Thursday, June 16, 2011

SI Joint Management; or, how not to become Dr. Octopus

A couple of days ago, Viviane, a fellow Ashtangi from Encinitas, emailed me. She has been reading this blog for some time, and asked me to share my experience of dealing with issues with my SI joint. I replied with a long email about this; in the course of doing so, I realized that I actually have enough material to write an entire post about how I have managed my SI joint issues!

So I have decided to say something here about my SI joint issues, and how I have managed it more or less effectively in the last couple of years: I mean, I'm still walking, and as far as I can remember, I did full primary and second up to Karandavasana this morning. So I can't be managing too badly, can I? But as usual, I think it is a good idea to issue a couple of disclaimers here:

(1) As most of you already know, I am neither a medical doctor nor a body worker. As such, I do not pretend to have any specialized knowledge of any part (or the whole) of the body. But having dedicated myself to a full-time Ashtanga practice (six-days-a-week, minus moon days and Sundays) for almost two years now, I can see and feel how the practice has made me deal with certain underlying issues with my body and mind, including my SI joint. And I think that if the reader were to keep an open mind, evaluate what I have to say on its own merits, and perhaps test out some of my views intelligently, while listening closely to his or her body at the same time, he or she may derive some benefit from my, ahem, limited wisdom of my still limited experience.

(2) Notice that I use the word "manage" rather than "treat" or "cure". This is because, at least in my case, I don't think whatever it is that is bothering my SI joint has disappeared completely. If you read my practice reports, you will know that I have days when I feel this "off" sensation in my SI joints at the beginning of practice. But by carefully working through the postures, the "off" sensation almost always goes away by the time I get through the Suryas and to standing. And although I do not have specialized knowledge, I think this probably holds true for many SI joint dysfunction sufferers as well (gosh, doesn't this sound morbid?): SI joint issues are not issues that one can expect to just "go away" overnight. (As I said, I could be wrong about this...) But if one is patient and is willing to work respectfully through the practice with one's mind and body, one can be assured of a very high quality of life even though one suffers from SI joint dysfunction.

Wow, I have written so much, and all I have done is go through the disclaimers? Gee, this is going to be a long-ass post... (You might want to think about going out to get some popcorn before resuming your reading :-)).

I'll start by sharing my personal experience. From my own experience, and from talking to others who also have SI joint issues, SI joint issues often arise in people who are quite flexible. Being flexible is, of course, a nice thing. However, many people who are quite flexible (including myself) have a tendency to rely too much on this flexibility in getting in and out of postures, and to neglect cultivating stability and sound alignment. In fact, a few years ago, in an Anusara class, the teacher tried to bring my attention to my over-reliance on flexibility by telling me that I am like an octopus: Very flexible, but no bones/stability. To this day, I still can't figure out if she meant this as some sort of back-handed compliment (Note to reader: I have nothing against Anusara. But this incident actually did happen.).

Apparently, I bear more than a passing resemblance to my favorite comic book super-villian.
(Image taken from this website.)

At the same time, I also notice that many yoga classes out there (especially beginner classes or power yoga classes at gyms and fitness centers) seem to be primarily geared towards people who are lacking in flexibility. In these classes, the bulk of the instructor's instructions seem to focus more on helping "stiff" people become more flexible, and relatively less on helping flexible people achieve more stability and strength. At least, this has been my perception, based on the classes that I attended in my first couple of years of yoga practice: If you have a different viewpoint, please share.

The fact that I seem to be naturally flexible (at least in my hips and hamstrings: I could do the full expression of Hanumanasana within my first year of yoga practice), coupled with the focus on flexibility in the first yoga classes that I attended, meant that without quite realizing it, I was building a lot more flexibility than strength through my yoga practice. Which is a very dangerous thing. In his book, Ashtanga Yoga: The Intermediate Series, Gregor Maehle warns: 

"Never develop flexibility that is not counteracted and supported by strength. You might look good in the first few years of doing yoga, but after that, physical problems due to an increasing imbalance will arise. Some students practice for many years and wonder why their overall condition deteriorates rather than improves. Apart from faulty technique, the culprit here is often an increase in flexibility without a corresponding increase in strength." (page 116)

Which was pretty much what happened to me. I must also add that flexibility is a very addictive thing; the more flexibility you have, the more flexibility you want, even if this comes at the cost of compromising stability and strength. Before I knew it, I was "borrowing flexibility" from other parts of my body that were not supposed to stretch. I believed this is actually what precipitated my first SI joint injury. If I remember correctly, the first time I noticed something amiss with my SI joint was on a day when I tried to put my leg behind my head; I did not have sufficient hip openness on that particular day, so I compensated and "borrowed flexibility" from my lower back/SI area in order to get into the posture. Which threw the SI joint out of alignment.

But this is where the Ashtanga practice comes in to the picture. To me, the beauty of the Ashtanga system is that there is an equal emphasis on building strength and stability as well as increasing flexibility. Over the last couple of years, my SI joint issues have forced me to move more deliberately and carefully through my practice, and pick up on things that help with this issue. Here are a few: 

(I) Surya Namaskar: Working slowly and deliberately on "floating" in Surya Namaskar is actually very beneficial for the SI joints. Why? Because in order to lift up from Dve position and float back (and also, later on, to float forward into sapta position from downdog), one needs to really engage uddiyana bandha. Which is really stabilizing for the SI joint. Most people tend to think that floating is just a "showy" thing; I can boast of being one of the few people around who recognize its therapeutic effects, thanks to my SI joint issue :-) But I really must emphasize working slowly and deliberately; obviously, if you just fling yourself thoughtlessly into chaturanga from a standing forward fold (as sadly, many people seem to do), you will be more likely to hurt your back more than to heal it. David Garrigues has a very useful video on how to work on this effectively and safely.

(II) Using the bandhas to access forward bends: Beginners to yoga tend to fixate on hamstring flexibility when trying to get into forward bends. But a more productive and ultimately safer way of accessing forward bends is to engage the bandhas. At her recent Richmond workshop, Kino talked about this in great detail: 

(III) Working very carefully on building up the strength to jump through slowly with crossed legs in all primary series postures: Just as with floating in Surya Namaskar, this also requires really engaging the bandhas, which stabilizes the SI joint. I have written a post on this. Viviane has also made a very nice video of Kino explaining how to engage the bandhas to jump back at her recent workshop in Chino, California. Who knew the bandhas were a steering wheel? :-)


Well, that was a lot of blogging for one afternoon! I hope this post will be of some help to anybody who is working with SI joint issues. Well, actually, even if you do not have SI joint issues, it's probably a good idea to keep these things in mind... I mean, who wants to be like Dr. Octopus? :-)



  1. Oh my goodness. Kino's video is so detailed and technical, I'm going to spend hours on this figuring out the bandhas! I have to admit that I've been in a blur about where the SI joints are exactly. After doing some Googling and your post I realize that I'm probably headed for SI joint dysfunction as well. Am more flexible than I am strong and I do get achy around the SI joint area after practice sometimes too. Thanks for sharing your experiences with us and these resources. Bookmarking this for future reference!

  2. I am always paranoid about over-stretching in yoga class. You've nailed it... stretching is totally addictive for bendy people, just like strong people obsess about increasing the max weights they can lift, and long distance runners will attempt to do long runs even if they've got knee pains and shin splints. I don't know how much strength I need to gain though before I will feel safe about my joints.

  3. this post resonates with me as well. i have always had such a week lower back but before starting ashtanga i just tried not to use it and stay out of discomfort zone that way. however, since starting ashtanga the discomfort is there - very frequent. i told myself it is 'sagging' and improper upward dog pose even though i am very careful not to overload this part and always make sure my legs are strong and my uddhiyana bandha is helping.
    i have started reading more anatomy as obviously do not want major injuries to occur a year down the line. i did find it curious that once being adjusted in the last class in forward bend( very deeply) i passed the uncomfortable zone and relaxed full with my SI joint not hurting at all for couple of days. have you experienced anything similar?
    thank you Dr. Octopus ;-) Ivana
    p.s. sorry for the long comment

  4. Hello savasanaaddict, yes, Kino seems to have the gift of teaching on video in a very clear and detailed manner. Yes, now that I think about it, perhaps I should have included a paragraph or two in this post explaining why the SI joints are. May your SI stay healthy and happy forever! :-)

    Yyogini, I don't think there is a straightforward answer to how much strength you need to gain before you feel safe about your joints. It probably varies for different individuals. But I think this is why it is all the more important to pay close attention during practice, and ask ourselves where the stretch is coming from in each posture: Is it coming from the main body of the muscle? Or is it coming from some ligament or joint? All this is a lifetime's work :-)

  5. Hello Ivana, thank you for addressing me as my favorite comic book villian :-) Don't worry about long comments: This is a long post, in the first place. Your experience is very interesting. I actually have experienced something similar before (getting through a "discomfort zone" and then having a feeling of opening), although for me, such experiences occur more frequently in deep backbends. Maybe (and I'm just guessing; I don't know for sure) it wasn't your SI joint that was bothering you; maybe it was some lower back muscle? I say this because I get the sense that muscles respond better to this kind of adjustment.

  6. hhhmmmm... that's an interesting comment. i might speak to my teacher next class and see what she thinks. thanks - a valuable piece of info ~ ivana

  7. Cool, Ivana :-) Let me know what your teacher says.

  8. so helpful -- thank you for the links!