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Sacroilliac pian

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Sacroilliac pian
Hi,

For years I have been a flat footed, rounded shoulders, slouched posture disaster area with an Olympic gold winning sway back.  For the past 3 years I have experienced chronic sacroilliac pain leading to sustained severe insomnia. Yoga has helped, and sometimes agravated, my situation.

Following the teaching in the 8 Steps book has eased my spine and started to reduce the exaggerated curves in it. What I haven't found is any advice specific to sacroilliac pain.  From my yoga practice I reckon kidney bean feet, externally rotated legs and postures such as a gentle version of bow pose are useful.  What advice could you give me to help my painful sacroilliac?

Thanks

JohnC
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Hi John,

In my experience, sacro-iliac problems require a somewhat anomalous route to ideal and pain-free posture. When someone has S.I. joint strain, anteverting the pelvis sometimes hurts. You may even need to tuck the pelvis while you sort out the rest of the steps (stretchsitting, stretchlying, inner corset, hipghinging and using the buttocks to propel yourself in walking). You may also be best off using a sacral belt to stabilize the S.I. area so that your muscles don't need to strain to do this job (causing secondary pain and problems). As you get better, slowly explore pelvic anteversion as tolerated.

Glad you are working your way to a different sort of Olympic medal!

Cheers,
Esther
katestere
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Hi Esther, i fell on my sacrum when i was about 12 and i didn't see a doctor, but i couldnlt staighten up for months. I tucked my pelvis and coped. 18 years later i started to get nerve pain in both feet and ankles. Finally a chiropractor diagnoised my with hypermobile/unstable si joints. He felt that the pain in my feet was coming from lower back nerve irritation. It made much sense, as i would get periods (cyclical with period) of popping in both si joints. Unfortunaltely when the chiro began adjusting my si joints i began to experice sciatic down both legs. That was almost a year ago. I have tried PT, different chiros, accupunture, masssage. rest, anti imflammatory diets, many attempts at strengthening my posterior chain. Receently, i have been working with Eric Goodman  (Foundation Training), and his approach makes perfect sense  (but from mild never irritation and pelvis tucking my hastrings have become very tight further contributing to less hamstring flexibility and probably more ligament stretching than anything) but the hinging and hamstring stretching really flares me up. It feels as though i'm tugging on both sciatic nerves. SO, my question is, how do i activate my backside and hip hinge when it flares me up so badly? How do i get better? 

I had just recovered from a major neck injury when i finally had my life back and now this. I am 30 years old, very healthy otherise and very smart about the body as i am a personall trainer. My husband and I are so ready to have kids but i'm affraid that would add to this whole si joint dysfunction and can't imagine this getting worse...Please help.... i'm so frustrated! Ill do/try anything!

 

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Hi Kate, Since my original forum post in 2009 I have qualified a Gokhale Method teacher. The 8 steps we teach are great tools which are useful for most structural issues in the body. In my case 20+ years of chronic SI pain has led me to experiment with how best to use the Techniques, or tools, of the Gokhale Method to best effect. In my experience kidney bean shaping the feet and the Inner Corset are very helpful - they both bring the pelvis back into balance. if the pelvis becomes torqued, rotated/twisted left or right, this puts considerable strain on the SI joints. If this is the case for you it would be useful to use a simple exercise to check. Stretch lie on your back, on a very flat even floor, preferable with no carpet, pillow under your head and shoulders, feet hip width part on the floor knees bent. Very gently sway your knees side to side, about an inch either way, in tandem, and feel how "bony" each SI joint feels on each side. If 1  side feels bonnier or more "mountainous" than the other  this would suggest you are twisted within the pelvis to that side. Come to standing, strongly kidney bean shape your foot on the opposite side, and work with your Inner Corset. Do this a few times, the recheck your pelvic balance stretch lying on the floor as before. If the "more bony" side feels a lilt le less bony, maybe both sides feel similarly boney then you have reduced the imbalance in the pelvis which should take some of the strain off if the SI joints
 
Initially  I found a slight tuck in my pelvis helped, as did wearing a SI belt to mitigate excess movement in the joint.  Stretch sitting was my  preferred method of sitting, stack sitting was a challenge. Once I had come into approximate balance, using the exercise above to test this, I found that stack sitting became very helpful, being very careful to boost the anteversion on my less bony side and to reduce it on my more bony side. Using Esther's Gokhale Head cushion can be very helpful. The best way to teach this would be hands on, there are a number of other exercises that I have found very helpful. As  always let comfort be the measure - don't do anything that aggravates discomfort.
pkmasse
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I recently took the foundations course and my low back/hips pain flared up.  I do have rotated hips.  I found your post most helpful.  My teacher just told me to back off and only do what doesn't hurt.  But I want to get past this!  Stretch sitting feels best stretch laying works if I don't antivert my pelvis.  But everything else I've tried hurts it or even pinches the nerve.  I did what you recommended to check my pelvis position and try to reset it and my pelvis did seem more balanced but I still currently have pain.  I know it takes time for things to calm down so I will see how it feels in the next few days.  However, I was hoping you might have a bit more guidance on what to expect.  Do I need an SI belt? What exercises should I focus on? How do I get to the next step.  If all I do is stretch sitting and stretch laying will I progress in some way?  Do I just have to patiently persist in this stretch sitting until it doesn't hurt, then what should I try next? Or should I tuck or wear a support and continue through all exercises? I like to have a plan. 

Thank you for sharing your experience and your time,

Kerri Masse

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08/19/2015 - 5:15pm

Dear Kerri,

 

There is a lot we can do to take pressure off your SI joints, and allow them to heal. You are doing the right thing, keep on stretchl-lying and siting. 

 

What I would also recommend is that you do a lot of Inner Corset and Rib Anchor work. This frees your lower back and SI joints, which are normally under tremendous pressure. I would also recommend plenty of neck work to lenthen your entire body. There's a lot more we can try, most of which you've already practiced during the course.

 

You ultimately would benefit from a teacher further assesing your posture. Feel free to reach out to me at [email protected], we can set up an online session.

 

I can create a plan for you that we can fine tune over weeks and months.

 

Wishing you a quick recovery,

-Alejandro

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