Wednesday, November 11, 2009

Triangle Pose and your SI joints


The other day I was reading an article about yoga injuries. When you're a full-time yoga teacher, the subject of yoga-injuries is a pretty disheartening matter. I imagine an auto mechanic feels similarly when a wheel falls off during a test-drive (ahem, not that I know anything about that particular example!).

The article, titled Understanding and Preventing Yoga Injuries, appeared in the 2009 International Journal of Yoga Therapy. While yoga remains a safe and effective path, the article underscored the need for yoga teachers to better understand the mechanics of the body.

I was watching a colleague teaching Utthita Trikonasana, commonly known as Triangle Pose. It is virtually ubiquitous in most yoga classes; and while it has the potential to open the hips and free up the spine, it also has the potential to strain the sacroiliac (SI) joints. Given how many millions of Triangle poses are likely taught each day, a deeper understanding of pelvic anatomy could help many people live happier in their body, rather than contributing to the statistics cited by Dr. Fishman and his colleagues in the article.

Each joint has its healthy range of movement, just like the hinges of a door. Within that healthy range of motion, practicing yoga creates a healthier, stronger and more flexible body. Moving beyond that healthy range of motion places stress on the joints; and persistent stress on a joint is likely to be injurious. Perhaps you've had a door yanked out of your hand by a gust of wind? Most of the time it's no problem, though occasionally the hinges are bent and the door no longer closes properly. Triangle Pose, if done correctly, exercises the hip joints and surrounding musculature. Done incorrectly, this pose torques on the SI joints, which may cause sufficient strain , and subsequently, injury. Door hinges can be replaced - SI joints take a long time to heal.

The hip joint is a ball and socket joint. Like any joint, there's a balance of stability and mobility. Because the hip joint bears so much of the body's weight, its design favors stability over mobility. The hip joint has huge range of motion in flexion (folding forward) and significantly less mobility in abduction (movement to the side).

When a yoga teacher suggests that the pelvis face straight forward in Triangle Pose (perhaps you've heard the instruction: "like your pelvis is between two panes of glass") they are insisting that moving into Triangle Pose comes primarily from abduction. Because the hip socket has less range of motion in abduction, bringing the hand to the floor or onto a block takes the hip joint to the limits of its range of motion, and beyond. Unfortunately, it's often the sacroiliac (SI) joints that pay the price. I've seen many yoga students injure their SI joints in Triangle Pose.

In Triangle Pose, the hips should not face straight ahead. Yes, many practitioners can do that; though in the process they're often putting the hip socket into a bone-on-bone situation, or they're asking their SI joints to torque in an unhealthy way. When practicing Triangle Pose, be sure to let your hips turn slightly to the floor as you enter the pose. Once you're sure that both sides of the waist are lengthening evenly, then experiment with turning the hips forward. Since your body-weight is already shifted into position, the turning of the hips is less likely to strain the hip socket or the SI joints.

Caveat Emptor
The benefits of yoga come through regular practice. It's through regular practice that yoga passes from a theoretical pursuit, to a highly practical and life-affirming endeavor. It's also through practice that you get to test the instructions that got you on the road to a home practice. If these cues yield more vitality, you're on the right track. If you feel drained or injured after a particular pose or sequence, then you know there's something amiss.

Most yoga teachers are repeating the instructions they heard from their teacher. Their teacher is most likely repeating the instructions they heard from their teacher, and so on. The vast majority of instructions are insightful, beneficial and most assuredly safe. Some of these instructions, however, are taken out of context. Some of these instructions were misunderstood (remember playing Telephone when you were a kid?). Some of these instructions were flat-out inaccurate/incorrect years ago when they were first spoken, and have survived largely because the originating teacher spoke them with such confidence.

Many yoga injuries can be prevented. Be sure your yoga teacher is well-versed in anatomy and physiology. Also be sure they’re thinking independently, and not simply repeating what they’ve heard without having tested it in their own practice. If you feel pain, discomfort or feel drained in a particular position, inquire whether you’re moving in harmony with the body’s mechanics, or in opposition to the body’s brilliant design. Let’s see yoga injuries become a footnote in the history of this great path!

Namaste,
Scott
www.alignmentyoga.com

7 comments:

devDillinger said...

Using whether or not I am exhausted after a pose or sequence as a judgment point for something being "amiss" is hard for me because I practice bikram. In that hot room most things feel fairly exhausting... but I found this very helpful. It wasn’t until recently that a teacher corrected my hip in triangle and helped me move it toward the floor as I entered the pose. Everything changed then and now I’m starting to love this pose much more.

Jenn said...

Thank you for this really well expressed post. I've been helping students with si joint dysfunction who have been for years operating on this 'pelvis between a pane of glass' approach (as I too heard from my early teachers and then parroted back in my early years of teaching). It's brought such relief for them to stabilize the sacrum by turning the pelvis slightly forward and then twisting open laterally to lengthen the psoas and side waist.

Reading your post just reaffirmed for me this more therapeutic (and far more doable) anatomical view of the pose.

Anonymous said...

Hi there. I’m so glad you posted something on SI joint stability. Leeann Carey, an amazing yoga teacher, says that there are ways to protect the SI joint through yoga. She has a free yoga video on this that I think your readers might like: http://www.planetyoga.com/yoga-blogs/free-yoga-video-si-joint-stability/

Anonymous said...

My first time at Bikram Yoga and while in the Triangle pose I heard a pop in my right hip area. It didn't really hurt, however not sure how to treat it now. My hamstring hurts a little and don't want to injure it more. Any suggestions? What did I do? Did I tear a ligament?

Jugney said...

Dear Anonymous,

This is such a common injury - I wish more teachers were aware of the capacity/limitations of the SI joint.

Most likely you subluxed you SI joint, which is a technical term for slightly misaligning it. If the symptoms haven't subsided after a few days, I'd find a good chiropractor to help realign things.

You may have sprained some ligaments, but it's unlikely anything tore. You'd likely be in much worse pain if that were the case.

Hang in there! Yoga is a great path, and there are many different approaches. Many people love Bikram and get great results, so we cannot in good faith say it's a "bad" or "dangerous" system. If you find it's not working for you, please try another approach 'til you find the match that works best for your constitution.

In Yoga,

Scott

yogiclarebear.com said...

Thank you for this article. I am a teacher coming into a different understanding of Trikonasana, after many issues with my own SI. I really appreciate this and am glad that the triangle-SI issue is more "out there" in the community now.

Scott said...

In Triangle Pose, your best bet is to start with your pelvis and belly more or less facing the floor. Once you feel that your spine and torso aligned in the horizontal plane, explore opening your hips until you JUST CONTACT any resistance. That's far enough - pushing the pelvis to "square" offers very little in the way of benefits, and carries a higher risk of injury.