head to Knee, SSLH2K, Standing Bow.

St. Sep. Leg Head to Knee – I really had to take it easy. Focus on foot/hip alignment. Keep the pelvis stable.

Maybe even take a smaller step, if necessary, to avoid twisting pelvis & low back. Stomach in, engage core. Straight legs. Don’t push getting forehead to knee.

Don’t let her do a lunge here, it won’t help. DO NOT FORCE, always hip/pelvic alignment first, even if head is nowhere near the knee. When I was really hurting, I would go down with hands on upper thigh to keep from twisting hips or losing alignment.

I just focused on the hips & core the whole time.

My Chiropractor told me he sees a lot of yogis with SI joint problems. We talked about core strength, esp. the multificus. That got me to really focus on the next two.

Full Locust – I worked very hard on this, making sure my hips/legs were solid, one piece. ONE LEG – feet together, tight legs, strong core, protecting the SI joint, strengthening the multificus. It felt SO GOOD to do this posture!

Sit-up – so important! But only when I was sure, and only doing it the right way. No partial sit-up, no bent knees, no relaxed legs.

Again, feet together, one leg, strong core, engage pelvic floor. When I was in severe pain, I skipped it entirely. But Full Locust helped prepare me to do it right. Once I was no longer in severe pain, I would try it (the right way), and each time, I would see how my body felt.

If it felt good, I would do it, if I wasn’t sure, I would skip the sit-up.

Good Luck to your student.

Reply

clarence on December 28, 2013 at 9:01 am.

Wonderful insights Rae Commons! Thanks for sharing these! I’ve had some similar issues. When you speak of triangle, do you mean to say that you are less concerned with the hips squared (opened) up toward the mirror?

I know I’ve irritated myself really pushing the strait leg forward and bent knee back. A chiro told me once that area is over stretched, you’re kinda screwed–it’ll never be the same again. I’ve really had to back off a few things (a deep standing bow kills me.

Took me years to drop the mantra of thinking all back bending for me was OK. No more trying to lock top leg, it’s just not worth it.)

I do exactly the same thing with the twist–top down. If you study a skeleton of the spine, you’ll notice that the facet joints in the lumbar region are really not meant to twist very far. The lower back is more about stability. The thoracic spine conversely, has facet joints with much more glide to rotate.

Yet that area is really where the vast majority of people need more mobility instead of placing the emphasis on the low spine so much.

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Celia on January 3, 2014 at 5:48 am.

Hi Chris – yes, I stopped squaring my hips to the mirror. It helped a lot.

Chiro told me something similar to you – that the SI joint, once overstretched, is likely to always be a weak area, prone to instability, & to be mindful of it. Not that it can’t heal – but the overstretched soft tissues take a very, very long time to heal.

It’s interesting that the two postures you mention (Standing Bow & Triangle) are both postures with spinal twists in them. Maybe there’s a continuation of that issue with overtwisting the lower spine … ?

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Ethelene on January 13, 2014 at 3:06 pm.

Well, I do know from things I’ve studied outside of Bikram, that rotation is the toughest on the spine as well as any scar tissue that is in there. I think with standing bow it’s really important to bring the body down parallel before getting nuts about kicking super high. Plus, people tend to forget to not only kick up but BACK and up.

I know Bikram doesn’t want anyone “squaring” the hip and I believe he means to prevent excessive torque. I do think that competitions style aesthetics are getting people to really crank the leg back before coming down.

Also, I try to keep my spine in an even arc much like floor bow rather than thinking of it twisting. I’m not a fan of teachers that point out that standing bow is a twist. I don’t think that image should be in the practitioner’s mind even if there is truth to it IMHO.

I can say that having lower back issues for 25 years now has definitely been a journey. Much of what Bikram does is really great for me but I’ve also suffered from going too far. Thing is, I was already pretty flexible (for a guy anyway) and some times too much flexibility becomes a big big problem.

It’s kinda the “dirty secret” about yoga. It’s almost always the flexible, the current and future teachers and the competitors that get jacked up. I rarely see a stiff guy get hurt.

It’s as if that stiffness is a built in safety valve.

All that said, I think the ranges in the beginners series are quite fine but I sometimes think we mistake more flexibility–in the lumbar area especially–as being a healthy thing to pursue when in reality for a lot of people they need to become more stable. It’s takes a good eye from the teacher and often a student willing to check the ego and back off.

The thing that bums me the most after all these years of teaching is seeing already fit, younger people get into the yoga and either though over-aggressiveness on their part or over-encouregement on the part of teachers, they wind up injured and often have nagging pain where they never had any. They deal with it because of the numerous other benefits that practice gives.

Anyway, may have gone off topic here but I think conversation about this is really important to make us all better.

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