Get To Know Your SI Joints!

SI Joint and hip bones for yoga
Illustration by Sharon Frost

Remember singing Dem Bones when you were a wee tyke? “The hipbone’s connected to the backbone” isn’t a bad beginning to anatomy lessons, but for those who practice asana, a few more details are helpful. The part of the backbone where the hipbones connect is the sacrum, and the connection is the sacroiliac joint, or SI joint for short. Refining your awareness of the SI joint can help you establish an asana practice that is pain-free…and even profound.

The sacrum, a wedge-shaped bone fused from five vertebrae, forms the back of the pelvic bowl, joining with each hipbone (ilium) at a cartilage-lined surface. Though short but strong ligaments limit SI joint movement, many asana students are all too familiar with the feeling of an out-of-whack sacroiliac, an SI joint prone to slipping out of alignment. Generally speaking, due to the shape of the female pelvis, women are more likely to experience what doctors refer to as SI joint dysfunction.

Keeping the SI joints in line begins with knowing where they are. Turn your back to a mirror and look above your bottom for the dimples of Venus, then reach back and slide your fingertips over them. Medial (closer to the spine) to each dimple, you’ll feel a bony landmark, the posterior superior iliac spine (PSIS for short). And just medial to each PSIS is the SI joint.

Signs of SI misalignment may be as subtle as always sitting with the same leg crossed to relieve joint pressure. Or you may feel a dull ache localized at the SI joint or spreading to the back of the thigh. Sometimes SI misalignments are mistaken for sciatica or lumbar disk problems. If you suspect you have an SI issue, check your joint alignment. Lie on the floor face up, and notice if one PSIS feels like it’s larger or pushing harder into the floor. (It helps to rock or circle over the sacrum.) Or stand in your very best Tadasana and have a teacher or partner check to see if one Venus dimple is higher than the other.

Yogis with pelvic hypermobility might notice a popping sensation in one SI joint during a particular asana, a sign that the SI has slipped out of alignment—or back in. The cause and cure may the very same asana, often a deep reclining twist like Jathara Parivartanasana. SI injuries can also occur during seated twists or aggressive forward bends or backbends. Over time, SI misalignment can lead to joint stress and uneven wear or inflammation.

To avoid SI injury, strengthen the muscles around the joints (massage the sacrum by rocking and circling it on the floor) and always practice asana mindfully. Bend from the lower hinge of the pelvis—the hip sockets—and not from the waist. During twisting asanas, spend a few breaths lengthening the spine before rotating. Rotate the spine gradually and evenly from bottom to top, beginning in the navel area. Move on the exhalations, pausing on the inhalations to allow the breath to “inspire” more length.

For those with tricky SI joints, the safest way to twist is with the pelvis firmly in neutral, such as from Vajrasana (Thunderbolt Pose). In twists like Bharadvajasana, turning the hips in the same direction as the chest can help protect the SI joints. Avoid pelvic torque when twisting deeply in a supine position (as in Jathara Parivartanasana), or when beginning a seated twist with one side of the pelvis higher than the other. (In this case, raise the lower hip by placing a folded blanket underneath.) In twists like Ardha Matsyendrasana (Half Lord Of the Fishes Pose), avoid using the upper body or arms to muscle your way into a deeper spinal rotation.

But even when we are armed with knowledge of contraindications and modifications, the delicious release of a deep twist can tempt us to overdo. Here’s a safer way to explore the depths: Go beyond physical anatomy to the esoteric realms. In Latin, sacrum means “sacred,” and in ancient Rome and Greece, the shallow bowl-shaped bone was associated with ceremony. In shamanic traditions, the sacrum was considered the seat of the soul, necessary for resurrection. In energetic anatomy, this is the location of Svadisthana, the second chakra, whose name translates as “one’s own place.” It is where your mother carried you, and where, perhaps, you’ve carried your own babies.

The lesson is that if we approach twists or any asana as something sacred, we are less likely to do harm. Have you triggered or healed an SI misalignment with asana? What have you learned?

Comments 4

  1. Hello, I have never tried yoga, I’ve always wanted to, but due to arthritis in my hips and scoliosis in my spine I wasn’t able to. In the past two years I’ve had both of my hips replaced. My hip pain is gone, but of course with artificial joints, I have restrictions. I still have a spinal issue but I try not to let it keep me down too much.
    Is it possible for me to learn yoga and do it efficiantly to benefit from it?

    1. Yes, Carrie, with modifications, you can safely practice. Yoga has helped many people with scoliosis and other spinal issues, and some teachers offer classes that focus specifically on back pain. When I started practicing yoga, one of my classmates was a gentleman with bilateral hip replacements. Our teacher showed him how to use a chair for sun salutations and helped him modify other poses. He was an inspiration to all of us!

      I recommend you begin by seeking out a gentle class with an experienced teacher. Talk to her about your concerns prior to class. Other options are to start with one or two private yoga sessions before joining a public class, or to see a yoga therapist.

      Best wishes for your health!

  2. I have a hypermobile S.I. joint on the right side which is most likely do to weaker hamstrings and gluteal muscles as my right innominate (hip bone) is more anteriorly rotated then the left. The right side is also where I have pain.
    I’ve learned in massage therapy school some very handy muscle energy techniques to help distract the S.I. joint from any adherence to in the innominate that may be causing the discomfort. It helps relieve the pain. And knowing that I am anteriorly rotated at the hip on the right side, working to strengthen those glute muscles and hamstrings that attached to the back of the pelvis will help pull that right hip back a little into either a more neutral position or a posterior rotation. It’s incredible how much it’s been helping.
    Increasing awareness on how one sits is crucial too. I have a habit of crossing the right leg over the left and twisting to the right to use my computer at my kitchen island. Big no-no. Sitting up straight, facing completely forward with my whole body with the core engaged is essential which inspired me to do plank daily to help strengthen my core and low back. Those surrounding structures that attach to the pelvis must to have the strength to support it. Strength in general will make the world of difference. So often is the case that the side of the body that is hypermobile and weaker will be the side that gives you pain. Not always the case, but something worth talking to your massage therapist or yoga therapist about so that you can start to get an idea of what exactly you need to do for self-care or your personal practice to help bring your body into a better balance.

    :)

    Namaste!

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