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SI Joint Dysfunction

orchid2010-07-04 22:27:02 +0000 #1
Hi there,

This is my very first post on this forum, and - in short - I was hoping Mukunda or one of his students could provide some guidance for a problem I'm having... I purchased Mukunda's book - Structural Yoga Therapy - a little while ago and really thought it was interesting. (I found out I have hyperextended knees, and since Mukunda's book familiarized me with some of the "effects" of this hyperextension, I've been able to consciously correct for them by improving my posture, etc. Also, learning about which poses isolate particular muscles has been quite helpful.)

But let's start at the beginning... I'm a 26 year-old female, married, with no children. I'm an engineer, and my job is rather stressful. The good news on that front is that I am going to be switching jobs soon - to one that I truly believe will be more enjoyable. My husband and I live in a high-rise apartment - we recently purchased a condo, and will be moving in soon! I keep a variety of plants (indoor and outdoor), including orchids! I love to read about all kinds of things- I usually have several books going at once. I also enjoy cooking and other domestic-type pursuits. I've been practicing hatha yoga since I was in college - it's been about 6 years now. It all began when I joined a jujitsu class, and our sensei incorporated the warrior series into every practice. I loved it so much that yoga stayed with me long after I left the jujitsu class. Since I've moved a lot, I haven't stayed with one instructor until recently - I've been with my current instructor for about one and a half years. Her class is like a moving meditation, and she's very passive about adjustments - in that she rarely gives them! I really enjoyed this sort of non-interference in class, but - in hindsight - I think it has contributed to my recent injury. In other words, I believe some of my poses have gotten sloppy, but she hasn't said anything. This has probably become especially problematic since my poses have been steadily advancing in difficulty. If you don't have the basics down perfectly, it's easy to hurt yourself in the more advanced poses. But anyway, that's a side-bar, because I believe my injury occured while I was doing rather "basic" poses.

During my practice (which I do three times a week - twice with my instructor and once at home), I've been spreading my knees further and further apart while in childs pose. At first, it felt great to release all that tension in my lower back, and spreading my knees seemed to release the tension even further. My instructor said, "spread your knees as far as it feels comfortable," so I have been! In the past month or so, however, I noticed that spreading my knees in childs pose started to make my lower back and hips ache a bit while in the pose. The ache quickly went away when I came out of the pose, and I hadn't been spreading my knees any more than usual, so I basically ignored it - not a good idea. I think spreading my knees so far apart may have loosened up my sacral region too much.

I also do about 7-10 minutes of the warrior series during my practice, and this is where I believe - again in hindsight - I've gotten sloppy. When I would bring my foot up to meet my hands while transitioning from down-dog to warrior one, I used abs less and less and began swinging my foot forward. One day, I did this and pain spread from the right lower side of my lower back/hip area over to the outer side of my hip. This was about two weeks ago. Ever since that day I've felt this ache in my lower back/hip area - just to the right of my spine. It's been worse when I sit down, and it feels like something is out of kilter - rubbing maybe? Also, my right sit bone aches - especially when I stand up and put weight on it. I have discontinued doing yoga altogether - I truly don't know which poses will make the problem worse, and I don't want to risk aggravating it without knowing more. It seems like this area of my body is involved in so many of the poses I do! I did a rapid-walking session on the treadmill, however, several days after my injury, which seemed to make it MUCH worse.

Anyway, I visited a DO a couple of days ago. After I told him what happened, he declared that I had dislodged my SI joint. He proceeded to examine me. He had me walk on my heels forwards and backwards. He had me lay on my belly on a table, while he pressed the area around my sacrum. He then told me to lie on one side with my knees bent and press my shins outward (he was providing resistance). I then did that on the other side. Then, with me in that same position, he proceeded to quickly twist my lower body, which seemed to crack a bunch of stuff down in my lumbar and sacral region. He did this with me lying on both sides. He stated that he had put the SI joint back where it belongs and I should notice marked improvement.

Since that visit, I have noticed SOME improvement - the ache in my SI region is certainly less frequent. Prior to my "adjustment," the ache had been constant. I expect that any inflammation which is present will probably take a few days to go away. However, the ache in my sit bone is still present, and it hurts a lot to traverse stairs.

My question to you is this - is it even possible to put the SI joint back into place, as the DO claimed he did? Also, if my SI joint is back in place, what can I do to keep it moving properly? Does this problem completely resolve or is it something that will always be with me? I know this is a long post, and if you've made it this far - thank you. I'd appreciate any help you can provide.


InnerAthlete2010-07-04 22:29:38 +0000 #2
Hello Orchid.

Yes, it is possible for the sacrum to move in a way that it is not intended to move. Thus, "yes" it is possible to adjust, set, or realign it.

With SI dysfunction (which is a broadbrush term) it is possible, no, probable, for the musculature surrounding it to spasm, seize, or generally become unhappy. It may take quite some time to "recover" and that would depend on your lifestyle, nutrition, and your practice.

You may also have some other things going on at the same time. Only rest and time will tell.

I'm giving you a brief reply based on your question, though the topic can go on ad nauseum.
orchid2010-07-04 23:01:20 +0000 #3
InnerAthlete,

Thanks so much for your quick reply!

I think I was skeptical about the possibility of "setting" or "aligning" this joint because it doesn't appear to be like other joints in the body, which can experience relatively large amounts of movement. I think it would be difficult to tell if one has truly reset this joint at all (by moving it mere millimeters?), unless of course pain diminishes after the adjustment. So I guess we'll see what happens!

Your comment about the surrounding musculature makes a lot of sense. I'm sure I really strained all of my glut muscles and perhaps the hip flexors. I imagine any problem with these muscles can directly effect the stability of the entire area.

As for my lifestyle, it mostly consists of sitting, standing, driving, and walking right now - this is the bare minimum of activity I can get away with. I plan to ask the DO what types of exercises I can do without aggravating the area, because I really hate sitting still and I don't want my muscles to atrophy. I'm prepared for the possibility that I might not be able to do much for a while though. My nutrition is pretty excellent - little or no processed foods, no red meat, lots of fresh fruits and veggies, etc.

Thanks again for your thoughts - like you say - it seems like only time will tell. It's certainly unfortunate that I hurt myself, but it's been quite a learning experience, as far as my approach to my practice is concerned...
orchid2010-07-04 23:03:07 +0000 #4
Well, it's been about a week, and I thought I would log how my recovery is going. It's been very interesting. The pain around the SI joint has dissipated, no doubt in response to my prior adjustment of the sacrum. However, the muscles in my right posterior have remained irritated. I went back to the doctor for another checkup, and he told me that the piriformis muscle was extremely tight. Apparently it was also pressing against my sciatic nerve. This piriformis/sciatic nerve problem is evidenced by my right toe turning about 15 degrees to the right when I'm standing in mountain pose, as well as general pain and tenderness on the piriformis muscle and in "patchy" areas on the outside of my right leg. The doctor prescribed some stretches for the groin and hip, as well as some OTC ant-inflammatories. So far, the piriformis doesn't enjoy being stretched, but I guess the stretches are important to restoring complete range of motion in the muscle. According to my research, since the piriformis connects to the sacrum near the SI joint, SI joint problems and piriformis/sciatic nerve problems are sometimes found together. Anyway, I'll keep doing the stretches - hopefully that helps.

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