Stop Opening Your Hips: Yoga for SI Joint Pain

I’ve been dealing with pain right between my sacrum and my pelvis at the joint where the spine and hips meet, for years. I’ve been to massage therapists, chiropractors, and sports medicine doctors, all of whom tell me to open my hips. When I tell them I’m a yoga teacher and that’s literally all I do all day, they seem totally stymied: the best information they’ve had is that SI joint pain is relieved by opening the hips. One of them said, “Are you sure you’re opening your hips?” Once my foot is behind my head, how much more open should I go, doc?

It’s not bad advice, for most people. For folks who sit at desks all day and get this pain, hip openers probably really help. As yoga gains in popularity, however, there is increasingly an epidemic of SI joint pain in flexible women like me. Some of these specialists, are trying to solve the mystery. I got a solid clue, if not a final solution, from working recently with yoga teachers Michael Stone and Kathryn Bruni-Young.

The key thing to understand is that muscles tend to be both weak and tight. Desk sitters are letting their hip muscles atrophy, while intense yogis are stretching them to within an inch of their life. Bringing the hips and the SI joint back into a state of health means we need to stretch and strengthen in balance.

Strengthen

The hip muscle that tends to languish in a yoga practice is the gluteus medius, which moves the leg out to the side and helps it turn out, two movements we don’t see a lot in a classical yoga practice. This is an important hip stabilizer—think of it as a part of your core. Try some leg lifts and see how hard they are: if they make you want to die (which they did for me the first time) then you need to do this exercise at least 3 times a week (I promise it gets easier).

Lie on your side. Bend your bottom knee, and make sure you have a natural curve in your low back. You can prop your head up on your elbow or rest it on your arm. Straighten your top leg, lift it, flex the foot, and point the toes down so your leg is internally rotated. Lift and lower the leg five times. Then take the leg out in front of you 45 degrees and lift and lower five times, then towards 90 degrees and lift five times, keeping the natural curve in your low back and the toes pointed down the whole time.

Stretch

One of the best hip openers I know is Thread the Needle. It’s simple, safe, and accessible for most people.

Lie on your back with your knees bent. Place your right ankle on your left thigh close to your knee, hold your left thigh with both hands (right hand goes between the legs), and draw the legs in towards you as you press your right knee gently away from your face. Try a slow sway from side to side with your hips (not rocking on your spine) and you may get some different information as you stretch different parts of your hip.

Everyone is different, and especially if your pain is chronic or serious, look for a good doctor, physiotherapist, or other practitioner who can give you good advice that takes your lifestyle into account. In the meantime, try these two exercises and see if they work for you.