This morning, the SI joint knocked at my door. “I’m very upset.” Um – what? “You know, every one else is famous for causing lower back pain, the muscles, vertebraes, discs and nerves – they all laugh at me. No one talks about me, but I’m responsible for a LOT of that, too!” OK, I see. You want to be named and shamed, right? “Exactly! Can you help?” Well…
In case you’re wondering where or what the SI joint is, you’re not alone. It’s one of these things we take for granted and only pay attention to when it hurts (like so many things in life..sigh). Anyway. Imagine your spine. As yogis, we think a lot about the spine, right? And now picture your hips, or more precisely, your pelvis. How do they fit together? Exactly, you get my point.
The SI (sacroiliac) joint lies between the sacrum and the ilium of the pelvis. The sacrum bears the weight of the spine and distributes it to the two supporting iliums, one on each side. The SI joint, or rather joints, even though we mostly talk about them in singular, work a bit like a padlock. That’s quite technical, so I inserted an image. (Like with everything else, your SI joints will look completely different from the person on that sticky mat next to you.)
Normally, the SI joints don’t move much. They’re there to give stability, after all. Truth is, that probably only a very high impact shock could make them move at all (think of an elevator crash..). BUT. If you’ve been practising yoga for years and years and…, you’re kind of likely to develop a sort of nagging pain in your lower back, just below the belt line, where there’s that bumpy, bony bit, mostly on one side. There might be other reasons for this pain (such as sciatica), but there’s a high chance it’s SI joint pain.
So where does it come from and why does it only appear in relatively advanced students?
Imagine you are moving your joint while trying to keep the spine straight. If you don’t carefully align your hips, they will naturally want to follow the movement of the joint/leg. If the spine remains straight, the SI joint has to take the blame. We said the joints barely move – that’s right, but imagine how years of advanced (read: higher joint mobility) practice and thousands of joint movements can change this. Picture a cup that breaks. You can glue it back together, but what if you don’t get it right and there’s misalignment? Exactly – ouch! Overstretched ligaments add their bit to the pain.
Absolute killer postures are asymmetrical forward bends where one side of the pelvis is held back and the arms pull the other side forward. Even forward bends that are not absolutely even on both sides, for example because one hamstring is shorter, cause trouble. Another challenge for the SI joints are postures like Warrior II, where the pubic bones are pulled away from each other due to high abduction.
Of course, like for any other medical condition, there’s a name to it: Sacroiliac joint dysfunction. While it’s great to know what causes the pain, it’s better to know how to get rid of it (or even prevent it). I’ll post a summary soon.
Meanwhile wishing you a safe and healthy practice – Namaste!