Wednesday, March 2, 2016

SI-joint dysfunction may be exacerbated by some yoga poses

As a teacher of yoga therapy i should have known better...a large, mixed-level class taught by a young, very flexible Indian man in a local gym is not something i would recommend to any of the menopausal women i teach. But after practicing alone, and within my comfort zone for a long time, i accepted the free pass and decided to give it a try. Huge mistake. This free class resulted in a back injury that left me unable to teach and practice for 3 weeks!

Yes, i know, i should have listened to my body and put into practice what i tell my students, 'always work within the limits of your body, because everyone is different, your goal is feeling better, not joining the circus'.

But i forgot to leave my ego out of the door before rolling out my yoga mat. Besides, the teacher's 'military drill' style of instruction didn't leave much room for reflecting on and questioning his orders.

The sequence of poses was very odd, it overworked certain muscles and privileged asymmetrical poses. It just seemed to reflect a desire to show off the teacher's flexibility rather than cater for the different levels of ability and experience that one expects in a multi-level class. If he had set different intentions, they were totally lost on me.

The majority of people in the class couldn't safely perform most of the poses he had selected, but that didn't deter him. Instead he focused on those he deemed flexible enough to go deeper into those poses, and pushed us far beyond our comfort zone.

My injury happened because the sequence was ill-thought out and included an excessive number of revolved poses which we were asked to hold for a long time. Revolved Triangle Pose (Parivrtta Trikonasana) was followed by Revolved Side Angle Pose (Parivrtta Parsvakonasana) but the proverbial straw that broke the camel's back was Archer Pose (Akarna Dhanurasana) as i sat there holding my foot close to the side of my head the teacher stood behind me and prompted me 'pull your leg closer to your ear'. At that point I heard a snapping sound. That was my SI-joint. The pain became unbearable. I recoiled in Child Pose and stayed there till the end of the session. Then i could hardly walk back to the changing room. For the next 10 days i couldn't walk without a stick, let alone teach or practice yoga. It took me 3 weeks to recover.

Archer Pose might be one of the oldest classical yoga poses but is contraindicated for people who suffer from lower back pain and SI-joint dysfunction (a large part of the population!) and is one of the poses i never practiced because the risks outweigh the benefits, especially for women. Now i have definitely consigned this pose to the scrap heap.

It’s very important for yoga instructors to know the joints normal range of motion. It’s unnecessary, and many times unhealthy, to go over normal joints range of motion at any circumstances. Encouraging students to push their limit is unwise and in my opinion contrary to the spirit of yoga, which is not a competition.

There is no health benefit in having a hyperflexible body or being able to twist yourself into a pretzel or able to do splits. In fact, pushing your body into extreme stretches can cause injuries.

Women are more susceptible to sacroiliac trouble than men for several reasons. For starters, the width and structure of the female pelvis makes the SI joint less stable in women. Next, women (on average) have more flexible ligaments than men. By now we have enough evidence that many yoga postures do contribute to sacroiliac problems. Especially when the top of the sacrum tilts too far forward on one side of the body relative to the ilium. This may happen, for example, in asymmetrical forward bends, side bends, revolved poses.

Anybody suffering from Si-joint dysfunction should be extremely cautious and focus on strengthening core muscles rather than increasing flexibility in this part of the body.

PS: The Sacroiliac joint (SI-joint) is located between the ilium and sacrum (sacral vertebrae).

This joint does not move very much but it is critical to transferring the load of the upper body to the lower body and provides shock absorption for the spine.

SI-joint dysfunction is a common source of back pain.