Adventures in Sacroiliac Support
“Oh, hi, sacroiliac joints!” I posted this Facebook status several months ago after waking up to an all-too-familiar twinging at the back of my pelvis. My yoga friends soon responded with sympathetic “likes” and comments expressing solidarity, as achy SI joints are pretty common among yoga practitioners (especially women).
In case you're not familiar with them (and if so, you might consider yourself lucky), your sacroiliac joints are the joints where the sacrum (the triangular bone at the base of your spine, made up of five fused vertebrae) meets the ilia (the uppermost bones of the pelvis) on either side. When the sacroiliac ligaments become lax/overstretched—which might occur from hormonal changes, postural imbalances, intense asana practice, or all of the above—this can create pelvic misalignment and cause pain or discomfort around the joints.
Despite the fact that my SI joints love to make their presence known, they’ve always seemed somewhat of a mystery to me. Initially, all I really knew was where they were, and that they ached from time to time—especially after doing a lot of asymmetrical poses, and especially after demoing a challenging asymmetrical pose on only one side when teaching. (Note to self: Quit doing that!)
Eventually, I began to gather bits and pieces of SI joint info, but found myself as confused as ever. Often in class I’d hear an instructor say a particular pose was “good for the SI joints” or tell us to perform a particular action to “keep the SI joints safe,” but what did that mean anyway?
Twists seemed to confound me most of all. Somewhere along the way, I got this idea that in order to keep my SI joints stable, my pelvis needed to be perfectly square and level in twisting poses to ensure that I was twisting my thoracic spine (middle back), not my lumbar spine (low back) or pelvis. While my intentions were certainly noble, this meant that poses like janu shirshasana (head-to-knee pose), a seated twist in which the pelvis is naturally in an asymmetrical position, were out of the question, and that keeping my hips level enough to balance a yoga block on my sacrum became priority number one in poses like parivritta trikonasana (revolved triangle).
In my case, I was going a bit overboard—my practice was becoming rigid, and guided by fear, my poses weren't exactly easeful. To top it all off, my SI joints didn’t actually feel any better!
Now each individual body is unique, and I’m sure that maintaining a level pelvis in standing twists, or omitting janu shirshasana in its classic form from one’s practice, might truly be helpful for some people, but in my case, I was going a bit overboard—my practice was becoming rigid, and guided by fear, my poses weren't exactly easeful. To top it all off, my SI joints didn’t actually feel any better!
Luckily for my hips and my sanity, my perspective (and my practice) has shifted since then. My first of many sacroiliac “aha!” moments actually occurred a few years back during a class with one of my favorite teachers. As had been my custom for a while, when it was time for janu shirshasana that day, instead of taking the traditional form of the pose, I brought the entire sole of my foot to my inner thigh (think tree pose) in order to keep my pelvis square. My teacher spotted my variation and kindly asked why I was practicing the pose this way. After I explained that I thought it would be safer for my SI joints, she nodded and then explained that by practicing the pose this way, I was getting in a pretty decent forward bend, but I was totally missing out on the twisting aspect of janu shirshasana, which is both a forward bend and a twist. (As it turns out, by being so overprotective of my pelvis, I’d been missing out on a lot of twists!)
She reminded me that if I consciously and consistently practiced stabilizing and supportive actions and healthy alignment, it was okay to have my pelvis in a slightly asymmetrical position in an asymmetrical pose.
What my teacher said next kind of changed my life (or at least my janu shirshasana). She reminded me that if I consciously and consistently practiced stabilizing and supportive actions and healthy alignment, it was okay to have my pelvis in a slightly asymmetrical position in an asymmetrical pose. This meant that I could practice a traditional janu shirshasana as long as I stabilized the muscles around the SI joints by engaging from my legs all the way up into my pelvis, turned on my deep abdominal muscles by engaging the muscles between my two frontal hip bones, and aligned my sacrum by balancing the rotation of my femurs (which, in janu, generally meant finding a little more internal rotation on the bent leg side, and a little more external rotation on the straight leg side).
The Secret to Supporting Your SI Joints: It’s All in Your Head (Really!)
Further life-changing SI joint info came from my teacher Annie Adamson, co-owner of Yoga Union Community Wellness Center here in Portland Oregon, who regularly reminds me that my SI joints are, you know, joints, and just like other joints, they need space and they need stability. “We want the joint to be stable, but not locked,” she stresses. This once again serves as a helpful reminder that my pelvis doesn't have to be “rigid” in order to be safe. (Really, could you imagine someone saying “protect your knee joints/shoulder joints/hip joints by never moving them”? Probably not!)
But how exactly do you make space and create stability in the sacroiliac joints? Believe it or not, Adamson says that the alignment of the head plays a key role. “The back of the skull is so connected to the back of the sacrum,” she says. “When the head is forward, the sacrum isn't in its stable position, because—think about it—then the belly will spill forward, and you don’t have your abdominal muscles engaged, but when the head is in alignment with the sacrum, the abdominals can tone and support the SI joints, and then you can salsa dance, you can snowboard, you can do all sorts of things.”
With all of the time we spend sitting at computers and hunched over steering wheels and smartphones, forward head posture is a big problem nowadays, and its consequences can be more far-reaching than we realize.
With all of the time we spend sitting at computers and hunched over steering wheels and smartphones, forward head posture is a big problem nowadays, and its consequences can be more far-reaching than we realize—I mean I knew that my “computer posture” wasn't super healthy for my neck and shoulders, but I never considered the toll it was taking on my sacrum!
Adamson reminds us that it’s our day-to-day habits and postural activities that can have the greatest effect on the pelvis and lower back. “I feel like a lot of the misalignments are happening from the regular things,” she says—“picking up your bag, picking up your kid, reaching for a wine glass. A lot of times when people lift, they hurt their back, because even though they might be using their legs, their head is pushed forward, and they pull their back because it’s overarched.”
With all of the info available on SI joints, it’s certainly easy to get overwhelmed, but sometimes the solution is simpler than we realize. “You don’t have to know all of the anatomy; you don’t have to know every core muscle,” Adamson reassures. “What if instead, when you go to pick something up, you just keep your sacrum and the back of your skull in alignment? Think of your head like it’s floating over your spine—it stays centered, but it’s not robotic. Breathe, and when you go to pick something up, pick it straight up, so that you’re lifting up with it, not falling into it.”
The same can be said for our asana practice. Keeping your SI joints safe and healthy doesn't have to be complicated. Yeah, it’s interesting to learn the names of the sacroiliac ligaments or to observe the subtle differences between the two halves of the pelvis, but ultimately it’s the little shifts in our habits—on and off the mat—and an increased awareness of our body as a whole, that makes the biggest difference, not memorizing facts from a textbook or trying to perfect ten different alignment cues at once. How refreshing is that?
A Recipe for Happy SI Joints
Staying with the trend of keeping things simple, here are three basic tips to incorporate into your asana practice:
- Know where your head is. In general, focus on keeping the back of your head in line with the back of your pelvis. Imagine your head “floating” over your spine. Avoid leading with your chin in backbends like cobra, updog, and cow, and when you come in and out of forward bends.
- Engage your transverse abdominals. Engage the TVAs by drawing your two pelvic points (the anterior superior iliac spines—ASIS—for the anatomy geeks out there) toward each other. This action helps to keep the pelvis supported and aligned.
- When you twist, twist from your belly, keeping the rotation in your middle back, not your low back or pelvis. This doesn’t mean your pelvis has to be perfectly level, or that it can’t move at all, just that the twist is focused at your thoracic spine.
Kat Heagberg is the editor of Yoga International and has been teaching yoga since 2005. She loves to write about ways to make challenging poses more accessible, the power of language in yoga culture, and to offer encouragement and advice to new yoga teachers. Though she initially trained in alignment-based styles of yoga (which continue to inform her practice and teaching), Kat likes teaching vinyasa flow best of all. Read her work and take her classes here on Yoga International!