Saturday, May 06, 2017

SI joint, new insights from someone who has been there


Yesterday I listened to a video with David Keil on the SI joint. David Keil is an expert for three reasons:
1. He is an Ashtanga yoga practitioner for decades and also a teacher
2. He wrote a book on anatomy
3. He had awful lower back pain, caused by the SI joint, too.

What strengthens my hope. He got rid of it.
I don't know how often I nodded with my head when I listened to his video. He verbalized what I felt. I know that I'm right with my theory and my experience. I got background information.

I share this experience and also what I think might help to get rid of this pain, because there is not so much expertise. One must really search to find information.

David Keil first described the pain. It can be felt as a bit of pain. It can be also be experienced as a nightmare that influences the entire life. There he was. There I'm sometimes.

What caused this pain?



The first reason that David mentioned were the leg behind head poses. Many students of Ashtanga yoga are not yet ready for this pose. They force the leg behind the head. The hip doesn't allow this movement. Quickly the SI joint is injured. 
In my case my hips were open enough after a decade of daily practice. The picture is from 2015 before my injury. I can tell exactly when I injured myself. It happened while performing one of these leg behind head poses, but not because I was not able to do it, but because I got too fast into such a pose. 
I've been in a led class. 80% of the students in led classes are beginners. So the teacher helped several students to bind marichyasana C and D. I got cold. Due to this interruption of the flow time for the rest of the series was short. The teacher started counting faster. Students for the next class were already in front of the door. Quickly I moved into supta kurmasana as I liked to perform this pose. Damned, I felt at once that I made a wrong movement. 
I cursed and swore not to go to a let class anymore.
As it is these days, led classes are designed for beginners. 
Then followed the next huge mistake. The pain didn't disappear. I wanted to avoid all the leg behind head poses, but I was asked to practice them in the Mysore classes. This made everything worse. I didn't go to classes anymore. 

What is injured?
According to David Keil the SI joint is held by ligaments. Ligaments cannot be stretched. They hold the joint. Many soccer player or basketball player tore ligaments, mainly those of the knee joint, finger joint, feet joint. Who tries to take the leg behind the head? It's a minority world wide. This is also why most doctors have no clue. 
The consequence of this injury of the ligaments of the SI joint is that the muscles around this joint are stressed and hurt.

What can be done?
1. Please have a look at the first picture. When the body moves forward, the lower back must carry a lot of the weight of the body. This hurts, when the joint is injured. During the last months I avoided this pose. I practiced a variation. I lied on my back. It's a hip opening asana, it's not necessary to balance in addition. 
This also explained why I couldn't get into sirsasana (headstand) with straight legs. It has been too painful. The back had to carry my body weight, this was not possible anymore. Some students are rather long in sirsasana. It's not recommended to be longer in sirsasana with the legs parallel to the floor as it's too much stress for the back. 
I had/have pain when performing all these forward bending asanas while starting from a standing position. I'll avoid this till my back is healed. I can support the movement, I can put weight on the arms. It's possible to get into sirsasana with bent legs.  There are variations, that don't put pressure on the lower back.
In sum: All forward bending asana that stress the lower back shall be avoided. It's easy to find out which poses shall be avoided as it hurts to practice them. 
2. All poses that are not symmetric shall be avoided, according to David Keil. This can even be Janu Sirsasana A.
3. Last but not least something that can be done actively. Muscles are the second layer. Strong muscles can protect the joint and ligaments. Also this can be felt. When I engage my abdomen poses become less painful. Strength training is important. Strong abdomen protect the lower back. 
4. Fascia massage of the back muscles bring almost immediate relief. 

Obviously ligaments need to heal. Even inflammation can arise. It takes time. But healing is possible. 

What I still don't understand is why the pain disappears when I move. In the morning when I wake up back pain is so awful, I really wonder why. This makes it difficult to start practicing. 

Saturday is my day off. 

A lot can be practiced, but pain must be avoided. 
Strength training is important!!!! I'll start my yoga practice with strength training. It's a good warm up. 



2 comments:

DebbS54 said...

I can't tell you how very sorry I am that this malady continues for you. Please, don't ever lose hope that it will be healed. I had SI joint injury now about 4 years ago? It did take about 3 years to heal completely. But it did heal! (I know every body is different though, as well as the severity of the injury) Now, I have other "ailments" haha... Recently, about 5 months now, it is my outer hip on the side, where the leg starts, sitting cross legged is PAINFUL, I must always sit with this leg extended. But, three weeks ago I suffered with a case of The Shingles (result of chicken box in childhood) it attacks the nerves. I had it in my neck and scalp. Very painful. Consequently, I did not exercise or do yoga for about 10 days, and that was enough time for my hip issue to heal. But, as soon as I started my yoga practice again, it has come back just a bit. I think of you often as I am on the mat, and appreciate your continued blog, I find it inspiring and comforting.. my best wishes for you, dear U..

Ursula Preiss said...

Dearest Debra,

Oh my, I regret that you have some issues as well. I often think of you. I appreciate that you shared your story with me. It gives me hope that my back can heal, too.
I don't want to complain. Neither do I blame anybody. But that's what on my plate now. My yoga must go in a new direction. To go to the limits every day, only on moon days not, is too much. Now I get to know another part of this practice. One must practice smart.
B.K.S. Iyengar has had a lot of issues, too. This is not a reason to stop practicing yoga.
I'm relaxed.
A few weeks ago a dear friend of mine passed away. We're still alive. Live has so much to offer. My back pain is not so important. I write about it, because it's now part of the journey. Perhaps my experiences can help someone some day. I'm also so happy when people share their stories.