Podcast: Episode 38: Sacroiliac Joints


All physical activity can cause injuries and issues in the body, and when it comes to the practice of yoga, the sacroiliac joints are the ones that commonly feel the strain. This week, we’re digging into the sacroiliac joints – more commonly known as the SI joints – and why there are such issues with them in the practice of yoga.

Many people who enter into yoga or become yoga teachers have no idea what the SI joints are until they hurt them. Some of the movements in yoga can be quite complex, involving several joints moving at the same time, so it’s no wonder these joints can be affected.

Join me this week as I discuss the importance of getting clear on a deeper level about how your body is being affected by your practice. I’m sharing why having an awareness and understanding of our movement patterns can help us in the long run, and how you can use this awareness to gain progress, return to normal functioning and reduce pain in the body.

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What You'll Learn from this Episode:

  • Why people believe that pain is a part of yoga – and why this isn’t always the case.
  • Some reasons the SI joints can be problematic.
  • Why there can be an over-focus on the stretch sensation in yoga.
  • What we can do to support people in their practice.
  • Why we must be aware of how our body parts are moving, not just the sensation in our body.
  • How to stop overcompensating and creating extraneous tension in your body.

Featured on the Show:

  • If you want to deepen your knowledge of this yoga perspective on the SI joints, whether you are a practitioner, health professional or teacher, click here to learn more about the upcoming course I’m leading.  

Full Episode Transcript:

Male Announcer: You’re listening to From Pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.

With this episode I want to dig into the sacroiliac joints. And we often refer to them as the SI joints. And I want to dig into this for two reasons, the first is because in the practice of yoga the SI joints are in the top one or two parts of the body that tend to have problems. This isn’t necessarily a bad thing, I mean all activity has their issues, runners, skiers, tennis players. There’s tendencies and patterns around where people get injured when they do those activities a lot. And so in yoga the SI joints tend to be that source.

The other is I’ve seen so many patterns with people, yoga practitioners or not practitioners, who have SI joint issues. And there are some common themes that I have found when I work with them that have helped them gain a lot of progress. Have helped them return to function and reduce their pain. So I want to discuss those two aspects of A, why I see such an issue in the practice of yoga, and what we can do to really support people. Whether they are yoga practitioners or not.

So the first place I want to go is I remember back in the early 2000s and I was very, very fresh in my career as a yoga professional. And I remember reading an article from someone saying how there are a lot of people who enter into yoga or become yoga teachers who had no idea what the SI joints were until they hurt them. Which I remember thinking of being so interesting that even though yoga is an activity, or part of yoga is that it’s an activity, it still struck me that this pain was happening inside the practice. Because to me the practice was about ease and balance. And if we were actually practicing this then that injury wouldn’t necessarily occur.

Now I realize now looking back that’s not a fully formed thought but there’s still some interesting truth to it. Because if we’re really practicing yoga from a mindful perspective and from a place of awareness then we can tune into that. And what I see within the practice, or back in the day anyway, things have changed a lot inside of the industry. But there can tend to be a pushiness side of symptoms that we shouldn’t be listening to the body at all. That the body’s sensations are really just a distraction from the evolution and the enlightenment that was possible within the practice of yoga.

There has been a long history of pain in the practice and I remember actually having Matthew Remski at my dinner table a number of years ago who was saying, you know, “Susi, you’re quite eccentric in the overall history of yoga when you are actually someone who talks about moving in a pain-free or in a range of motion that doesn’t increase pain.” Because there was such a conversation about pain in the practice.

Now, a lot of that has changed, but I remember when he was doing his research on what on earth are we doing in asana, I think is what the title or something like that. The stories that are coming out around, you know, for you to progress in yoga you’ve got to be in pain. Or for you as a yoga teacher, pain is just part of the process. And I remember reading some of the comments that were coming through with just both awe and horror that that is what people thought, pain was a part of it.

And so that was feeding into a lot of the practice. And so I would see people at workshops and trainings thinking that you just had to keep pushing through. And that by pushing through you’d get to the other side perhaps. But that’s not really anatomically the way the body works.

Then what started to happen is that people began to realize that maybe this pain thing is not necessarily what we need to move through. And since about 2011 and 2012 the dial has really started to shift on this practice of pain and the practice of yoga. And there’s been a bit of a transition. But it’s taken a lot of time. A lot of time.

Now, when we look specifically at some of the movement practices within yoga one of the reasons that SI joints can get into a bit of a predicament is because a lot of the yoga poses that are taught are quite complex movements. And what I mean by complex is they move through a variety of planes. So they involve the sagittal, the transverse, and the frontal plane. And there’s a number of joints moving at the same time. And so we’re asking the body to do quite a number of things and we’re also asking our minds to focus on a number of things. So that can become challenging, it’s complex.

And way back in the day when I first, one of the very first classes that I started teaching is I remember the director of the studio that I was teaching at said to me, “These people, when they finish the eight-week registered series that you’re teaching them need to be able to do these poses.” Now I should say as a caveat I wasn’t in a drop-in studio; I was in a studio that taught eight-week series at that time.

And so she had directed me to say, “Okay, so by the end of the eight weeks these people need to have been able to do like a set sort of recipe or set menu of poses.” Because I remember going in and seeing the group of people, there were about 25 people, and thinking, “Oh boy, how am I going to do this?” Because these were complicated positions, pyramid, extended side angle, triangle. And I would watch the people move and thinking, “Goodness, they don’t have the basic hip mobility, they don’t have the basic hip stability. They don’t have the basic shoulder mobility and stability. What am I going to do?”

And so what I started to do is move people into the smallest component of the moment. So instead of teaching them the pose right from the get-go, I started by teaching them how their joints move. How the leg bone moves in the pelvis and how the arm bone moves in the shoulder. And the relationship between shoulder movement and hip movement. So I was able to bring in a lot of the knowledge I had already gained as a person who knew and studied kinesiology and had a background in biomechanics and exercise physiology and brought that into the yoga world.

And then as they got more aware of how their body parts moved, and as they became more aware of how those body parts moved into the actual poses, they were able to take something very simple, which is their singular component movement of joints, to something more complex, which were these yoga poses.

And I started to say to people that, you know, yoga poses are terrific, they’re some of my most favorite forms of movement out there because it’s so simple. You know, all you need to do is get on a yoga mat and do your practice. And yet, what makes it complex is that so many human beings who practice it, don’t have the underlying functional capacity to do the movement.

Now, it can all be changed. We are very, very plastic. Our neuroplasticity is very much available to us and we need to be able to slow it down, we need to be able to feel, we need to be able to utilize that awareness in order to do that movement well. Or the physical structure of our system is going to poop out, to put it in a bit of a raw way. Right? There’s only so much bandwidth our system has and so if we keep pushing it past, if we keep compensating, if we keep moving beyond what we really have as capability we’re going to get ourselves into trouble.

Now, just as easily as we can get ourselves into trouble, we can get ourselves out of trouble, and we can also avoid the trouble. And it starts with that place of awareness. It starts with that understanding of the movement patterns of how our body parts move.

So when people come into positions like triangle, for example, where you got one leg doing one thing and another leg doing another thing and then we start to move our body. The way our leg bone, or front leg bone is moving in the hip socket compared to the posterior leg bone, the forces at play on the sacrum and through the SI joints are different. Same thing with warrior two. Same thing with extended side angle. So it makes sense that we have a base that’s somewhat unstable.

Now, this isn't bad, there's lots of places in our life, that we are in unstable places, and to be able to gain stability in an unstable place is phenomenal. But if you don't have the underlying mechanics, then you don't have that foundation to do the work in an unstable place.

So that's a piece around teaching yoga and practicing yoga that people need to keep in mind, is that we talk about ease, and we talk about Sthira and Sukham, and we talk about balance. And at the foundation of that is our ability to be aware of what is going on, to be aware of how our body parts are moving, not just be aware of the sensation that's present in our body. Right?

Because that's the other part of the yoga conundrum is that there can sometimes be an over focus on that juicy, awesome, yummy, super yummy stretch. I'm a lover of that stress sensation as the next yoga person. And the thing we need to keep remembering is that a stretch sensation is merely a stretch sensation. It does not indicate that we're doing anything right or anything wrong, doesn't indicate that at all. So when people rely on the stretch sensation as an indicator of what they're doing, like if they're doing something well, they could be misinformed because anybody can compensate their way into a stretch sensation.

So whether it's extended side angle, or whether its triangle pose, or whether it's warrior two, to pay attention to that feeling becomes tricky. Whereas if we can help our clientele or ourselves to actually feel the segment, like the leg bone moving in the pelvis, or the pelvis relative to the spine, feel the actual bony segment and what that feels like, now we've got more of a focus on the experience that we're having inside of the practice, inside of the movement, inside of the asana.

So this then segues me into the work that I do with my clientele who have SI joint pain. And some of those people might be yoga practitioners or yoga teachers, and some of them might not be. But the consistent patterns that I see are that, again, as I mentioned earlier, is that there's a limitation of leg bone movement in the pelvis. So that when they do movements that are meant to be solely femur movement in the acetabulum of the pelvis, so their thigh bone in that hip socket, they tend to not do that. They use their knee, or their foot, or their spine, or their rib cage, or their jaw, or their shoulders.

Or when they are meant to move through the relationship between their spine and their pelvis and something else gets involved. And so because of that something else being involved they don't actually absorb and dissipate the load very, very well. So early on, my job is to bring them into their component movement and just teach them what that biomechanical movement is at that smaller component level. Help them grow their awareness of what's actually happening.

Because so often, particularly when people have a persistency of pain that might go away for a period of time and then return, go away for a period time then return, is that they've dealt with the sort of superficial, if I can use that term, the superficial tendencies, but not the deeper layers of tendencies. And when we can look at something on a component level, then we can get clearer on some of those correlating patterns at that deeper level. And a lot of times that deeper level is under our awareness.

So it's not uncommon for someone with SI joint pain to think that they've got great hip mobility, when in fact they move their leg bone into what they think is a hip mobility exercise and their pelvis is all over the place, or their rib cage is bracing and gripping like crazy. Or they're holding their jaw, or they're holding their breath and they're, “Er, er” and they're kind of doing that, that's not uncommon at all. Or they utilize the plantar fascia of their foot to kind of brace themselves or grip in through the rear part of their pelvic floor.

So when people tune into that and bring that into their awareness, then it's like, “Oh, I understand. I think that I'm doing the movement but in fact I'm not. I'm doing all this other stuff. I'm doing all this extraneous movement and creating all this extraneous tension, which doesn't actually need to be present. And I can let that settle out. I can let that go a bit. Now, let's move the body part I think is meant to be moving for this mobility or stability exercise and now let's see what happens.”

And invariably what they'll notice is their movement is a lot smaller than they thought. Which can lead to other issues, because it's like, “Oh, darn it all. Like, I need to get better range, or I need to get more strength, or I need to get... And this is way too small.” But the good news is, is that they're now into the reality of what’s so. They've got a very objective understanding of how their body parts move relative to their body parts.

And it's not an imagery that they're having to utilize, it's, “I can feel my arm bone moving in the socket.” Or “I can feel my leg bone moving in the socket. I know where my pelvis is in space, I understand where my spine and my rib cage and pelvis are.” There's a growing sense of both this interoception of feeling plus this proprioception of where things are in space.

And they can tune in more clearly to that sensation that they're feeling in their body. And they can pace themselves so much better, recognizing what's too deep, what's too little, and finding that Goldilocks place in the moment of what really works for them. And as they get that foundation, what becomes really interesting is then they have greater connection and greater clarity, and overall better feedback between their nervous system and their anatomical muscular myofascial systems.

And they tune into what I call the yellow lights or the whispers so that then as they take that foundation, and they take it up into more complex movement. So they started off at base component level movement, then add more either planes of movement, more biomechanical patterns, more joints adding in, add more load, add more force, add more length of time to how long they hold a particular position.

So they're adding more complexity to what they're doing. They can tune more into the whispers or the yellow lights, and so they know when to get out or when to adjust to be able to support themselves. Because as we know, when you listen to the whispers, you don't have to hear the screams.

When you notice the yellow lights you can ascertain if it's a fresh yellow, and some people like to push on the gas pedal at that point. Or if it's more of a stale and they know they need to slow down because the red is coming. So someone's got a much better barometer of what their body is saying to them, they get a sense of their battery and where that energy ebb and flow is. So they can just tune in so much better to what they are capable of.

So if I can summarize then, the SI joints, to support them from this place of yoga, to support them from this place of breath, of movement, of stillness, what we're looking at is the neighboring areas to those SI joints that move. Looking at those component movements, where the compensation is. How the movement is supporting their form and they're form’s closure. Abductors, adductors, transversus, abdominis, pelvic floor, the diaphragm, the connection to the breath, the ability for someone to be still. And then building upon that and adding complexity within the bandwidth that they have, so that they can tune into their yellow lights, they can tune into the awareness. They can tune into the sensation and what that sensation is actually directing them toward.

So that when we get into the complexity of yoga poses, we can tune into, “Ah, okay, now we're going into Warrior Two. Now we're going into extended side angle, now we're going into Triangle Pose. One leg is doing one thing and the other leg is doing another thing. The forces that play on that SI area are different from one side to the other. We're in an unstable place but we can make it more stable by tuning into how things are moving, like truly cluing into the proprioceptive capability of ourselves and our body.

And then the practice can really come alive, then we really settle into that Sthira and Sukham, we can settle into that ease. We can settle into what I love calling asana, which translated is sitting comfortably and still, and finding that comfortable and still place in everything that we do. That seat, that pelvic bowl, how those legs move within that pelvic bowl. How that spine connects into that pelvic bowl, and what that can then do for us in all of our life.

Now if you want to dig into this more, you want to dig into your SI joints, the sacroiliac joints. Whether you are a practitioner or not a practitioner, whether you're a teacher or a health professional and you want to dig into more of this yoga perspective on the SI joints, I am leading a course coming up. And you can take a look at that at the following link. www.functionalsynergy.com/sijoints. I would love to support you in the learning and deepening your knowledge of the SI joints and what it means for your own practice and for your own activity. See you there.

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