Thread: SI Joint and Belly dance

I've been having problems with my SI for several months now. (The SI joint is where the sacrum and the ilium join.) The doctor did an X-ray yesterday and it looks like I have mild arthritis developing. At first I was confused because I didn't think it was a joint that would get much "action," but from what I am beginning to understand it's involved in most pelvic movement... and belly dancing involves a lot of pelvic movement!

So given what I'm learning, I'm wondering if any other BDers have had any SI problems. Symptoms include lower back pain and can mimic sciatica. I've never heard anyone talk about SI until this all started, but I've heard many dancers complain about their sciatic nerve.

Is SI dysfunction the hidden curse of belly dance?? I'm just thinking out loud here, but if there are any physical therapists in the room I'd love to hear your thoughts.

SI issues here too, just learning about it myself.

My doc said it was because I have too much muscle in some areas and not in others. I need to balance the muscles between my back, hip, and belly. Also caused by wearing high heels lol.

I have recurring SI pain, but mine is manageable via regular massage therapy.

And yes, the time it was the worst was when I was rehearsing my meleya leff in heels for hours (I normally dance with Foot Undeeze).

Amity--your doc said too much muscle? Mine just keep telling me to build muscle in all the surrounding regions to help stabilize it. The plus side to all of this is that I've gotten really strong and can now do drops to the floor without any hesitation.

Laura, my doc is sending me to PT. I'm hoping it consists of weekly massages!!

I'm not a PT, but as a yoga teacher I have some experience with this one.

SI joint issues are really common. I think I see them *less* among my bellydancers than among my yoga students. I think bellydancing (with great technique and posture) may be good for the joint in a preventative way -- but I can see where an SI that's out of whack could easily be aggravated by BD moves.

In my yoga classes, I have students lie on their backs and hug their knees loosely to their chest, then circle their knees in the air. When you do that, you'll feel the SI joints pressing against the floor, and some of my students can feel one joint poking out against the floor while the other side feels recessed.
Here's a pic for those who don't know where the SI joint is


There's a great book called 'Yoga for Back Pain' that has a whole chapter on exercises for the sacroiliac joint. I usually show my students the exercises but also tell them to seek massage therapy or chiropractic care for this issue (one of the few problems I routinely suggest chiros for).

One more thing -- be VERY careful getting in and out of your car, especially if it's low to the ground. If you get in and out one foot at a time, you're straining the SI joints every time by opening the legs and twisting slightly at the base of the spine.

Instead, get out by putting BOTH feet outside the car, turning completely sideways in your seat, then stand. Get in by lowering your tush into your seat first (sideways again), THEN bring one foot and then the other into the car as you turn to face front.

I'm a yoga teacher and I've had SI problems, too.

I think SI dysfunction is probably way more common than it seems, and like you said, aazura, it often goes misdiagnosed as a sciatica or lumbar issue.

I agree with Lauren that a chiro and regular massage will give you some relief.

Be careful with any kind of twisting action-- that is where there is the most risk for re-injury. SI injury is super common among yogis for exactly this reason!

If you practice yoga, here's a great article with a basic practice for SI health:
YogaNerd: Maya and the Financial Crisis: What does this have to do with your sacrum?

In addition to that, I find utkatasana (chair) and garudasana (eagle) stabilizing to my SI. Also, in my case, tightness in my hip pulls my SI out of alignment, so if I'm starting to feel it, lots of pigeon, half-fold at the wall, and firelog help relax my piriformis especially.

I have SI issues. I have found [ame=http://en.wikipedia.org/wiki/Myofascial_release]Myofascial release - Wikipedia, the free encyclopedia[/ame] to really help. In my case I had a prior twisting/bone break injury above the left ankle which I think is responsible for my SI issues. So the therapy focuses on the site of the injury and the SI pain has noticeable lessened. I can't believe it's worked, even my massage therapist has noticed.

After belly dancing for a year or so, I started having really bad muscle pain in my hip/lower back area. A trip to the chiropractor and several x-rays revealed that I had an abnormally formed SI joint as well as a leg length discrepancy. The difference in my leg lengths was causing my already weakened SI joint to grind and then all my pelvic muscles were locking up to protect it.

SERIOUIS OUCH.

Luckily, the solution was as simple as putting a lift in one shoe. Now I absolutely have to wear shoes when I dance (unless I want to tape the lift to my heel, which just looks ridiculous), and I have to be sure to keep my pelvic muscles strong with exercises, but I'm now mostly pain free and dancing all the time.

Luna-same thing with me! Scoliosis on top, but get up off the couch is a little easier

Originally Posted by aazura

So given what I'm learning, I'm wondering if any other BDers have had any SI problems. Symptoms include lower back pain and can mimic sciatica. I've never heard anyone talk about SI until this all started, but I've heard many dancers complain about their sciatic nerve.

Is SI dysfunction the hidden curse of belly dance??

I wouldn't say that SI dysfunction is the hidden curse of belly dance. I've been dancing for 29 years and never had a problem with it. I have scoliosis, and for me, belly dancing actually REDUCES the amount of back pain I have rather than causing it! If I take a few weeks off from dancing, as I'm doing now around the holidays, my back becomes really angry with me.

However, if you happen to be someone whose posture isn't quite correct, then belly dancing can irritate the bad-posture situation and lead to lower back pain in the sciatic nerve. I'm not saying that's YOUR situation, Aazura, just explaining why you might hear a lot of other belly dancers complaining about it.

There are two common problems with belly dance posture.

One problem is that many dancers have some degree of swayback posture. This swayback can be caused by wearing high heels a lot, which many women do in their daily lives, and then when the shoes come off (as they might for belly dancing) these high-heel wearers still carry themselves in the posture they use when wearing high heels - a swayback. This swayback posture, when combined with the hip movement of belly dancing, can lead to sciatic nerve pain. In contrast, if the pelvis is in a properly neutral position, then belly dancing probably won't cause sciatic nerve pain. That's why it's so important for belly dance teachers to educate themselves about posture and correct students whose posture is incorrect, and that's why it's so important for students to seek out teachers who care enough to have developed this knowledge.

(continued)

The other common problem with belly dance posture occurs when the dancer's rib cage is leaning back from where it should be, such as the posture we frequently see in Turkish-style dancers - shoulders leaning back, hips pressed forward. It's important for the glutes to be relaxed as the default posture, although it's fine to squeeze them periodically for the purpose of producing a particular move. If seen from the side, the side seam of the dancer's clothes should be straight up and down, not slanting toward the back up by the armpit. This means that the bustline and front of the rib cage should be forward of the pelvis. The weight should be evenly distributed, front to back, on the feet. Many belly dancers keep their weight primarily on their heels, which places stress on the lower back. This leaning-back posture can lead to lower back pain, including sciatic nerve complaints.

I wouldn't say that the posture problems I described above cause SI joint issues in particular, I'm just saying they can cause the lower back pain such as that associated with sciatic nerve pain.

It's actually amazing how a minor tweak to posture can really relieve back pain. Again, Aazura, I don't know whether this is your situation, and maybe in your case it's not. But I thought I should mention it for the benefit of people reading this thread who DO have the posture issue.

Well Dear Indigo You're getting old but worse than that I know from watching you dance form your earliest years that you turn your toes in. Its a Ruby thing sadly. I saw many of her girls have the same issue over the years. I am not being a ***** here its just what I know. Some Phys therapy and some retraining to re align proper stance will help. Yoga stretches and some anti-inflammatories to help keep the swelling down and to help heal the offended joint.

Just MHO from seeing you from your beginnings.
Andrea

Originally Posted by RaqOn

Luna-same thing with me! Scoliosis on top, but get up off the couch is a little easier

I neglected to mention in my post, but I have scoliosis as well, as a result of my pelvis twisting to compensate for my abnormal leg length... my spine was rippling sideways to even me out.

Thanks to the lift in my shoe, the scoliosis has mostly corrected itself.

I thank heaven every day that I started belly dancing. Not only has it boosted my confidence, made me more comfortable in my own skin, and gotten me up off the couch, but dancing was the thing that finally drew attention to a hidden physical problem that might have caused me severe chronic pain in the future.

I don't know what I'd do without this art form!

i never had SI problems until i took a nasty fall snowboarding last Feb. it freaked me out because i thought i'd broken my pelvis and i had to dance at a very important-to-me fundraiser 2 days after. well i walked it off a little and was actually able to go on with the snowboarding that weekend. the performance went very well. a week later i was vacuming and reaching out with the vacume sent an electric tingle down my leg from the SI. ever since then i've needed to do extra stretching and use a foam roller on those muscles that are right on top of it. i've asked my dad (who is a chiropractor) and he said that the dancing i've been doing is probably one of the best things for it and to just keep dancing and stretching.
not arthritis, but along the lines. basically BD helped me with the injury, although it still requires extra stretching.

This thread is a couple years old, but I've been suffering from SI joint pain for 6 months now and would love any follow up from the ladies who contributed to this thread. I will be starting PT and chiro, as well as MFR when finances allow to try and help this. I'm not sure if my SI joint is hyper or hypo-mobile, but it's certainly inflammed. Hope you are all doing better, but would love to hear either way!

Originally Posted by siradancer

This thread is a couple years old, but I've been suffering from SI joint pain for 6 months now and would love any follow up from the ladies who contributed to this thread. I will be starting PT and chiro, as well as MFR when finances allow to try and help this. I'm not sure if my SI joint is hyper or hypo-mobile, but it's certainly inflammed. Hope you are all doing better, but would love to hear either way!

Hi Sira,
I posted earlier to this thread (2009! Wow!) Unfortunately that article I linked to is gone now :( I stand by what I wrote earlier, but I'll add salambasana/locust to the list of stabilizing yoga postures. It's funny that I learned for myself that firelog and pigeon were really helpful to me, because, since then, I have started practicing and teaching yin yoga and that has been the #1 thing that has relieved my SI issues. As Shira posted earlier, some common postural misalignments in bellydance can cause strain in the lower back, and also I find that bellydancers get to be really strong in the back body, and long holds in forward folds can be very therapeutic for balancing that out.

Here's a yin yoga sequence I put together for low back/SI pain:
Yin Practice for Low Back Pain and SI Relief | Om Chantress

Hope that is helpful to you! You can also learn more about yin yoga at yinyoga.com and paulgrilley.com.

I have problems 'down there too'. Mine all started after I had my third child. Several years ago I had terrible L hip pain and w/ xrays they said it was my SI joint. They also told me my L hip was rotated slightly forward and that I need to build up strength and gave me a bunch of exercises to do. Since then, I started "jazzercise' which is aerobics/weights, ect but I still have problems. So I honestly don't know what my problem is. They also told me my hip flexor was extremly tight and b/c everything is connected that was causing pain too. My pains have moves up to my arm now.

LOL

Today, when I saw my massage therapist, I thought of this thread and asked her what she thought.

She said she gets a LOT of clients with pain around the SI joint. The advice she gives to those clients is:

1. Do stretches designed to lengthen the quadriceps (front of the thighs)
2. Do stretches designed to lengthen the ilio-psoas (hip flexor)
3. Do exercises designed to build strength in the transverse abs (lower torso)


For #1 and #2 together, one good stretch is the yoga "dancer pose" - see Yoga Journal - Lord of the Dance Pose . Initially, you can stand by a wall (to hold on to keep your balance if needed) and you might just bend the free leg enough to come up to your butt. Over time, with continued practice, you can gradually bring the back foot higher.

After a couple pulled hamstrings I started experiencing SI issues as well. I go to a great physical therapist who specializes in sports. This video includes several of the exercises we do
Strengthening Exercises for Rehabilitation of Sacroiliac joint pain - YouTube
Many of which are Pilates exercises in addition to being physical therapy exercises.
This video doesn't mention / show the important stretches mentioned in posts above- but- basically strength and flexibility imbalances need to be addressed. This is what fixes my SI pain issues.

I want to add that I used to sleep w/ a heating pad on my upper leg (hip flexor area). This would relax it and I could then 'open up' my leg. I had a problem for a while w/ it being so tight I could not extend my leg open....(would interfere w/ certain..um...activities)...anyway....
Anyway, after doing this for over a year, I gave myself 'toasted skin'..LOL...and yes, it is a real condition. LOL...I have spots on my upper thigh now...I don't use heating pad at all anymore and and it is getting better. The heating pad does work, but be careful

Okay, so I'm learning to live with possible chronic SI issues. It's not fun, but life goes on...

Great to know about the yoga positions that help! And thanks for that youtube for strengthening! Something else I will share that has been helping me when I wake up with stiffness and pain in the SI joint is "resetting" the joint myself. Here's a link with diagrams that explain how:

Sacroiliac Joint Correction - A Different Model

In addition to this, I do adductor squeeze exercises (squeezing inner thighs with applied resistance) which strengthen the transverse abdominis and resets the pubic symphisis.

And someone else advised that a sit-stand desk is a good idea, since prolonged sitting can irritate it too. I'm going to look into options...

Good luck to us!
Sira

I have a question for those with SI joint problems: how does one distinguish SI joint pain from other lower back pains?

Also, I was just reading an article on core strengthening and found something that might be relevant to someone:

Quoted from this paper (link is to a pdf file) Akuthota et al 2004

Diaphragm and Pelvic Floor
The diaphragm serves as the roof of the core. Stability is
imparted on the lumbar spine by contraction of the diaphragm
and increasing intra-abdominal pressure. Recent studies have
indicated that people with sacroiliac pain have impaired recruitment
of the diaphragm and pelvic floor. Likewise, ventilatory
challenges on the body may cause further diaphragm
dysfunction and lead to more compressive loads on the lumbar
spine.22 Thus, diaphragmatic breathing techniques may be an
important part of a core-strengthening program. Furthermore,
the pelvic floor musculature is coactivated with transversus
abdominis contraction.

I'm not sure how common it would be for a dancer to have poor function with respect to the diaphragm and pelvic floor, given how vitally important both are to dance, especially the torso isolations that require diaphragm involvement.