SIJ (sacroiliac joint) injury can present as symptoms that are very painful or uncomfortable in the lower back, buttocks, hip, groin and sciatica, and they affect the student’s normal walking patterns due to stretching or weakening of the ligaments holding both or one side of the sacrum and ilium together. These ligaments are avascular - meaning they receive little blood supply at all - therefore healing time is greatly increased. Ligaments are designed to be very strong and inelastic so once they are stretched beyond their capacity, they do not return to their normal length and shape. This means that once a student has endured an SIJ injury, they are vulnerable to further injury or misalignment. Misalignment causes the sacrum to endure depressions and the ilium no longer fits perfectly into the joint, leaving a gap that compromises structural integrity, therefore the surrounding muscles are forced to work harder to support the SIJ and the weight of the upper body. In addition, the sciatic nerve can be pinched due to misalignment causing further discomfort. Female students are also at greater risk of SIJ injuries due to hormones released during pregnancy and lactation that relax the ligaments for childbirth.
Knowing all of this, it is not a great idea to push yourself into any pose that causes uneven tilting of the hips or pelvis. As you force yourself into these postures you place yourself at risk of overstretching your strong ligaments and increasing vulnerability to SIJ injury.
Post injury, twisting and external rotation of the hips should be avoided, as well as too many asymmetric poses (e.g. trikonasana, janu sirsasana). These cause the sacrum to move unevenly in the opposite direction from the ilium, therefore exacerbating misalignment of the SIJ joint. Paschimottanasana is likely to stretch the SI ligaments even if performed perfectly and should also be avoided. Backbends can be either uncomfortable (grinding the bumps of the sacrum and ilium against each other) or therapeutic (if the student is able to return the SIJ to its original positioning).
For prevention and post-recovery, balancing postures help to build strength and stability in the pelvic region. Prone backbends (where the front of the pelvis is connected with the floor) are the most stable position for the pelvis, like cobra and locust.
By Alyssa McLeod
Understanding our Sacroiliac Joint – Ekhart Yoga. 2016.[ONLINE] Available at: https://www.ekhartyoga.com/blog/understanding-our-sacroiliac-joint. [Accessed 19 October 2016].
Yoga Journal. 2016. Protect Your Yoga Students' Sacroiliac Joints | Yoga Teaching Methods. [ONLINE] Available at: http://www.yogajournal.com/article/teach/protect-the-sacroiliac-joints/. [Accessed 19 October 2016].