Yoga and the sacroiliac joints
Full disclosure: I am not a yogi. I've only done yoga a handful of times, and that was only when I conceded to my wife's request to join her because, "it would be fun". I learned enough about yoga in chiropractic school to understand some of the health benefits it offers, such as maintaining good joint mobility. As beneficial as I know it to be, it just hasn't stuck with me yet. I still spend most of my exercise time on a bike. Now, having said that, I would like to discuss something that I have observed clinically in my office.
I have seen a number of patients in my office who are avid yoga students and suffer from sacroiliac joint dysfunction causing pelvis and butt pain. Not knowing if this was cause, correlation, or coincidence, I treated these patients by restoring normal motion to the joints, correcting muscle tension around the area and having the patient take a break from exercise. The good news is that sacroiliac joint dysfunction often resolves with proper treatment. But many of these patients asked me if yoga was causing their problem. I told them that I truthfully didn't know enough about yoga to comment, but in the back of my mind I kept the question:
"Does yoga cause sacroiliac joint problems?"
Joint injury is often caused by too much compression. Compressing a joint beyond its capacity to withstand the pressure occurs in two ways. A force can either be a large, sudden-impact collision like getting hit by a car or it can be a series of small, repetitive-type forces like choosing to stand in a shift stance whereby you put most of your weight only on one leg. Either way, the result can be the same: inflammation, improper joint motion, and eventually, pain.
This weekend I did an informal investigation and asked my two sister-in-laws, both yoga instructors, if they had heard of any concern regarding SI joint injury and yoga. They both replied with an emphatic yes and explained that if people were not properly aligned when doing certain poses that they could indeed cause SI joint dysfunction. Specifically, they talked about the yoga pose called, "Warrior One". One of them even stated that she often skips that pose because of her history of sacroiliac joint pain. A second concern that they mentioned was that sometimes people don't self regulate or listen to their own body. Because it is usually done in a class setting, a person may try to "match" another person in the class and do a pose that their body is not ready to do.
To validate these statements I consulted with Kim Valeri of Yogaspirit Studios. Kim has been training and certifying yoga teachers for about 20 years. She agreed with these concerns and took the time to explain the physiopathology (mechanism or process of a disease or injury) by simply stating that too much external rotation of the back leg in Warrior One can be very stressful on the SI joint. She suggested that a person focus on keeping their hips square and their back foot facing more forward when doing Warrior One pose and that this would prevent SI joint injury. She further reiterated the importance of doing each pose in the proper biomechanical alignment to avoid injury and then spouted off about 10 other poses with similar concerns and voiced the merits of working with a trained yoga teacher- such as our very own Stephanie McQuillan of Bodhi Living in Beverly, Ma.
So, in conclusion:
I am not a yogi.
Yoga is a healthy exercise and like any other exercise, it can be done improperly and cause problems.
Work with a certified instructor. A private (one on one session) may be the best way to start.
We are blessed to have a lot of great studios here on the north shore. Find one that fits you and have fun.
Dr. Jerry
P.S. If you see my wife there, tell her I'll join her next time.