Back Care Mantra - How to deal with Sacroiliac Pain

By Yogesh Varun
Sacrum is a Latin word for sacred bone. In yoga, the sacrum is considered the form of Sakthi. Sakthi means the female
power which resides dormant in the base of the spine and travels upwards to become one with the Siva, the male power -
this process is called kundalini yoga.
The sacrum is made up of fve vertebral bodies united by four ossifed vertebral discs. The frst sacral body has a prominent,
oval, upper surface with a distinct forward tilt. The body of the frst coccygeal vertebrae is united to the lower end of the
sacrum by a fbro cartilaginous disc making this a moveable joint; so we can actually wag our tails like a dog or a cat.
The sacroiliac joint or SI joint is the joint in the bony pelvis between the sacrum and the ilium of the pelvis, which are joined
together by strong ligaments. Sacrum + ilium is called sacroiliac joint. In humans, the sacrum supports the spine and is
supported in turn by an ilium on each side. The joint is a strong, weight bearing synovial joint with irregular elevations and
depressions that produce interlocking of the two bones. The human body has two sacroiliac joints, one on the left and one
on the right, which often match each other but are highly variable from person to person.
What is a Sacroiliac Pain?
Many people confuse sacroiliac pain with sciatica because the two conditions share similar symptoms, a pain between the
sacrum and the hip on one side. The reasons for the pain are quite diferent. Sacroiliac pain is caused by misalignment and
a prolonged stress in the sacroiliac joints (SI joint) on either side of the base of the spine, where the fat triangular sacrum
joins the other bones of the pelvis. Sciatica is caused by irritations or pressure on the sciatic nerve as it exits the sacrum and
passes between the layers of the deep buttock muscles and then into deep muscles of the back of the thigh. With sacroiliac
problems, the pain is felt in the SI joint. With sciatica, the pain if felt deep in the buttock in the soft tissues near the SI joint
and extends down the leg along the course of the sciatic nerve. It is not unusual for the two conditions to coexist when tight
piriformis muscles pull the sacrum and the pelvis closer together, simultaneously compressing the sacroiliac joint and the
sciatic nerve.
Cause for the Sacroiliac pain
The joints of the bones that form the pelvis, unlike those of the arms, legs and spine, are held frm together by ligaments to
give great stability and to allow little movement. The SI joints are on the either side of the base
of the spine, where the sacrum meets the wing shaped ilium bones of the pelvis. To feel your
SI joints clip your thumb pointing forward and the fngertips pointing towards each either
below the waist. As the tip of your fngers will rest at the slight bulges marking the SI joints.
Sacroiliac pain results when slight pelvic rotation creates abnormal stresses on the ligaments
that join the two bones together. Prolonged stress on the SI ligaments can eventually result in
wear and tear of the joint surfaces causing additional pain. Sometimes the SI joint pain is
misunderstood to be a lumbar or the lower back pain.
The pain caused by the SI joint can also be experienced in the groin, back thigh, and lower
abdomen. SI joint problem can be caused by the joint itself or can be caused by the nerve
signals sent to this area by the injury elsewhere, such as lower lumbar spine or the hip joints.
This causes the dull and heavy feeling in the legs.
Asymmetrical pelvic bones, uneven legs or hamstring length can also cause the SI joint pain.
A hyper mobile SI joint often leads to SI pain in pregnant women due to the hormone relaxant,
which relaxes the ligaments in preparation for the childbirth.
Stretching the hamstring, buttocks and lower back muscles, which frequently go into spasm when there is a SI problem, is
essential to get some relief from the pain.
Strengthening all the muscles of the hip girdle to provide support for the pelvis and strengthening the abdominal muscles
to support the front of the spine will reduces the stress in the SI joint and brings stability in the pelvis.
Things to understand
The cause of the SI joint pain is due to a misalignment in the pelvis. To understand the problem you must be aware of the
asymmetry that exists and any asymmetrical posture will make things even worse. Things like sitting cross-legged or
standing with your weight on one foot should not be done.
You may experience pain in the joint when you hold a weighted object on one side of the body. Because the pelvis is rotated
to the right or left, there may be tenderness and pain in either sacroiliac joint. In order to perform the therapeutic posture
for the SI pain, you must know which side of the pelvis is rotated. If the pelvis is rotated to the right then the right SI joint
will protrude more prominently than the left. Similarly if the pelvis is rotated to the left, the left SI joint will be prominent.
Hatha yoga is all about alignment and bringing symmetry in the postures. Samasthiti also called Tadasana (the mountain
pose, standing up straight): the very name gives the depth and the purpose of the posture. Sama means upright, straight,
unmoved or even; sthiti" means still or steadiness.
Bring stillness or balance in all our postures is very important, no matter what activity we do in our daily life. There are many
reasons that can lead to pain in the SI joint, or any other part of our body. The only reason yoga says is imbalance in the body.
Most of the time one may not even be aware of how the pain began
One should not panic or become depressed, simply become calm and accept or recognize the pain and practice with
awareness to heal on your own. One should avoid practicing intense forward bending postures or backward bending
postures and start practicing some restorative postures. Restorative postures will energize, relax and relieve stress from the
afected area. Some of the following asanas will help to diagnose, strengthen and heal SI joint pain. Practice some of the
calm and basic asanas for a week or until the pain has subsided. These times will be memorable as how far you can be true
to yourself. You will have a better understanding and an invaluable experience born in your yoga practice.
Pain is my Guru - B.K.S.Iyengar
Asanas
Jathara Parivaritanasana with the legs bent will help determine which of your SI joint is
more prominent.
Lie down on your back with your knees bent and your feet parallel on the foor a few
inches away from your buttocks. Make sure you dont have any towel or soft cushion
under your sacrum.
Keep your knees together and your feet on the foor. Move your knees slowly to the right
about six to eight inches, and then back to the starting position. Then move your knees
slowly to the left and then back, repeat this at least ten times.
Pavana muktha asana. - Figure A and B
Lie down on your back with your knees bent. Cross the left leg over the right and
rock back and forth over the sacrum for thirty seconds. Then put the right leg on top
and repeat on the other side.
By performing both Figure A& B, you are massaging your sacrum and the SI joint against
the foor. Stimulating them sends waves of relaxation up the para spinal muscles,
encouraging them to release their spasm. For this reason, use a frm surface and perform
the pose gently as you can comfortably tolerate. Notice any asymmetry in the right and
left side of the sacrum during the rocking action. If one SI joint seems to push into the
foor more prominently than the other, the pelvis is rotated to that side.
Supta Baddha Konasana Figure C
Lie on your back. Keep the soles of your feet together with your knees bent and have your heels as close to your sitting
bones as comfortably possible. While breathing, quietly rock your pelvis slowly in a
circle over the sacrum pressing along its outer edges.
Imagine a circle around your sacrum and move the weight of your pelvis smoothly
around the periphery of that circle. Go around the circle clockwise twice and then
counter clockwise twice. Repeat two to four times.
By moving the pelvis in a circle, you can massage the sacrum and determine additional
information about the symmetry of the SI joint. The SI joint will gradually slip back into
alignment. This is also an abdominal muscle strengthener.
Pavana muktha asana - Figure D
This pose will help you correct pelvis torsion. Lie on your back with both knees
bent, feet on the foor.
Bend the knee on the side of the more protuberant SI joint towards your chest
and hold it there with your hands holding the back of your thigh, not your knee.
Straighten the other leg and lift it three inches from the foor. Stretch out
through the heel and then slowly place the leg back on the foor.
Draw the bent leg closer to the chest. Lift the straight leg three inches from the
foor, extend it out to the side as far as it will go. About one to two feet and the
slowly lower your legs. Do the same thing with the other leg. The weight of the
leg helps to derotate the pelvis.