Saturday, 10 January 2015

Protect your SI joint

Yoga injuries are relatively few compared to other physical activities/sports/fitness regimes, especially if you practice ahimsa. 

However, one of the effects of practicing yoga is that we become more flexible. In many ways this is good, for instance flexibility in the hamstrings can help prevent lower back issues. But too much flexibility of the ligaments around the SI joint may lead to injury.  Most advanced practitioners of yoga will be aware of the problems the SI joint can cause.  I discovered towards the end of last year just how painful a SI joint injury can be.  

The SI (sacro-iliac) joint is located between the sacrum (the triangular bone at the base of the spine) and the ilium, the largest of the hip bones.  It is usually fairly immovable unless strained. I moved mine! Och!  I knew what I had done when the pain was on one side and down the outside of my thigh.  I continued with my practice but even Cat/Cow was a struggle. (I would not advise you to continue with any activity that makes you feel worse-remember ahimsa). Fortunately a local physiotherapist put the joint back in place in only one session and I can practice as normal again. 

Women are particularly at risk because our hips have to have some degree of flexibility in order to give birth.  In fact pregnant women are even more at risk because the hormone, relaxin causes the ligaments around the hips to have more 'give'.
I know that once you have had a SI joint injury, it may easily happen again so I now intend to take extra care when practicing.  Here are some tips for avoiding such an injury:-

  • Take care in standing forward bends- use a block or bend your knees if you need to.
  • Revolved Triangle, and seated twists - many yoga practitioners use their arm as a lever to deepen the twist and this can put strain on the SI joint.  Allow your hips to turn as one unit in the direction of the twist.  In reclined twists you may need to support your legs with blocks or cushions while you hold deeper reclined twists.  Bring your legs back to centre, one at a time.
  • Trangle, Warrior 2, Side Angle - in these poses the advice used to be to have the hips perfectly aligned to the front of the mat. If then you try to fully rotate the front thigh you can strain the SI joint. It is now thought to be better to allow the back hip point to come forward. The advice if you have SI joint issues is to have your back foot forward of your front so that your feet are hip distance allowing the hips to turn more.  In these poses also make sure your tailbone is tucked under.
  • Janu sirsasana (Head to knee pose) - asymmetric seated forward bends need care too.  Turn your body to face the extended leg and hinge from your groin.  Support the bent knee with a block if you need to.  It is really important not to use your hands to pull you into the forward bend.  
  • In Baddha konasana and Supta baddha konasana support your thighs with blocks or cushions to avoid straining the SI joint.  In Baddha konasana also sit on a block. 
  • In Wide leg seated forward bend sit towards the front of the block so that your hips are hinging forward from the groin.  You may need to bring your legs closer together.
  • Lotus is an advanced pose and forcing your body into the pose can lead to SI joint injury so be very careful. 
The bottom line is practice ahimsa, never strain or force yourself into a pose that feels uncomfortable for you, use props and do modifications of poses when you need to.

Enjoy your yoga
Janet x

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