Ep 74: SI Joint Dysfunction and Yoga

Many students practicing yoga encounter the frustrating and often debilitating experience of SI joint pain. I even experience it from time to time myself! Despite its prevalence, it remains widely misunderstood, and well-intentioned advice can sometimes exacerbate the problem rather than alleviate it. 

A common solution in yoga classes for SI joint pain is to "engage your core" or "engage your glutes." While core and glute engagement are undeniably important for overall stability and movement, applying them as a blanket solution for SI joint issues often falls short and can even be counterproductive. This episode is specifically designed for you if you’ve heard or even offered this advice and have come to the realization that it doesn't quite address the nuances of SI joint pain. 

In this episode, we will dive deeper into the complexities of the sacroiliac joint & explore the potential underlying causes of pain and dysfunction. Let’s throw away simple cues and discuss more effective strategies and considerations for helping students find relief and promote long-term stability in the SI joint. 

Transcript

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Many students practicing yoga encounter the frustrating and often debilitating experience of SI joint pain, discomfort, or even dysfunction. I even experience it from time to time as well. I. Despite its prevalence, it remains widely misunderstood and well-intentioned advice can sometimes exacerbate the problem rather than alleviate it. A common solution in yoga classes for SI joint pain is to engage your core or engage your glutes. While core and glute engagement are undeniably important for overall stability and movement, applying them as a blanket solution for SI joint issues often falls short and can even be counterproductive. This episode is specifically designed for you if you've ever heard or even offered this advice and have come to the realization that it doesn't quite address the nuances of SI joint pain. With your students, we will dive deeper into the complexities of the sacroiliac joint and explore the potential underlying causes of pain and dysfunction. Let's throw away simple cues and discuss more effective strategies and considerations for helping students find relief and promote long-term stability in the SI joint.

1:26

Welcome to the Essential Conversations for Yoga Teachers Podcast with me. I'm Monica Bright and I've been teaching yoga and running my yoga business for over a decade. This is the podcast for you. If you are a yoga teacher, you're looking for support. You love to be in conversation, and you're a lifelong student. In this podcast, I'll share with you. My life as a yoga teacher, the lessons I've learned, my process for building my business and helpful ideas, tools, strategies and systems I use and you can use so that your business thrives. We'll cover a diverse range of topics that will help you, whether you're just starting out or you've got years under your belt and you wanna dive deep and set yourself up for success. I am so glad you're here. Listen, I don't take myself too seriously, so expect to hear some laughs along the way. Now let's do this together.

monica_4_09-17-2024_122441: 2:35

Welcome back to the podcast. I'm Monica, and I'm so glad you're here. If I sound a little nasally on your end, it's because I am, I don't typically have springtime allergies, but seems like I'm dealing with a little bit of something, something. So you might hear it in, your ear. Just bear with me as I try to. articulate myself as well as I can with this nasally sound. on this podcast, we get real about yoga's role in injury prevention and recovery. And today we're tackling one of the most misunderstood and often mistreated issues in yoga. And that's. Si, joint pain, a little discomfort, and sometimes students have dysfunction. If you've ever heard, or maybe you've even said, engage your core or engage your glutes To help relieve your SI joint pain. Uh, but you realize that this isn't the most helpful advice than this episode is for you. I'm gonna bust a few myths, explain why common cues backfire, and give you some practical solutions you can use starting today. So let's dive right in. Here's the first question we need to ask, and we need to understand the anatomy and function of this very important joint in the body. the scro iliac joint is a small but critical articulation where the sacrum, which is the triangular bone at the base of your spine, where it connects to the ilium, the larger pelvic bones, unlike most joints, it has very limited mobility due to its primary role in stability rather than motion. The joints on the right and the left side are held together by some of your body's strongest ligaments. The SI joint is a shock absorber because it transfers forces between your upper body and your legs during walking, running, or maybe even lifting. The movement in this joint is minimal because it's designed for load transfer and not flexibility. If you're a believer that we evolved from walking on four legs to two, then let me explain how this evolution to Bipedalism changed the role of the SI joint in your body. When we evolved to walk upright, the SI joint underwent major functional shifts. It had to, because our center of gravity shifted and the weight we placed on our lower body increased significantly. Its roles shifted from mobility to stability. In Quadric, HEADSS, the SI joint is more mobile, aiding and climbing, walking and running. but in humans, it became a rigid weight-bearing structure that handles vertical forces like gravity's impact on your spine. To adapt for upright posture, the sacrum widened creating a stronger base for the spine. The iliac blades shortened and curved inward improving balance over the legs and the joint surfaces became more textured, increasing friction to resist sheer. Forces. However, because of this, we encountered new vulnerabilities. Bipedalism introduced sheer stress, which are a side to side forces during walking, making the SI joint prone to dysfunction like ligament strain and misalignment. This deserves more of a conversation, but knowing that men and women have a different size and pelvis shape is important to remember. During childbirth, the female pelvis needs to move to adapt for wider birth canals, which can further stress si joint stability. Why does this matter for you as a yoga teacher? Understanding movement helps you see your students differently. That's been my overarching. Message throughout many, of these episodes, so I hope that that is connecting for you. The SI joint wasn't designed for extreme mobility like deep twists and asymmetrical poses Or overstretching in hip openers, which can overload ligaments leading to chronic and persistent pain. But we teach this in every class. Oftentimes teaching more deeper and longer holds, stretches and twists. Modern sitting habits weaken the glutes and deep lateral rotators, the muscles that stabilize this joint. Let's talk about what the SI joint actually does and how yoga can make it worse. First, it's the sacrum's shock absorber working to transfer force between your spine and your legs, and unlike other joints, it has very limited movement. The instability comes from ligament laxity, not the muscles, which is why some say once you overstretch those ligaments, you cannot restore them to their initial length. What we teach in yoga can make it worse. Think about asymmetrical poses such as Warrior one and tree pose. The action of practicing different movements with each hip joint can lead to shearing of the SI joint. Do you over cue core engagement, like pull your navel to your spine. This is an ineffective cue for queuing core engagement Because of the anatomy of the core container, this cue can increase intraabdominal pressure and lead to further ligament stress. Be honest. Do you use forced alignment cues like squaring your hips in lunges or asking students to create a flat back or even stack their knee over their ankle? These cues ignore natural pelvic. Asymmetry and create an environment where students are forcing their body into unnecessary and sometimes unattainable positions. Let's talk more about what doesn't work and why. Strengthening your glutes. So the glute max is a global mover, not a stabilizer. Overworking. It can actually shift the sacrum out of alignment. It's small and very minimal movement. What about tucking your tailbone? Tucking compresses the sacrum and reduces its ability to absorb force. Have you ever heard the advice to use an SI belt? These are bands that help temporarily by applying compression and support around the hips in an effort to stabilize the SI joint movement. However, these are not a long-term solution. They decrease proprioception long-term and don't address the source of the problem in the first place. Okay, let's get to what actually helps. First, you've gotta train the real stabilizers of the SI joint Focus on the deep lateral rotators, the piriformis, the opterator, and the pelvic floors, posterior fibers, which anchor the sacrum. How to do this, I know that clamshells get a bad rap, but they're effective. Think about having students wrap a resistance band above their knees. Guided imagery works really well here too. If you don't actually have bands to teach with, Ask students to keep their feet planted gently. Press their knees outward. And move without arching their back to teach this, I often cue students to take the alignment. I don't want them to take like arching their back so that they feel what that feels like. Then when we practice it again, they can feel in their bodies where not to go. Another exercise is a supine piriformis engagement. It looks like a supine figure four, but the intention is slightly different. Cue students to lie on their back with knees bent and cross one ankle over the opposite knee. Figure four. Instead of pulling the legs in for a stretch, you would ask them to press the crossed knee away while resisting the press with their hand. So pressing the hand against the knee. Pressing the knee against the hand. This is an isometric contraction. Hold this for five seconds and release. The purpose here is no stretching, just activation, and you can easily incorporate this into your classes. Next, you gotta stop shearing the joint, Although you may not be able to completely avoid asymmetrical poses like Warrior One and Warrior two, until stability improves, you can talk to students about not practicing these poses as deeply. Instead, ask them to pull back a bit. Be mindful about how you assist students. Are you assisting them into deeper twists, like chair twists with the knees in line with one another, or deeper hip opening, like in triangle pose where you'd be shearing the SI joint on the side of the front leg? Your assists can contribute to their SI joint pain, so you have to be super mindful of how your assists affect the student with SI joint dysfunction. Okay. Third, teach students to breathe intentionally diaphragmatic breathing over core engagement. Teach them to let their ribs expand 360 degrees. Speak about reducing downward pressure on the pelvis, and instead filling out the abdominal container. Teaching breathing can be very effective and students can take this teaching off of the mat and they could be practicing it out in the world, maybe at the grocery store or while they're sitting in their car in traffic. Always remember it is a good idea to know when to refer out. Some red flags here include a pain that radiates down the leg, which could be sciatica Or it could be a disc issue, an inability to stand on one leg without hip hiking or a history of trauma, like maybe a car accident or a fall or even childbirth. In the case of childbirth, pelvic floor therapy is a great idea. I was just talking with a student about this last week. I'm so glad that we're having more conversations around the pelvic floor and menopause these days. I never had these conversations with my mom, but that was normal back then. Here's what I want you to remember. Unfortunately, si joint issues thrive on misinformation. You can for sure stop teaching students to do more crunches and start working with their anatomy. True stability isn't rigid, it's responsive, but you have to be intentional about the yoga you teach and how you teach it. Okay. When you have a deep understanding of anatomy, biomechanics, and the effects yoga Asana have on the body, you help students understand that the yoga practice is not a workout, but a tool to help them look inside themselves, to listen to themselves, and to realize that their bodies might benefit from slight adjustments in the alignment of their poses in order to suit. Their own bodies. It's so important for us to have these conversations so that you remember that there's so many opportunities for you in the teaching world. You know that my goal is for you to love the yoga teaching life. It's important to understand movement and the issues students come to your classes with. If you love this episode, let me know. Don't forget to download the ebook sequencing for different injuries. The link is in the show notes and I promise you it will help form a foundation for teaching students with injuries and aging bodies. The information will also help you understand how to accommodate students of different accessibility. And it'll be a great resource for you to return to again and again. When you download the ebook, you'll be joining my newsletter. That's just for yoga teachers. I've got more exciting teachings coming really soon, so I wanna tell you all about them. The link is in the show notes below, and I would love for you to join it so we can always stay connected. I've also added a link in the show notes for you to send me a quick text message about your thoughts on this episode. I won't know your phone number. It's just a neat addition to the platform I use that allows for this new and super easy way for you to communicate with me. Once you click on it, it will take you to your messages, but don't delete the code. That's how your message will get to me, and I would love to know your thoughts. subscribe to the podcast so you're always in the know when a new episode drops, and share it with another yoga teacher who you think would love to be in on these conversations. Thank you for helping to spread the word about this podcast, and if you've been taking notes in your journal as you listen to these episodes, I'm so glad you are and I would love to hear about it. Alright, that's it for now. Bye.