Sacroilliac Joint Dysfunction in Yoga

What a pleasure it was sharing the Roger Cole workshop with you last weekend. I so appreciate Roger, his clarity as an anatomist and his equanimity as a scientist, as I imagine you do as well.

Much interest was generated in the Sunday Sacroiliac, SI joint, workshop. Roger did an excellent job teaching us the SI joint anatomy with the help of his bones . . . and how to progress experientially through a sequence of adaptive yoga moves that have the potential to reset our SI joints to their natural pain free position. A question arose from one of the students wondering if long standing “misalignment” of the SI joints would lead to joint dis-figuration with the concern of having to live with that particular pain thru time.  Roger held to the perspective that creating proper alignment was the best choice and accessible with the appropriate time and effort.

In my personal journey, SI joint “dysfunction” has been part of my life for over 30 years. Sometimes the pattern is not noticeable, sometimes very painful for weeks on end, and most notably my dysfunction creates a scoliosis pattern with knee and shoulder strain on the opposite side. What I can confidently report is that coming to understand and apply the right yoga moves has given me a fairly high degree of functioning even though my SI joints are out of alignment at least 50% of the time.

It turns out I am not alone in this.  Approximately 1/3 of the population exhibits a short leg/ long leg profile.  Although SI joint displacement is not likely to be the cause of all those short legs, it is a notable one.

Over my 30 years of teaching, I have found SI joint dysfunction to be “recurring” especially in women. Whether this is due to the shape of our pelvis, the tendency toward long loose ligaments, or some other stress pattern- including an unbalanced or improper yoga practice, women seem more susceptible to hyper-mobility along with SI joint dysfunction.  Therefore although there is a joy in flexibility, there needs to be a balance of tone, flexibility and stability if we are to be “pain free”.

Being located deep inside on the front side of the sacrum, the SI joints are somewhat perplexing and mysterious. Is the right side misaligned or the left or both? Are the muscles or ligaments to tight or to loose? Is one side twisted forward and down, or up and back?  Whatever position or for whatever reason your SI joints are “out of place”, the manifestation will be seen in the muscular imbalance between your two legs and hips. So by beginning to observe the muscles that are chronically short or long (tight/stiff vs. loose/weak), we can apply our discriminating intelligence and work toward creating balance with our yoga practice.

Over the years I have come to understand and balance/ maintain good SI joint functioning by addressing the asymmetry of my body much like a person with scoliosis. IE; my right leg and left leg are just different and each side calls for its own focus and its own poses or patterns of execution.

My general advice is to examine the current balance in your own body identifying your longer muscles and your shorter ones. Watching to not overstretch your already long muscles by holding those poses for shorter time and by learning to activate/tone those muscles while in the poses.

There are two keys to my success of remaining “pain free”:

One is to use the Basic Hip Series to help you identify the balance of flexibility in the hip joints by extending in all the anatomical movements of that joint. Those 6 poses are Supta Padangusthasana 1-2-3 – leg up, out, and over for flextion, abduction and adduction, Traction twist for internal rotation, “the number 4 stretch” (on your back, ankle on opposite knee, knees toward chest) for external rotation, Lunges or ardha supta virasana for extension.

* Please note that in Supta Padangusthasana 3 with the leg over, place your foot on the floor or a block and stack your hips one on top of the other so as to not stress an already loose or mis-aligned SI joint.

Two is to create stability and tone in the pelvic floor, the core abdominals, the hamstrings, gluteal and lateral muscles. Choose;  abdominal poses that tone each side of the psoas muscle individually; salabhasana legs only hands under the front hip, and lift the weaker leg only several times before lifting both, this will tone both the hamstrings and gluteal muscles; belt the calf muscles with your feet hip width or slightly wider and repeat salabhasana pressing out on the belt to tone the lateral muscles and piriformis on the weaker side (depending on the degree of weakness you might choose to lift only the weak leg when using the belt).

Good luck. Watch for my upcoming blog postings that will guide you through a simple SI joint stabilization series on video.

Thank you for reading.  Namaste, Lillah

This post was written by Lillah on November 28, 2009
Posted Under: Articles by Lillah

Reader Comments

Hi Lillah, and thanks for sharing with us!! I love the specificity. My two cents is that in my experience (mostly as massage therapist), I have noticed that muscles can be tight and weak (from being overstretched over period of time) as well as loose and weak. Makes it a bit more difficult to discern what’s happening, but I think it’s an important distinction. Thanks again!

#1 
Written By julie on May 31st, 2010 @ 12:22 pm

That is absolutely true that a weaker side can have a percentage of the muscle really overworking so it feels tight when you stretch, yet overall the area is weak and needs to be built up. Thanks for your comment! Lillah

#2 
Written By Lillah on May 31st, 2010 @ 7:46 pm

i always do Yoga every week because it is essential to my overall well being-:”

#3 
Written By Bath Screens  on October 21st, 2010 @ 3:26 am

hello Bath Screens ( great pen name), the Si joint can sure be squirily. Thank you for reading. I hope you find value in the content of my blog.

#4 
Written By Lillah on October 21st, 2010 @ 2:19 pm

Hi there i have a question, after looking at you sacrum stablization exercises on youtube. i have very unstable si joints, to the point where i cant walk for a long time (si joint dysfunction), im in deperate need stablize this are. is it ok to do these exercises even if my si joint is not in place ?

many thanks

#5 
Written By lianna on May 27th, 2011 @ 7:42 am

Dear Yogini, With your situation, I recommend you practice the 2 part morning leg warm up series to begin giving your sacrum a chance to realign. Then practice the following poses from the SI series; down dog, some version of leg lifts to build your core, pelvic lifts (keep your buttocks firm and tail in), then end with traction twist from the morning leg warm up series. Try these for a while they should help. Then if all is going in a positive direction you can add up dog on the chair.

#6 
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