3 Ways to Encourage SI Joint Health in Yoga Practice
Lower back pain is shockingly common in the general adult population. The root cause of 15 to 30 percent of low back problems is related to sacroiliac (SI) joint pain. Despite how common it is, SI joint problems are often not correctly diagnosed as such. Do you consider SI joint health in yoga practice?
One might think that yoga could help, and in some cases it most likely does. Yet, due to certain trends in practice and teaching, and in vinyasa-style yoga in particular, sacroiliac joint problems are a leading repetitive stress issue among dedicated yogis. How can yogis maintain SI joint health in yoga practice, and especially in vinyasa-style yoga?
The Plant and the Soil: Yoga, the Hips and the Spine
I took a refresher teacher training in the summer of 2020. When we were discussing twists, our teacher trainer shared an analogy with respect to the hips and the spine. When you transplant, you don’t pull a plant up directly by the root. Instead, you take with it the soil that it’s already in.
How does this connect with sacroiliac joint health in yoga practice, you may ask? Vinyasa-style practice can negatively impact sacroiliac joint health when it strains the joint’s stabilizers by forcing the pelvis and sacrum (which meet at the SI joint) in opposing directions. Due to the size and shape of the lumbar vertebrae’s facet joints, the lumbar spine (the lower back) is designed to twist little to not at all. So, something has to give to make the twist happen, and the body asks sacroiliac stabilizers to do so. This can cause pain and functional issues over time.
Those stabilizers are primarily ligaments, but muscles and fascia also help out. A wiser approach is to move these bones and stabilizers together by allowing the pelvis to move in the direction of the twist, thus, moving the soil and the plant together.
Stability over Mobility for SI Joint Health in Yoga
The plant-soil analogy aligns with an important focus on stability over mobility. The sacroiliac joint is part of a stabilizing system at the very base of the spine, designed to absorb shock along with movement rather than provide mobility and dexterity.
If we push it toward mobility, at the expense of stability, we’re going against the body’s natural form and function. That can lead to pain, numbness/tingling, and tenderness to the touch.
How to Promote SI Joint Health in Yoga Practice
Here are three ways to nurture, rather than jeopardize, sacroiliac joint health in your vinyasa yoga practice:
1. Avoid doing more than three to five asymmetrical yoga poses in a row. If you’ve practiced vinyasa-style yoga with any regularity, you’re familiar with sequences that include many different poses. These sequences are often variations on basic Sun Salutation (Surya Namaskar) frameworks. Therefore, we practice each sequence on one side of the body and then move to the other side.
That structure keeps the work on each side of the body even. Moving through many poses in one sequence can additionally feel dynamic and just plain fun!
There’s a significant downside there, however, one that brings risk for sacroiliac strain. With asymmetrical poses, one side of the sacroiliac joint is fixed while the other moves along with the spine in whatever direction necessary to execute the pose at hand. With long sequences of asymmetrical poses, the spine moves in various directions at various degrees of motion. This causes one side of the sacroiliac joint to remain fixed while the other moves.
That can ask a lot of the side of the sacroiliac joint that’s moving and therein pull at the ligaments, muscles, and fascia that we need to keep the SI joint stable. That makes those stabilizers lax enough to potentially cause instability at the joint. (Generally speaking, there’s an inverse relationship between mobility and stability).
That laxity can be particularly problematic with ligaments, the main stabilizers of the SI joint). They lack a nutritive blood supply, so once they’re overstretched to a certain length, they stay that way.
In another way of looking at it, fixing one side of the sacroiliac joint while the other moves is little by little separating the plant from the soil. This can cause significant problems if done time after time, practice after practice.
Alternatives for Better SI Joint Health in Yoga Practice
If we’re a yogi who loves to flow (and I’m one of them), how can we avoid doing these sorts of long, potentially unsafe asymmetrical sequences? We can probably do so most directly if we’re instructors, simply by sequencing fewer symmetrical poses together on one side of the body.
Break up asymmetrical pose sequences flowing through Four-Limbed Staff Pose (Chaturanga Dandasana) to Upward-Facing Dog Pose (Urdhva Mukha Svanasana) or a prone pose, or simply shifting from Plank Pose (Phalakasana) to Downward-Facing Dog Pose (Adho Mukha Svanasana), and then doing the other side before adding on more poses. Three poses on one side is a good guideline, and five is a reasonable maximum.
We can bring the same principles to our home practice and how we choose which instructors with whom to practice. That can encourage SI joint health in our flow-style classes and home practices.
2. Allow slight rotation of the pelvis when you twist. This is the sacroiliac safety guideline to which my teacher trainer was directly referring that day. It’s the one for which the plant/soil analogy makes the most sense. Is a Revolved Chair Pose (Parivrtta Utkatasana) part of your practice? How about seated twists or twists from a Lunge Pose (Anjaneyasana)?
These are common poses in vinyasa-style yoga. You may very well have heard your instructor tell you to keep the hips even and stable and only move the spine in these poses. Or if you teach, you may have given this cue yourself. I know that I used to before I knew a big reason for not doing so.
The reasoning behind that cue seems sound enough. If some of the twist is happening in the pelvis, there’s less twist for the spine (where we want it). But remember that the lumbar spine doesn’t twist. So if the pelvis doesn’t twist with the spine, the sacrum will have to twist within the ilium, causing those SI joint stabilizers to stretch more. Over time, that can lead to less stability in the joints. Bring the soil with the plant, because they’re meant to move together.
The Plant and the Soil Moving Together: Ways to Twist with the Spine and the Pelvis
If you teach vinyasa, you can instruct your students to allow the pelvis to move in the direction of twists. Alternatively, simply refrain from telling them to keep their hips fixed when they twist, and their bodies will know what to do. The exception to this is if your students have already heard the instruction to square their hips from you or from other teachers. If that’s the case, they’ll tend to square their hips automatically. So you’ll need to reeducate them. Make sure to allow yourself to rotate your pelvis in your home practice as well.
If an instructor cues you to keep your hips fixed while you twist, know that you can make a different choice. You, or your students when/if you’re teaching, might twist a little less deeply, but that’s a small thing to sacrifice to keep the SI joint safe and healthy in yoga practice.
3. Practice a balanced set of stabilizing yoga poses to avoid overstretching the SI joint stabilizers. A good way to avoid overexerting any particular part of the body (which, over time, can cause repetitive stress issues) is to practice a balanced set of yoga postures that gently works and challenges the whole body. Stabilizing poses can also help to balance out flexibility work. This helps avoid stretching to the point of causing hypermobility.
Luckily, vinyasa-style posture practice is conducive to balanced sequences of many postures. It also offers plenty of stabilizing poses to choose from. Yet, whether you’re practicing on your own or sequencing for your students, it does take some intention and creativity to remember to include both stabilizing and mobilizing poses.
Vinyasa Practice Guidelines for SI Joint Health in Yoga
Symmetrical poses are great for stabilizing and resetting the sacroiliac joint.
- Gentle prone backbends, including Baby Cobra Pose (Ardha Bhujangasana) and Locust Pose (Salabhasana) are a helpful subfamily of symmetrical poses for sacroiliac joint health. Bird Dog Pose (Parsva Balasana) similarly engages the fascial subsystem that stabilizes the SI joint. There are a couple of stabilizing nuances to keep in mind with practicing these poses. Strengthening the latissimus dorsi muscles on the sides of the back that act on the shoulder joint is one way. Strengthening the glutes, as well as simultaneously engaging the pelvic floor muscles and back extensors can enhance the SI joint stabilizing effects of these poses.
- Warrior Poses (Virabhadrasana) and one-legged standing balances are effective as well, so long as you don’t practice them in a long, long string of poses on each side (see approach #1).
- Lower abdominal and back muscles support the pelvic area. So comprehensive, integrated core-strengthening work, including the back, glutes, obliques, and deep core muscles, is important for SI joint health in yoga practice.
- Take particular care with seated forward bends and twists, as the pelvis is in a position that makes it even more vulnerable to sacroiliac strain. Avoid overstretching sacroiliac stabilizers by not holding seated forward folds for too long. Five breaths or so is generally plenty. With twists, remember to move the pelvis and spine together. Liberally use props for additional support.
- Ending practice with Legs-Up-the-Wall Pose (Viparita Karani) can be an incredible reset for the sacroiliac joints. Gravity guides the upper thigh bones deeper into the sockets and therein resets sacroiliac joint stabilizers from any stretching that practice might have asked of them.
When you practice these few simple steps, you can smile a little knowing that you’re making choices that support rather than harm your sacroiliac joint. You’re keeping the soil and pot together, allowing them to nurture each other, and you, to enjoy the beautiful bloom of good health that can result. At the very least, you can keep your SI joint healthy in yoga practice!