Reader Question: What poses help the SI joint?

"What type of yoga positions would you recommend for someone who jams the SI joint? What are the symptoms?"

Irritation of the sacroiliac or SI joint can present in a variety of different ways. Often there is pain across the bony, flat part of our lower spine, sometimes into the buttock or wrapping
around into the groin. It might be experience as a pinch or as an ache. Sometimes the pain can travel down the outside of the leg to the knee, but not past the knee. Aggravating activities
often include standing, walking, or sitting for extended periods of time. In yoga, twists and wide legged groin openers can sometimes be aggravating. Visit with a health professional familiar with yoga to determine the exact source of your discomfort and also to receive advice tailored to your body.

With an irritation of the SI joint you have to find the middle ground in postures. Often postures that can aid in relieving discomfort, can aggravate the condition of done too vigorously. It is important for you to become aware of your root lock / mula bandha / pelvic floor muscles. These are the muscles that control the flow of urine (help you stop and start). These muscles (particularly in women) help stabilized the SI joint. Bring your attention to your pelvic floor, and using your bathroom muscles, gently lift and contract. Then relax. Repeat this a few times, then trying holding the contraction while breathing normally. You may find it difficult to access these
muscles as they often get 'switched off' in people with SI joint pain.

Another important area to become aware of is your transverse abdominus / lower belly. This muscle acts like a girdle for the lower spine, stabilizing and supporting. Lying on your back with your knees bent feet flat on the floor, bring your hands so that the fingers are gently resting on the lower belly, below the belly button. Imagine drawing your belly button in and up, you should feel your lower abdomen contract. Repeat this a few times then try sustaining the contraction with the breath flowing. You can use both of these muscles throughout your practice to support
your core.

It is also important to ensure that all the muscles that attach into the pelvis and SI joint are long and open. This is where the middle path comes in. Sometimes being a little too enthusiastic can result in a tweak of the SI. Poses that open the Quadratus Lumborum ( a triangle shaped muscle attaching from your mid spine to pelvis), glutes and piriformis (buttock), hamstrings, and hip flexors are particularly helpful.

Here are a few I like if the SI is not currently out of alignment:

Janu Sirsasana / Hurdler's Stretch: Sit with one leg extended one knee bent foot into groin. Inhale, lengthening the spine, draw in the lower belly and draw up with the pelvic floor, then
exhale hinge at the hips towards the extended leg, letting the hands rest on the shin, ankle or foot. Keep the spine long and do not round.

Parvritta Janu Sirsasana / Revolved: With the same legs, turn your torso to face the bent knee leg, lets say your left leg. Slide your right hand along the inside of your extended right leg. Keeping your left hip and sitting bone moving towards the earth raise your left hand overhead and towards the toes of the extended leg.

Thread the needle: Lying on your back with knees bent, cross your right ankle onto your left thigh above your knee. Use your hands or a strap to pull the left leg towards you (under the
thigh). Imagine gently sending the sitting bones towards the earth.

Crescent Lunge variation: Lunge forward with your right foot so that your knee is stacked over top of your ankle. Keep the left knee on the floor. Contract the pelvic floor muscles and gently tuck your pelvis until you feel an opening in the front of the left hip and the lower belly engages slightly. Raise your left arm overhead then over to the right side to access higher up into your hip flexors (in the area of your abdomen).

If your SI is feeling out of alignment, gentle slow, cat-cows can help mobilize the pelvis. Begin on your hands and knees, hands under shoulders, knees under hips. Without bending your arms, on an inhale begin to stick out your tail allowing the lower belly to drop towards the floor, opening the chest and looking up. On an exhale uncurl the tail, round the spine and let the head hang. Repeat slowly, paying special attention to the tail end.

The Twists and Turns of our Yoga Practice - Part II

The second part of my recent article on myyogaonline.com
Special Considerations for Standing Twists

In standing twists, such as the revolved poses, we often add an element of flexion at the waist. When we are moving purely from our hips joints, and maintaining the natural front to back curve in our lower spine, twists are a healthy and satisfying pose. Problems begin to develop if we start to also flex or round in our lower spine. This might be due to tightness in our low back, our hips, or a compensation for stiffness further up the spine – and this predisposes us to injury.

The most likely position for your disc to herniate - or bulge out pressing on a nerve - is in flexion combined with rotation. As the spine flexes forward, the disc moves backward, and as we move backwards, the disc moves forward. So when we put the disc in a position where it is moved to the back of the vertebrae, then increase the pressure by adding rotation – we leave it vulnerable to injury.

If you know you are at risk for a disc herniation – such as suffering a previous injury to your discs – stick to seated twists, or significantly decrease the amount you twist in your lumbar spine and focus on your thoracic spine. All of us can be mindful of sticking to flexing at our waists, and avoiding rounding into our lower spine.
Special Considerations for Seated Twists

Depending on the flexibility of our hamstrings and lumbar spine, when we come to the floor we may find our pelvis tipping backwards, resulting in flexion into our lumbar spines. An easy way to check this is to find the top of your pelvis - your iliac crests - with your hands. Sitting with knees bent, feet flat on the floor, place your hands at your waist and press in slightly, so that your thumbs are towards your back, your fingers wrapping towards your front, with the space between your thumb and first finger is fitting into your waist. Move your hands down until they come to rest on a ridge – this is your iliac crest. Play with tilting your pelvis back and forth by tucking and sticking out your tail, and notice how your hands move. When you tuck your tail under, your fingers start to point upwards, stick out your tail and your fingers point downwards. The pelvis is in neutral if the hands are making an arc on the crest, fingers arcing down at the front, and thumb arcing down at the back.
In addition you can observe how the lumbar spine adapts with these motions – rounding and removing the lumbar curve with a tuck of the tail, and increasing the low back curve as we stick out the tail. Now extend your legs out and notice what happens to your pelvis. If it starts to tip backwards (fingers up) then you would benefit from taking some height under your sitting bones by sitting on the edge of a folded blanket or foam block. Take enough height that your pelvis moves towards neutral.
Just as in standing twists, in seated twists we want to eliminate the addition of flexion into the lumbar spine so as to protect our discs and receive the full benefit of twists.

Enjoy the curves
Twists can take us deeper into our practice by lengthening and strengthening our spines in ways that allow us to venture further into other poses. When we become aware of our antomy we can practice safely and with confidence to receive all the benefits that twist hold.

The Twist and Turns of our Yoga Practice - Part I

From my upcoming article on myyogaonline.com - Part I
Keeping the spine long in twisting postures

Twisting postures are an enjoyable, challenging, and some might say vital part of our yoga practice. Poses like marichyansa /Marichi’s pose, revolved poses like parvritta trikonasana /revoloved triangle and parvritta parsvokonasana /revolved extended side angle pose allow us to move and lengthen our spines to improve our spinal and pelvic flexibility, as well as our strength. Traditionally twists are thought to be detoxifying, literally wringing out the organs of digestion and detoxification.

To better understand the benefits and considerations surrounding twists, let’s take a closer look at the spine. The spinal column is formed by 24 mobile vertebrae, and the nine fused and immobile remnant vertebrae of the sacrum and coccyx. Each mobile vertebra is separated by a shock absorbing, jelly filled disc. The vertebrae move and glide in relation to each other according to the angle of the joints between each vertebra, known as facet joints. There are four facet joints per vertebrae – two joints on the left and right part of the top of the vertebrae, and two joints on the left and right part of the bottom of the vertebrae. The angle of the joints dictates how much motion can occur in each part of the spine.

The spine is divided into the seven cervical vertebrae of the neck, the twelve thoracic vertebrae of the mid back, and the five lumbar vertebrae of the low back. The neck is the most mobile section of the spine with generous movement in flexion, extension, and rotation. The angle of the facet joints change as we move into the thoracic spine where flexion and extension are limited (also due to the attachment of the rib cage) and rotation is free. In the lumbar spine the angle of the joints change once again, flexion and extension is freely available but rotation is limited. These restrictions in movement are literally created by bone meeting bone and preventing further motion. Of course there is muscle and connective tissue that covers the vertebrae, and if certain muscles are tight or shortened, this can further prevent motion in certain ranges.

In twists, we can create more space by preserving the height of the discs between each vertebra. When we slouch, or the discs begin to degenerate, the disc ‘squishes’ and looses its height. This further restricts our motion by allowing the ‘bone on bone’ effect to occur sooner. This is particularly relevant in the lumbar spine, which is already limited in its rotational range. When entering a twist, inhale and lengthen from the tail to the head, imagining your healthy, pink discs springing back to their fullest height. Once you’ve created the room, exhale and twist, recognizing that the majority of your motion will be occurring firstly in your neck and second your mid back. With every inhale create a little more space, and with every exhale softly move into the space as you twist a little further.

To be continued.....