What Every Yoga Teacher Needs To Know About The SI Joint
I was working it in a pretty fast-paced vinyasa class. Things in my body freely opened. As for my earlier back pain, it was nonexistent. It was one of those classes that leaves you feeling exhilarated and open to new things thanks to the plethora of hip openers and backbends we did.
I came home, showered, and turned on some music. Blissfully sedated and with a magazine in my hand, I sat down on the couch and OUCH. There it came, a pain so agonizing that my entire back felt like it had crumbled. I attempted to get up, but instead spent the next three days lying down. Once in a while, I walked around crouched into an L shape — a much less desirable shape that the V shape we speak of in Down Dog.
A sacroiliac (SI) joint injury is very common in long-term yoga practitioners. In some cases, it can be avoided. All you need to do is get to know your, and your students’ pelvises. This is what you should know and do as yoga instructor to keep you and your students safe.
1. Know what the SI joint is and how it moves.
The sacrum is part of the pelvis and is composed of five fused vertebrae. It is attached by ligaments to the ilium (another part of the pelvis). The space in between these two parts of the pelvis is called the sacroiliac joint. There is still controversy about how and when this joint moves. It's easy to say that any time we put pressure on the pelvis of any kind, the SI joint could be affected. When we fold forward (hamstrings pull on the pelvis) and when we sit (weight bears down on the pelvis) the SI joint is likely to move. The movement that’s not as obvious is in our legs and feet. When we rotate our thighs in and out — think pigeon toes in prasarita padottanasana (standing straddle bend) — the SI joint can be affected as well.
2. Know when to cue for strength rather than overstretching.
With all the stretching that happens in yoga– backbends, forward folds, half pigeons and hero poses to name a few, we get stronger in our hearts. However, we also become super loose in our pelvis. To prevent injury, it's important to strengthen muscles around the pelvic area also, so they keep the pelvis safe. The butt, inner thighs, core, and outer thighs have to remain strong to support in order for us not to be all loosey goosey. So, as you cue opening, remember to cue strength as well. Examples of these cues are, “Engage your core” and “Hug your muscles towards your bones,” which encourage isometric contraction and can be used in any posture. Another example is, “Squeeze inner thighs toward each other” in half pigeon and any other split leg poses. This cue also engages the core and other muscles that surround the pelvis.
3. Remember what you don’t know, and always consult a professional.
In spite of popular belief, SI pain is not sciatica. Sciatic nerve pain can occur due to a few different factors, including slipped disk injury and piriformis tightness. You'll feel it in your lower back, running down the backside of your leg. SI pain can also be felt in the lower back, but the pain runs down the back side of the thigh and sometimes also occurs as referred pain on the outside of the lower leg. Regardless of what you know and what your student thinks, I always recommend that your students confirm the cause of their pain with their doctor/chiropractor/physical therapist.
Yogis love to experiment, and achieving a posture we've never done before should always be a positive experience. As a practitioner and teacher, just make sure this achievement always comes from a place of body awareness and knowledge rather than ego and pushing through things in spite of our bodies telling us “no.” In life, true beauty always comes with a state of awareness and kindness; thus being aware of and kind to the body should be part of achieving a beautiful pose.