So far in this series, I’ve focused on what not to do to maintain a healthy SI joint. This post will focus on what yoga practices and poses might help heal a misaligned SI joint. In addition, I’ll suggest poses that can help you build stability in the joint.
What Is SI Joint Dysfunction?
There are five ways that SI joint dysfunction can occur:
- Anterior rotation of the ilium
- Posterior rotation of the ilium
- Flare (gapping) internally/externally of the ilium
- Rotation of the sacral body
- Superior or inferior slip of the ilium
All of these conditions have potential to displace the sacrum from the ilium. Quite often, these misalignments are asymmetrical. This creates asymmetrical pressure on the SI joint that displaces the sacrum from the ilium. So stabilizing the joint and strengthening the muscles around the joint are essential.
Because we may not be aware which of these conditions are causing our (or our students’) SI joint pain, it’s important to approach the practices I offer with care. None of these practices is meant to be a magic bullet. Our bodies, and our SI joint problems, are all different.
So, as with all yoga asana practices, be mindful as you practice. A particular pose that I suggest here may not be appropriate for your condition. If there’s pain or discomfort, stop doing what you’re doing. Also, be mindful of the aftereffects of your SI joint practice as they unfold over the next 24 hours. Ultimately, your practice experience will be your most reliable guide.
First, SI Joint Relief
When your joint is inflamed or possibly misaligned, gentle, patient practice is key. My go-to pose for SI relief is Viparita Karani (Legs Up the Wall Pose). If you are feeling acute joint pain, especially if it’s accompanied with sciatica, this may be the only pose you’ll want to practice, at least until things start calming down. You can practice Viparita Karani with a Standard Yoga Bolster (as shown above) or with your pelvis on the floor.
In this pose, the weight of the legs feeds down into the pelvis, while the pelvis rests in a symmetrical position on the floor or on a bolster. My experience with it is that this gentle weight can start to realign the joint. A yoga sandbag on your feet can provide some extra weight. This can be really helpful in some cases. I’d suggest practicing without a sandbag at first. If that seems to be beneficial, you can add a sandbag next time around.
Relief and Prevention
Bringing your SI joint back to balance requires patience. The following suggestions include practices that have been helpful for me and for my students. As always be gentle and give your body time to heal.
- Stick with Symmetry: In general, if your SI joint is in pain, practice symmetrical poses. Make sure that you always bend from the hips and not from the waist in these forward-bending poses:
- Adho Mukha Svanasana (Downward Facing Dog Pose) or Wall Dog Pose
- Uttanasana (Standing Forward Bend Pose): Be sure to support your hands on blocks or on a chair seat so that the weight of the torso isn’t pulling on the SI joint.
- Prasarita Padottanasana (Wide-Legged Standing Forward Bend Pose)
- Upavista Konasana (Wide-Legged Seated Forward Bend Pose)
- Supta Baddhakonasana (Reclining Bound Angle Pose) This is not a forward bend, but it’s an excellent pose for relieving SI joint pain.
- Stabilize: Prone backbends engage the muscles that help to stabilize the joint. Here are a few suggestions:
- Baby Backbends: These include Salabhasana (Locust Pose) and its variations, Bhujangasana (Cobra Pose) and Ardha Bhujangasana (Sphinx Pose). As the joint heals, Dhanurasana (Bow Pose) can also be helpful.
Rebuilding Your Practice
Once your SI joint is feeling stable and pain free, you can begin adding in some asymmetrical poses. Here are some guidelines as to how you might do this safely:
- Standing Poses: As you add standing poses, such as the Warrior poses, into your practice, make sure not to square your hips. Also, I’d suggest practicing Virabhadrasana I (Warrior I Pose) with a narrow stance.
- Asymmetrical Seated Forward Bends: Think Janu Sirsasana (Head-of-the-Knee Pose) and Marichyasana III (Marichi’s Pose, the forward bending version). Approach these poses with care. These poses have potential to put asymmetrical strain on your SI joint, especially if you bend from the waist, leaving your pelvis behind. Practice with your hips elevated on yoga blankets, and stay well inside your comfort zone.
- Twists: Twists are some of the trickier poses to add back into your routine. Start with a gentle twist, such as Jathara Parivarttanasana (Revolved Belly Pose) with bent knees and support such as a yoga blanket under your knees. Make sure not to square your hips in twisting poses. Also, I’d suggest staying 5 to 10 percent inside your comfort zone, so don’t move to your maximum range of motion. The last poses to add back into your routine would be those that use the arms for leverage, the “binding” poses, such as Marichyasana (Marichi’s Pose, the revolved version). If you choose to practice these, again, stay inside your edge.
Remember that you may need to back off all practice except for Legs Up the Wall for a period of time. Asana practice has tremendous power to help us heal. Its healing power requires that we make informed choices about the poses we practice. Even more important, it requires that we practice patience. It may not be a good idea to return—maybe ever—to certain poses that put asymmetrical pressure on the joint. Kapotasana (Pigeon Pose) and Hanumanasana (Monkey Pose) come to mind.
Your yoga practice can be a lifelong ally. Part of creating a lifelong practice is to be open to adapting the practice to your body—not the other way around. So, as you practice either to heal or to build stability in your SI joint, remember to be mindful and patient. Let your practice evolve along with you.