I gotta say: I had never heard of sacrum problems before I began my Viniyoga instructor training course. Yeah, I knew what a sacrum was, however my very first instructor training course had never discussed it, and my students had never raised any complaints regarding the matter. I had never had any trouble myself with it. There I went through life just completely ignorant of the matter. Then… I began my Viniyoga instructor training course. Out of nowhere, the sacrum had come to be something of vital importance. I began to hear things like “don’t do this pose if you have sacrum issues,” “to take care of your sacrum, make sure to do this,” “don’t let yourself feel any discomfort in your sacrum,” and so forth.
It’s kind of like when you buy a car in a certain color and then you start to notice it everywhere. Well it was the same way with the sacrum and how many people had issues with it.
So, in order to be a bit more specific, it isn’t actually the sacrum we may have have problems with, but rather the SI, or sacroiliac joints (unless you experience back or hip pain).
Just to remind you of where it is located, the sacrum is right at the bottom of the spine. It happens to be made up of the five vertebrae bones which together are about the size of your hand and are fused together to form one solid base for your spine. The sacrum fits snugly in the middle of your right and left pelvic bones and is joined to them through the SI, or sacroiliac joints.
Sacroiliac Joint Pain Relief During Yoga
Sacroiliac joints happen to be weight-bearing. This is because the sacrum holds the load of your upper body and the forces are transferred through these joints to the pelvic bones. Your weight is then further carried by your legs from there. As with any load-bearing joint, stability is key to being pain free. Hence several ligaments are in place to bind the pelvis to the sacrum to restrict any over-extended movements.
A certain number of us may have a bit more flexibility in our sacroiliac joints than other people. This is what can potentially cause problems. The sacrum itself may have a tendency to lean forward a bit with respect to our pelvis (which we refer to as nutation) or perhaps a bit back (which we refer to as counternutation). It may lean 5-10% at the very most. However, even this amount of offset can result in a sense of our pelvic area not being stable.
Women coming of reproductive age – Essentially the flexibility of their sacrum is to allow the passing of a baby through the pelvic opening. Counternutation is first to provide an opening for the baby’s head to come into the pelvis while nutation then allow tailbone to move out of the way. The fact is that in pregnant women, relaxin is released, which is a hormone that provides more flexibility for the ligaments so that it can accommodate the process of birthing. If your students have given birth before, are of reproductive age, or are pregnant, they may have more flexibility in their sacroiliac joints.
There are some of use that may have more flexible ligaments than others. This is because some of us happened to be born with more flexible ligaments that allow us to enact more advanced yoga poses. However, this also provides more risk to injury to our sacroiliac joints as the extra mobility in our sacrum is a given.
So the problem may be that when you’re a young girl, you’re trying to put your foot behind your head. When you do this, your sacrum has a great tendency to move out of place, and this is usually on just one side. When it is actually forced out of place, it will tend to pull on ligaments which are meant to maintain its positional integrity. This could cause a sharp pain to arise above one of her hips on one side of her spine. When this happens, it could take a long time for the pain to go away and for this injury to heal because ligaments, like cartilage, are avascular. This means that they get very poor circulation. When parts of the body do not get ample blood flow, they do not get a regular supply of nutrition that provides for the building blocks of healing.
Once you unfortunately injury the area, you may just be prone to injure it again. This is especially true if you are practicing yoga that focuses on some extreme poses while you are ignoring the pain signals that your body is sending you. A student may have a “hot sacrum” if it is prone to injury. Women that are suffering from this will need to change their yoga routines as they remain in the healing stage. It is important to practice healing yoga after you are injured to minimize the chances of injuring yourself again.
What Are Ways We Can Minimize Injuries To The Sacrum?
Do not teach asymmetric poses to these students. This is especially true for those where one of their hips is in a raised position curving the spine towards their other hip. However, take a look at Janu Sirsasana which is generally not an advanced pose yet does aggravate sensitive sacrum.
Pulling The Sacroiliac Joint
You may take great care when teaching the advanced asymmetrical pose:
Don’t utilize the leverage from your arms to put yourself into this pose when you feel pain in your sacroiliac joints.
Be sure that the bodies of your students are amply trained preceding any attempt to make these advanced poses especially if they cannot yet touch their toes.
Be absolutely sure not to demonstrate advanced yoga poses to your class if you are not properly warmed up yourself. This is the leading cause for injuries to yoga instructors.
Be sure to let your students, as well as yourself, to stop if it hurts.
Don’t show your class too many asymmetrical poses that only involve one side. This can cause accumulating tension on the sacroiliac joints. Let’s take a look at some of the poses I was presented in one of my most recent classes:
We actually did this entire sequence on just one side first while we were holding each pose for 4-6 breaths. We never asked about moving over to the other side or changing the position of our feet and utilizing abdominal contraction to support us.
Can you begin to see issues here? Our left leg remains in a fixed position and means our left side of our pelvis will stay in mostly a forward-facing pose. When you take your spine through a forward bend, side bend, and forward bend, then twist your sacrum tends to follow the motion of your spine. This causes twisting, torquing, and tugging the left sacroiliac joint.
This certain motion happens to remind me of attempting to remove the top part of a plastic bottle. I mean to break the little piece of plastic you would have to keep bending back and forth until it finally came free. This is a similar motion you are doing to your sacroiliac joint. Sure the sacroiliac joint wouldn’t just break off, however it may destabilize and become more susceptible and vulnerable to injury.
Don’t force them to keep their legs straight during forward bends because it creates what is known as shear stress on their sacrum.
When you create the curriculum of your classes, ensure you don’t forget to include certain poses that will help to stabilize their sacrum.
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