Yoga and Prevention of Sacroiliac Joint Injury
Many yoga participants have had to endure the pain of sacroiliac disfunction and injury due to improper approaches to forward bending yoga poses. Dr. Robin Armstrong has posted a new article, Asana Anatomy-The Sacroiliac Joint, which discusses the anatomical processes in some forward bends that cause sacroiliac joint problems.
By bringing awareness to the cause of these injuries, this yoga anatomy article also offers simple, but effective tips and applications to prevent sacroiliac injuries in these yoga poses.
This is a must-read for all yoga participants regardless of level as sacroiliac injury can occur at any point of one’s yoga practice.
“Poses like prasarita padottanasana (wide legged forward bend), baddha konasana (bound angle pose), and upavishta konasana (seated wide legged forward bend) can be a concern for people with a history of SI joint pain, and can predispose the SI joint to injury.
Wide legged yoga poses can be an excellent way to open the muscles of the groin, bring awareness to our root chakra, and release tension in the hamstrings. Much like any asana, when we proceed without being fully present and engaged - physically and mentally- we are at risk for injury. If we are mindful about engaging the muscles that support the SI joints, we are more likely to enjoy a wide legged practice that is safe and pain free.”
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Hello Grace,
Irritation of the sacroiliac or SI joint can present in a variety of different ways. Often there is pain across the bony, flat part of our lower spine, sometimes into the buttock or wrapping around into the groin. It might be experience as a pinch or as an ache. Sometimes the pain can travel down the outside of the leg to the knee, but not past the knee. Aggravating activities often include standing, walking, or sitting for extended periods of time. In yoga, twists and wide legged groin openers can sometimes be aggravating. Visit with a health professional familiar with yoga to determine the exact source of your discomfort and also to receive advice tailored to your body.
With an irritation of the SI joint you have to find the middle ground in postures. Often postures that can aid in relieving discomfort, can aggravate the condition of done too vigorously.
It is important for you to become aware of your root lock / mula bandha / pelvic floor muscles. These are the muscles that control the flow of urine (help you stop and start). These muscles (particularly in women) help stabilized the SI joint. Bring your attention to your pelvic floor, and using your bathroom muscles, gently lift and contract. Then relax. Repeat this a few times, then trying holding the contraction while breathing normally. You may find it difficult to access these muscles as they often get ’switched off’ in people with SI joint pain.
Another important area to become aware of is your transverse abdominus / lower belly. This muscle acts like a girdle for the lower spine, stabilizing and supporting. Lying on your back with your knees bent feet flat on the floor, bring your hands so that the fingers are gently resting on the lower belly, below the belly button. Imagine drawing your belly button in and up, you should feel your lower abdomen contract. Repeat this a few times then try sustaining the contraction with the breath flowing. You can use both of these muscles throughout your practice to support your core.
It is also important to ensure that all the muscles that attach into the pelvis and SI joint are long and open. This is where the middle path comes in. Sometimes being a little too enthusiastic can result in a tweak of the SI. Poses that open the Quadratus Lumborum ( a triangle shaped muscle attaching from your mid spine to pelvis), glutes and piriformis (buttock), hamstrings, and hip flexors are particularly helpful.
Here are a few I like if the SI is not currently out of alignment:
Janu Sirsasana / Hurdler’s Stretch: Sit with one leg extended one knee bent foot into groin. Inhale, lengthening the spine, draw in the lower belly and draw up with the pelvic floor, then exhale hinge at the hips towards the extended leg, letting the hands rest on the shin, ankle or foot. Keep the spine long and do not round.
Parvritta Janu Sirsasana / Revolved: With the same legs, turn your torso to face the bent knee leg, lets say your left leg. Slide your right hand along the inside of your extended right leg. Keeping your left hip and sitting bone moving towards the earth raise your left hand overhead and towards the toes of the extended leg.
Thread the needle: Lying on your back with knees bent, cross your right ankle onto your left thigh above your knee. Use your hands or a strap to pull the left leg towards you (under the thigh). Imagine gently sending the sitting bones towards the earth.
Crescent Lunge variation: Lunge forward with your right foot so that your knee is stacked over top of your ankle. Keep the left knee on the floor. Contract the pelvic floor muscles and gently tuck your pelvis until you feel an opening in the front of the left hip and the lower belly engages slightly. Raise your left arm overhead then over to the right side to access higher up into your hip flexors (in the area of your abdomen).
If your SI is feeling out of alignment, gentle slow, cat-cows can help mobilize the pelvis. Begin on your hands and knees, hands under shoulders, knees under hips. Without bending your arms, on an inhale begin to stick out your tail allowing the lower belly to drop towards the floor, opening the chest and looking up. On an exhale uncurl the tail, round the spine and let the head hang. Repeat slowly, paying special attention to the tail end.
Dr. Robin Armstrong
Chiropractor & Active Release Provider (ARTâ„¢)
Qi Integrated Health
2618 West Broadway
Vancouver, BC
http://www.stayactive.ca
What type of yoga positions would you recommend for someone who jams the SI joint? What are the symptoms?
Good article. Precaution though is important that if adduction as well as internal rotation of the femurs is not engaged before the engaging the pelvic floor musculature and its pelvic tilt action, it is possible to “jam” and bruise the SI joint due to lack of space in the joint. The right balance between the two is the yogic challenge.
Well written. Thanks!
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