How do you know if it’s SI Joint pain & will yoga help?

This blog post is in answer to a question from a reader, Shinaz. I’ve excerpted bits of our email correspondence for you, with her permission.

Hi Nadine. I read something that you wrote about yoga being bad long term for people with SIJ problems. I have suffered a lot with that since the birth of my second son. I’ve had yoga in my life on and off for about 13 years. Mostly home practice. And I started up again after my physiotherapist recommended yoga to help with my SIJ. It has benefitted. And yes I have been doing some of the poses that have your legs doing different things like pigeon!! I’ve even been toying with the idea of a yoga teacher training course via home study here in the UK! Last night I came across something you had written about yoga possibly causing SIJ problems further down the line. Am I risking further problems if I continue and consider teaching as a possible career?!? I’m writing to ask as I have really enjoyed reading some of your posts and watching some of the videos. You come across as being very knowledgeable in your field. I really hope you will find the time to reply.

 

What a great email – thank you! You ask a very valid question, and the answer is: it depends. It depends whether your pelvic instability was just as a result of the pregnancy-related hormones or whether you actually have ligament damage.
I will also say that if you don’t have pain, and you are working as much on strength in the glutes and other important pelvic stabilisers, you are probably fine to do things like pigeon.

 

The SIJ problems were present in my first pregnancy. My back used to lock up and I couldn’t move! After the birth it seemed to go away but second time around wasn’t as straight forward. The locking up continued long after the birth and my son will be two in March and I’m still suffering on and off. For a time I couldn’t lie flat on my belly in bed without my lower back locking. After doing yoga for a few weeks I managed to do it for the first time in a long time!!! Now sometimes I get twinges of pain between my legs. Like sometimes if you set off walking too fast it causes pain. And sometimes after doing something heavy going like carting the shopping around I will ache and have twinges of pain. So there is damage. And I also had core problems. A split down my front that didn’t quite go back together properly after the birth. It has a name which I can’t remember! It was slight but caused weakening all over the rest of my body. Everything else having to work harder to compensate. It got to the point where just reaching up an arm was difficult to do. Again the yoga has helped and I’m not struggling as much now. I started to feel strength in my body quite quickly with a daily practice. And please please suggest as many poses as possible to strengthen the glutes and stabilise the pelvis. I’m eager not only to heal my body but to learn as much about yoga as possible! :)

Whew, big ask eh?

If you are wondering whether your back/pelvic pain might be SI Joint instability, pop over and read this article.
Also, to start understanding how your sacrum (sacred bone, yes, that’s what it’s called) moves in your pelvis, read this.

Link love out of the way, let’s talk about Shinaz’s question: is yoga bad for your SI joints long-term?

The short answer: not if you do it right.

The reason that SI joint issues are so common in the yoga community is that lots of us are doing poses our bodies aren’t ready for, or that are inappropriate for where we are, physically, right now.

Our needs change as our lives do.

For example, as I have said before, when you are in acute pain from a jammed up SIJ (they get jammed when there is too much movement between sacrum and ilium, causing a cramming or crunching. Very painful) you need to work on realigning the pelvis and stablising the joints. Things like pigeon are an ABSOLUTE no-no when you are in this state because you will almost certainly have gotten to this state by being hypermobile in some parts of your pelvis and hypomobile in others.

Symmetrical poses are way safer when you are rehabbing an SI joint injury, because they don’t ask your body to be nutating the sacrum on one side and counternutating on the other. This can happen whenever you have one leg forward and one leg back, as with warrior pose, and can be exacerbated in things like warrior because one leg is in internal rotation and the other is in external rotation.

Triangle pose is a rotten culprit for SIJ cramming too, as many (many many) people aren’t able to move their pelvis (as a unit) smoothly sideways over the front leg. This results in initiating the side bend from the SIJs or lumbar spine. Not as stable. Pretty vulnerable.

 

this is clean alignment...

this is clean alignment…

 

In other times though, once you’ve gotten your pelvis more stable (sequence for that coming), you may well enjoy doing stretches like pigeon. It’s matter of context, and body awareness, and feeling out what the results of your practice are – if you get more pain, it’s clearly not working, and if you get relief during or after the practice, then it’s working.

Good yoga for SIJ rehab would entail things that stretch and release your psoas muscles like reclining hero pose and constructive rest position.

It’s not a universal, of course, but there is a common pathology that the psoas is super-tight and the glutes don’t fire properly, which can set you up for SIJ problems. So, the other aspect of good yoga rehab for SIJ’s is to get those glutes working.

Here are my favourites for doing that:

  • Squats, especially Utkatasana, done like this and with great awareness of what your pelvis is doing, and whether you feel your glutes firing.
  • Mountain pose. It’s amazingly difficult to do this pose well, you know. It’s worth practicing!
  • Prone backbends (you can do supported ones first then active ones)

 

Happy exploring, folks.

 

 

 

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3 Responses to How do you know if it’s SI Joint pain & will yoga help?

  1. Tree February 16, 2013 at 5:39 pm #

    i love the picture of you in trikonasana – i find it such a tricky pose!

    • Nadine (@YogawithNadine) March 12, 2013 at 4:55 pm #

      It is SUCH a tricky pose. We mm…Yoga! teachers spent, quite literally, hours talking about it at our last supervision session. I will write a detailed post about it soon xx

  2. Shinaz February 14, 2013 at 9:36 pm #

    Hi Nadine. Ace answer to all my questions. Plenty information there to keep me going. Thanks so much! And I’m sure all of it will be helpful to your other readers with SI problems! :) Shinaz x

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