Tying in the last 2 articles towards happier hip movement, we dive further down the proverbial yoga rabbit hole to look at pelvic rim imbalances and possible sacroiliac pain and how to progress experientially towards a sequence of adaptive yoga moves that have the potential to reset our SI joints to their natural pain free position. One of the most common structural breakdowns I work with is often a “misaligned’ pelvis and lower back pain.
Over the years more and more SI joint dysfunctions or “issues” seems to be “recurring,” especially in women. Whether this is due to the shape of our pelvis, the draw and trend of Western Yoga or the tendency toward long loose ligaments we don’t know, or perhaps even some other stress patterning effects- including an unbalanced or improper yoga practice, women seem more susceptible to hyper-mobility along with SI joint dysfunction. Even though there is a joy in flexibility, there needs to be a balance of tone, flexibility and stability if we are to be “pain free and live a life of symmetry.
There are a number of theories about the details of the pathology related to the SI Joint disorders , however in yoga over stretching is often a key indicator. Strong ligaments hold together the SI joint, the only way to move it out of place with yoga is to overstretch those ligaments and if we stretch more on one side then the other, or more anterior (hip flexors) the posterior (hamstrings) this can throw off pelvic stability. Our bodies move through recruited sequencing of muscles, and therefore, when one set or group of muscles is “too flexible” it throws off the sequencing of the entire mechanical chain.
The cardinal symptom of SI pain is an ache on or around the posterior superior iliac spine (PSIS). The PSIS is the rear-most point of bone on the pelvis. However, it’s very important not to confuse what we are calling SI pain with other types of back pain, because, in most cases the “pain” referral point, is only where the energy gets blocked, but the structural breakdown that is causing the mis alignment is usually located some where else in our mechanics and this takes time to determine.
Sacroiliac Joint Anatomy 101
The sacroiliac joint is where the sacrum bone and the ilium bone join one another, Your sacrum is located at the base of your spine and is comprised of five vertebrae that have fused together during development to form a single bone roughly the size of your hand. Each half of the pelvis is composed of three bones, the ilium, the ischium and the pubic bone, that are fused together during development. The sacrum sits between the left and right ilium bones and bears the weight of the spine, kind of like a wedge.
The SI joints main function is to distribute this weight with equal balance to each hip and to each leg, and the energy then makes it’s way down out through the feet to the earth via our muscles (to put it into simple terms).
There are many working parts to the hip and SI Joint, some of the ligaments that stabilize the SI joints cross directly over the line where the sacrum and ilium meet. Those on the front are called the ventral sacroiliac ligaments, and those on the back are the dorsal sacroiliac ligaments. Other strong ligaments (the interosseous ligaments) fill the space just above the SI joints, holding the ilium bones firmly against the sides of the upper sacrum.
Corrective Strategies & Tips:
First, identify the balance of flexibility in the hip joints by extending in all the anatomical movements of that joint. This should be done by a health professional who can assess bio mechanical breakdowns and asymmetries via a selective assessment.
Secondly, work towards establishing stability and tone in the pelvic floor and trunk, learn the ins and outs of balance and breath work for proper intra abdominal pressure, then establish if you require mobility or stability in the hip flexors, the hamstrings, gluteal and lateral muscles of the hip.
Thirdly, modify your asana practice. As a general framework for understanding which poses contribute to helping you relieve pain, these poses traditionally fall into 4 categories:
- Careful with backbends: (Reclining Hero Pose) can help by directly pushing the top of the sacrum backward into place, as well stretching the anterior chain.
- Modify your Twists and Rotational Poses: wrong twist can easily make matters worse. Gentle movement and transitioning from pose to pose by rotating one side of the sacrum backward and the other forward.
- Try One Sided Poses: Reclined postures that focus on one side at a time, can create more symmetry by focusing the adjustment specifically on the joint that may be out of alignment, so that the ilium shifts in the right direction relative to the sacrum.
- Practice Postures that Spread the Sacrum: By applying lateral pressure to the hips, may help by opening the top part of the SI joint space, as well as postures that spread the sacrum wide and relieve pressure to the lower lumbar spine.
Next week we Continue our series to Happier Hips with the pelvic rim and stability!