By Gopi Rao
Yoga is often regarded as a panacea for a number of bodily discomforts. A quick web search will produce yoga “prescriptions” for almost any malady. Sacroiliac (SI) joint pain is no exception, but SI dysfunction and yoga have a tenuous relationship.
What are SI Joints?
The SI joints are located near the base of the spine where the sacrum and ilia meet. When we stand, ligaments stabilize the sacrum wedges into the pelvis between the ilium bones and these SI joints. The sacrum lifts out of its wedged position when we sit. Bone misalignment or over-stretched ligaments lead to pain.
Men and women can suffer from SI joint pain, but it is a more common problem for women. Hormonal shifts and structural differences in the pelvis related to childbirth cause this predisposition. Advanced yogis are also at a higher risk for having SI joint pain because they are more likely to hyperextend the ligaments that keep the SI joints in line. Poor posture while standing and sitting can cause SI joint problems. Sleeping on the stomach or without proper support can also be problematic.
Can Yoga Help?
In the case of SI joint pain, yoga can help or harm. In yoga, we celebrate opposition. This opposition holds our concentration and contributes to the power of the practice. In the case of SI joints, we must be cautious about how we use opposition.
Yoga as a Cause
Since the sacrum and ilia separate when we sit, we are more likely to send them out of alignment in seated postures. Bound Angle Pose, Head-to-Knee Pose, and Wide-Angle Seated Forward Bend present the greatest risk for inducing SI problems. Standing postures that can allow for potential separation and misalignment of the SI joints includes: Wide-Legged Forward Bend, Warrior II, and Extended-Triangle Pose. Any posture where abduction and forward bending occurs is a recipe for SI joint issues.
As is often the case in yoga, it is not just what we do, but how we do it. The aforementioned asanas can be performed safely, but they must be done with care to protect the SI Joints. To avoid sending the spine and pelvis into opposition, awareness is essential. Taking one’s time rather than cranking into an asana goes a long way toward ensuring a safe practice.
Yoga as Treatment
If an SI joint misalignment is identified, some asanas can be used to work the joints back into alignment. This therapy should be undertaken at the advisement of a physical therapist or chiropractor. Reclined Leg Stretches, especially with the aid of a strap, can encourage the SI joints to realign. Taking a Modified Bridge Pose, which focuses on abdominal engagement can also help to strengthen muscles surrounding the SI joints. Yoga may be used alone, or it may be prescribed with other medications or injections depending on the severity of the SI dysfunction.
Yoga for Prevention
In addition to causing and correcting SI joint dysfunction, yoga can also be used as a preventive measure. The best postures for this are: Triangle Pose, Bow Pose, and Extended Side Angle Pose. These postures engage the powerful muscles surrounding the SI joints. Strong gluteal and rotator muscles can avert misalignment.
Each asana has inherent risks and benefits. Mindful practice can prevent a host of problems from arising due to poor form or forceful execution of a posture. For those afflicted by SI joint pain, yoga can be a safe and noninvasive treatment. All yogis could benefit from undertaking practices to prevent misalignment from occurring in the first place.
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