Do you have sacroiliac joint pain? That's lower back pain that's really low, often below the
belt line, usually off to one side, sometimes radiating down your leg a little bit. If so,
this video is for you. This is part two. My first video is linked up above. If you haven't
seen that one, go check it out. I made part two because everyone keeps asking me "Lucas
what are the best stretches?". Stop stretching! For sacroiliac joint pain we want to stabilize,
hence this video. Hey, my name is Lucas. I'm a yoga teacher, I am a teacher trainer. I've been
working with people with back pain pretty much every day for the past decade. Hopefully what
I've learned can be helpful for you. In this video we'll talk about the anatomy of your SI joint,
why it's different than your lower back, why you need to focus on this joint specifically and treat
it differently. Number two, we'll talk about why it happens. And lastly, we'll look at some new
corrective exercises, not stretches, we'll look at stabilization exercises for your posterior pelvis,
the back side of your body specifically. A quick disclaimer: I'm a yoga teacher, not a medical
doctor. If you've got a major problem, please err on the side of caution and go get checked
out. Another thing, there's a PDF down below. If you'd like to skip ahead and just get the
corrective exercises, there's a quick reference guide down below. Let's talk about the anatomy.
Here's the way to think about your SI joint: it's very different than your lumbar spine. This
sacrum is held in place by ligaments and muscles, but mostly by ligaments. Think of it like your
ankle, almost everybody at one point in their life has sprained their ankle, you've rolled
your ankle. If you rolled your ankle, the last thing you would do is try to stretch the ankle
in the same way that you injured it. Meaning, if you rolled your ankle to the side here, you would
not start stretching your ligaments. What would you do instead? You would reduce the mobilization,
you would stabilize it, you'd put an air cast, or a splint, or a wrap, or something to keep it
stable while those ligaments heal. Think of your sprained ankle, think of your sprained SI joint.
This is very often what happens. Your sacrum doesn't want to have a lot of movement. Just
like your ankle doesn't want to roll over to the side. So while we're healing, we actually want
to reduce the amount of mobility, increase the amount of stability. In the world of movement,
strength and flexibility are always on a scale and we're trying to find a balance.
When we have an SI joint injury, we have laxity, we have over mobility, and we need
to stabilize. There are 40 different muscles that are indirectly or directly affecting the
stabilization of our sacrum, but the ones we'll focus on are the two big ones - your glute max
back here, and then your piriformis, which is one of your lateral rotators. These are probably the
biggest movers that we can use in the short term to make up for that ligament laxity, that rolled
ankle, we use muscular stability in the short term to add extra stability as you are healing.
Okay, how did it get injured in the first place? Well, the most common cause is some type of
trauma - falling off a bike, getting hit by a car, slipping and falling, especially when we have some
shear, meaning the joint is getting torqued or twisted. Obviously childbirth is a major cause
of SI joint problems as well. One of the lesser known causes, which is a major problem, is when
someone's had a lumbar spinal fusion, meaning L4, L5, these have been fused together surgically.
Sometimes reducing the mobility of your lumbar spine gets rid of the pain here but it kicks
the problem down the road and suddenly the lack of mobility here your body attempts to make up for it
in your sacrum, but your sacrum doesn't actually want to move. Whatever the cause, what we're
looking for in the short term is stabilization. Our ligaments will take some time to heal,
so we need to focus on muscles to pick up the slack. Let's look at some corrective exercises.
The first pose we'll do is called airplane hinges and the idea is to really load our
posterior chain, specifically our glute max. This is the biggest muscle by volume in your
body and it can get strong pretty quickly and make up for some of that laxity in your
SI joint. Here's how we do it. Step your feet about as wide as your hips, the outer edges
of your feet are parallel, soften your knees just a little bit, and then hinge at the hips,
so your bum goes backwards. Throughout this practice all the weight should be in your heels,
as if you were about to fall backwards. We'll inhale on the way down, and when we inhale
I'd like you to imagine that your torso is like a soda can that you shake up, so the pressure builds
like a shaking up soda can. And then as we lift, we'll exhale shhh with a shush sound. Tuck your
tailbone, squeeze your glutes, and imagine there's a marionette string lifting you up,
so you get as tall as you can. We inhale on the way down. Imagine that shaking up of a soda can,
lots of pressure, and then we'll exhale, tuck your tailbone, squeeze, marionette string. We'll do 10
in total. Remember, your fingers spread, your chest is open, filling and expanding your torso
as much as possible, and only hinge as far as you can without your spine buckling. Let's begin.
Soften your knees, drive your hips backwards, inhale. Now exhale.
Good. Second round.
Exhale.
Good.
Great. Shake that out. Now we'll try a one-legged airplane hinge. Same idea, we need a chair or
a countertop for the next pose. This next pose is the same thing, but we'll do side side. It's
called half airplane hinge. Now if this pose is too much, if you trigger any kind of pain,
option one lunge less deeply. Option number two just skip it and refer back to the one
we did before. Because we're starting to do some unilateral movements, sometimes that can trigger
your SI joint pain. If you feel pain, please back off. Here's how it works. I've got a chair,
maybe you use a high chair like this, maybe use a kitchen table or a counter in your kitchen,
a counter top can work really well. Step my feet just as wide as my hips like before,
outer edges are parallel, my left arm goes back like an airplane wing, my right fingertips will
rest on my chair, countertop, table, whatever you're using. I'll now lunge back. I'll show
you first, then we'll do it together. With my right foot, all the weight is in my left heel,
not my toes, driving into my left heel, and then I'll stand up and again tuck my tailbone,
and stand up tall. We'll use the same breathing pattern as before. I'll inhale as I lunge,
and I'll fill up my torso like a soda can, filled up with gas, and on the way up
as I release, but try to keep that decompression as you go, I'll be dragging my toe along the
ground. This is a really great variation when you're first starting out if you're having pain.
Eventually you can start doing this with your leg in the air. I'll keep my knee soft throughout. I'd
encourage you to keep your knees soft. If you practice with a straight leg, that can really
load your hamstrings, which is not wrong, but it's not exactly what we're doing here. We'd like to
primarily load our glute max. Okay, let's practice together. Step your feet as wide as your hips,
outer edges are parallel, my left hand wings out, my right fingertips are on top of my countertop,
table, chair. Let's inhale, fill up as I lunge my right leg back.
Exhale, stand up tall.
Good. Inhale.
Shh. My gaze stays forward throughout. Inhale.
Remember, your left heel is heavy.
Shh.
Good. Shake it out. We'll switch sides. I'll change my angle just so you can see me
here. Some of you are wondering: "Do I really need the chair?". Some of you are wondering:
"I don't need that support." Some of you are thinking: "I can lift my leg higher."
These are all options that you might explore later. When you're in an acute pain phase,
when you're early on in an injury, better to err on the side of caution. Let's do our
other side. My feet are as wide as my hips, the outer edges are parallel, my right hand
is in that wing shape, my left fingertips on top. Remember, my knees stay slightly bent,
so a little bit softened. Drive the weight back into my hips, and my right heel is what's really
heavy here. Good. I'll lunge back, inhale, fill up my torso like a soda can, and then exhale.
Inhale. Exhale.
Inhale.
Exhale.
Good. Inhale. Exhale.
That's four. Keep your gaze forward. Inhale. Exhale.
That's five. Inhale. Exhale.
Six.
Exhale. Seven.
That's eight.
That's nine.
And that's 10. Good. Now you might not feel this as strongly in your glutes. In fact, you might
feel it more in your hamstrings, or even your calves. If you're doing this correctly, if you're
driving the weight back, don't be concerned. Your glute max is a big muscle. It can take quite a
bit of pressure. You're doing things right. Let's move on to our next pose, which we'll need a band,
an elastic band, and a stool. The next pose we'll practice is called seated clamshells.
I'm using an elastic band here, an exercise band. If you don't have one of these you can order them
online. They often come in packs of three, that's what I recommend. They have different resistance.
It's usually weighted like a three pound, five pound resistance. When you get the packs then you
can figure out which one works well for you. I've actually got a really long one, I'm just going to
triple it up. Don't overthink it, get any elastic band, they're very inexpensive. I'm sitting on a
stool, you can do this in a chair. Just scooch your back away from the edge of the chair.
I'll put the band around my upper leg, so above my knees, and again there's nothing magical about
this band, you use whatever band you have, but it should be tight enough so that my knees are
about hips width, not too wide to start. We'll be working specifically our piriformis muscle here.
Our piriformis muscle is underneath our glutes. It's one of the major deep six lateral rotators,
which means when I open my hip to the side, like we'll do in a moment here, underneath your glutes
you may or may not be able to feel that muscle contracting. Your piriformis muscle attaches at
your sacrum and it crosses over to your femur. So it's a very important stabilizer which can make up
for some of that laxity in the short term. Here's how we'll practice. We'll start off with a little
bit of tension which we'll hold throughout. We'll steeple our hands and then we'll open to the side
as far as we can with control. Then we'll return to center, but holding tension, we'll open to the
left as far as we can with control. We'll return to center, but holding tension. Open, open, that's
one round. We'll do 10 rounds in total. Let's begin. Get some tension on your band, steeple
your hands, open your leg to the right, back to center, hold the tension, open to the left,
back to center with tension. That's one round. Right, center, left, center, that's two. Right,
center, left, center, that's three. Right, center, left, center, that's four. Right,
center, left, center, that's five. Right, center, left, center, six. Right, center, left, center,
seven. Right, center, left, center, it's eight. Right, center, left, center, it's nine. Right,
center, left, center, and that's ten. Release your strap and take a break. Now, if you didn't
know where your piriformis muscle was before, you almost certainly know now. You can feel it back
there. Why are we doing this seated? Could you do this in a squat position and do lateral squat
walks to the side? You certainly could. This seated version, especially if you're in pain,
can help you to feel a lot more secure, and it helps you to control the intensity quite a bit,
meaning I was going relatively wide, you might take smaller steps, that's a perfectly good way
to modify. Let's take a look at our final pose which is down on the floor. The final poses that
we'll work on today are called bridge thrusts. So we'll do a bridge pose thrusting our hips into
the air. We'll work both our glute max and our piriformis at the same time. In order to do that,
we need a belt. Now this is a yoga belt, but you can use any belt you might have in your closet,
like a robe belt, or even a belt from your pants works just fine. When you put the belt around your
legs you want it above your knees and you want it tighter than you would think, about two-fifths,
maybe even a little bit less. See, we need to press out and up at the same time. That outward
press fires up our deep six lateral rotators, specifically that piriformis muscle. We'll
use the same breathing pattern as before where we'll inhale to create intra-thoracic pressure,
we'll hold at the top, clench everything, and then we'll exhale with that shushing sound,
and we'll lower down, but keep the tension on those muscles on the back side if you
can as you lower. We'll do 10 thrusts in total. First practice. So I've got the belt just above
my knees, I've got maximum two-fifths distance between my knees, now I'll lie down on my back,
place my feet about as wide as my hips, remember the breathing, we'll inhale,
thrust our hips up, drive our hips out, fill my torso like a soda can, hold, and then exhale.
Good. Round two. Inhale. Hold.
And exhale.
Inhale.
Hold.
And exhale.
Keep driving your knees to the outside. When you're up, imagine tucking your
tailbone to really squeeze your glutes. That was three. Let's do number four.
Hold.
Heels are heavy, knees drive to the outside. Let's do round number five.
Round six.
Number seven, heels are heavy.
Number eight, fire up your glutes, drive your knees to the outside.
Exhale.
Legs should be fatiguing now let's inhale.
Heels are heavy, drive your hips up as you inhale.
Exhale.
Good. Release your legs, rock up to a seated position. Again, when we have an SI joint pain
problem it's almost always laxity, the sacrum is wobbly. As the back door of your pelvis, our
objective here is to recruit some of our posterior chain muscles to stabilize as those ligaments
heal, as that inflammation, articular cartilage heals. And that's what we're doing here with our
glute max and our piriformis. If you'd like more science-based yoga videos, please hit subscribe
down below. If you have questions about these exercises or any suggestions for future videos,
I'd love to hear from you in the comments down below. You can always find my teaching calendar
at yogabody.com. And lastly, don't forget to grab the PDF from the poses we just covered
down below here in the description. Thanks for joining me and I'll see you in the next video.