Pain in the sacrum

There are often many questions about Yin Yoga and specific spinal conditions. Feel free to ask your question here, or check out other posts or contribute input from your own experience.
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milvia martinez
Posts: 6
Joined: Fri Mar 18, 2011 4:38 am

Pain in the sacrum

Post by milvia martinez »

I have a sharp pain in the left side of my sacrum , also I have congenital scoliosis and that has always been a bother but being a yoga practitioner for more than 15 , years I keep up, untill now I have never had such sharp pain and it is triggering a lot of fear ... I have stoped all the back bending since the pain first appeared . the quiropractic thinks I have weak ligaments and that my bones move too easily ... if that were so is yin yoga contrindicated?
I am waiting and watching before I do an MRI ...
How does yin yoga work with scoliosis?
I just discovered yin yoga a year ago and found it an amazing and beautifull road to explore so I started to include it in my practice then I wet to Sarah Powers TT in kripalu this past month. It would be so sad if its the worng practice for my body because the energetic and pshicologyc aspects are so interesting to me. I can understand it is hard to help without actually knowing me in person but maybe you have some experience with a similar case...?
thank you for your time and help.
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Yoga for scoliosis

Post by Bernie »

I am sorry to hear about your health challenges. Of course, I can't offer any medical advice and, as you point out, I don't know you so I can only offer some suggestions based upon what you have described.

First, let's talk briefly about your scoliosis, which is a curvature of the spine away from the normal double-S curves. There are two main kinds of scoliosis: functional, which can be fixed through yoga because it is caused by muscular asymmetries, and structural. Since you say that you have congenital scoliosis, I am assuming yours is structural - yoga will not help correct this kind of scoliosis, but yoga can help you deal with the fact that you have the curvature. Yoga can help to reduce pain and reduce some of the imbalances that often accompany scoliosis. Virtually all of the yoga therapies applied to students who have scoliosis are yang, and they do work, but they won't fix the underlying problem. You can learn a lot from reading Elise Miller's articles: she is a senior yoga teacher who also has significant scoliosis. [Just Google her name and you’ll find lots of resources.] Since you have been doing yoga for 15 years already, I am sure you have come across hers and many other suggestions for helping with your scoliosis from a yang point of view.

Can yin yoga help with scoliosis? Not with curing it, especially if the condition is structural. Structural scoliosis is a condition of the shape and orientation of the bones. Yin Yoga can help remodel the bones, which means we may help the bones grow thicker in certain places, but it will not change the length, shape or orientation of the bone. Think about the example of braces: this is a yin form of exercise designed to change the shape of the jaw bone - it takes years of constant, 24-hours per day stress to change the shape. There is no way a Yin Yoga practice can be done for that length of time to each of your vertebrae.

However, like the yang forms of yoga, Yin Yoga may be able to help you deal with some of the pain and associated problems caused by your scoliosis. Generally with scoliosis one side of the body is overly contracted and the other side too loose. Through our yoga practice we can try to balance the two sides, to strengthen the lax side and mobilize the tight side. Part of the tightness can be due to the connective tissues: the ligaments and the fascia within the muscles. Yin Yoga can help to open up your tighter side. You may have already discovered this in your own practice – try reclining twists for example: hold the tight side longer than the lax side and allow the tighter side to open.

Secondly, let's look at your sacrum: can Yin Yoga help tighten your lax ligaments? Again, sorry - no. Yin Yoga will help to strengthen ligaments, but it also tends to make them longer and stronger, not shorter. The body does have a shrink-wrapping mechanism, and over time ligaments and joint capsules will shorten and tighten, but this doesn’t happen quickly to ligaments that have been stretched. Often, surgery is the only way to shorten a ligament. The normal yoga prescription for lax ligaments is to strengthen all the muscles around the area. In your case, yang yoga may be the best approach: you may want to do some mini-Cobras and mild Locust poses to strengthen the lumbar muscles. Plank and Crocodile can also help, as well as modified Side-Planks. Avoid constant vinyasa-like movements, such as going from Updog to Downdog and avoid really deep backbends. Work on stability, not mobility.

I am purely speculating here, but often students will create ligament problems through their yang practice by repetitively stressing their connective tissues. This is the old credit card effect: if you bend a credit card back and forth over and over, eventually it will break. That may have happened to the ligaments supporting your left SI joint. If so, it is not that your ligaments have gotten longer and thus lax, but they have gotten weaker, as you chiropractor suggests. There may be a tear in your ligaments, and that may take a long time to heal (it can take years to heal connective tissue tears, and sometimes only surgery can solve the problem.)

This does not mean that you shouldn’t do Yin Yoga! There are more benefits than just physical ones to the practice. You can still do Yin Yoga to obtain energetic, emotional and psychological benefits. You mentioned fear: a gentle yin practice targeting the Kidneys may be helpful. While I would not suggest you try to stretch the ligaments in the sacroiliac joint (avoid deep twists and hip openers), you may find that compressing this area helps to stabilize the joint. Saddle pose and Sphinx pose may be helpful.

As always, you have to be your own guru and check all this out for yourself and with your health care provider. Go gently but do try some yin poses along with the strengthening yang poses. Don’t stay too long for the first couple of days and see how you feel the next day or two. If things are okay, maybe stay longer (not deeper! Work towards deeper very slowly – time is more important than intensity.)

Good luck with the journey back to health! Let us know how it goes – others may be able to learn from you.
milvia martinez
Posts: 6
Joined: Fri Mar 18, 2011 4:38 am

Post by milvia martinez »

Thank you so much for your reply.
This is indeed a big challenge to deal with since my body is my first instrument , I am a yoga instructor and a devoted practitioner so to consider something like surgery is overwhelming!!!! I will have an MRI on monday to actually see what is going on on a physical level.
I am doing exactly what you mentioned working with stability more than mobility with a more Iyengar aproach to my yang practice and for know untill I know more I will limit my yin to sitting meditation wich I do daily.
And it is there, while siting, where I can sense and try to breath with the intense fear that is arising. And I feel challenged and a little dissapointed that after all this years I am still a trembling child in the dark so scared of illnes and pain. Similar sensation as when doing pranayama with the scoliosis ( my scoliosis is not as big as it feels but a keen eye can defentely notice it and my left lung feels colapsed and compresed so it triggers anxiety when filling the lungs more completely.It feels like a river that is interrupted by a dense blockage so I do pranayama laying down wich helps. I will look into Ellise millers book.
After coming out of siting for 1 hour when I lay on my back the sacrum bone pops and cracks strongly ..... what is going on!?!?!
saddle and sphinx both agravette the pain so I am skiping them.
I will post more as it goes . thank you again and excuse my possible missspelings english is not my first language and I also aprecciate the support for I live in a country where there is very little comunity.
thank you again.
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Sitting for 1 hour

Post by Bernie »

You mention that you get some cracks after sitting for a long time: cracks are probably normal and okay - I suspect that you are releasing fixation that has built up during your sitting practice. Releasing fixation frees the bones so that they don't get stuck together; while the noise may be a bit scary, it should feel good - like when your chiropractor cracks you.

Sitting for 1 hour at a time is a bit extreme though: you may want to reduce the time. How about sit for 25 minutes and then do a walking meditation for 10 minutes, then sit for another 25 minutes. This will reduce the strain on your SI joints.

If Sphinx is not available, how about Anahatasana (aka Puppy Dog)? Could that work? It is more of an upper back bend and it still can stimulate the Kidneys, which may help with your anxiety.

Good luck.
milvia martinez
Posts: 6
Joined: Fri Mar 18, 2011 4:38 am

Post by milvia martinez »

Hello Bernie,
Yes I anahastasana is available .... will try the walking meditation in between sitting it is a good plan. Extremes !!!! that seems to be part or my issues..... I went to see an ostheopath today and he had good feed back .... of course i didnt mention something very important in my post to you... that is that I gave birth to a huge 9 pounds baby 20 months ago and that I am a rather small woman.... so he thinks a lot might have to do with that and of coruse the scoliosis and everything we have been discusing carrying a heavy baby, being 40, and not expecting that pregnancy .... just wanted to add that bit of info ,, since you so kindly are offering your interest and support.... I feel more at ease after the sesion with him and with the posibility to share. thanks again....
milvia martinez
Posts: 6
Joined: Fri Mar 18, 2011 4:38 am

results from x rays and MRI

Post by milvia martinez »

Hello Bernie...
I finally decided to go for the MRI because the pain was strong and not even pain killers seemed to work. The results show a small bulging in L4-L5 and L5-S1 but acording to the doc who saw it they are small and should not be hurting besides my pain is not in the lumbar spine but in the sacrum. So nothing there to explain the pain. She is guessing that I have a tear in a a sacro iliac muscle or ligament ...???
So I am still dealing with the pain and all they suggest is a muscle relaxant pill 3 times a day ... for a month !!!!
LIke I said Bernie this is triggering a lot of fear and now some frustation not knowing what is going on or how it happened only leaves me in a place where I must let go and accept what is going on. I continue with forward bends because they feel safe and good and medicinal but of course there are different opinons about that. also I start my practice with standing postures to help align my hips and my sacrum get in place since it seems to be stuck towards the left. And I end with sirsasana and sarvangasana. when I am up in shoulder stand and I come down to halasana there is a bit in the way that is where i feel the pain then past that point is free again... is that a tear?? brushing my teeth in the morning is super painfull meaning when I bend forward , and by the way morning when I wake up I am a 200 year old ....what is going on? then as the day advances some days it is good to the point of having little to no pain and others it stays . but it always comes back on the next morning .... yes I have a super good bed and I am not partying in my dreams ....
My new questions then are : with bulging discs no forward bending in the yin style right? and in your experience if it is a tear in the sacrum area what is the best aproach.... ? how long can it take to heal and do you believe in muscle relaxants ? also they suggest to put heat on it .
thank you again and I hope my own experience can benefit someone who might go through a similar pain....
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Doctors

Post by Bernie »

Hi Milvia

I am sorry to hear about your ongoing challenges: as you know, I can not give you any medical advise as I am neither a doctor nor a physiotherapist, but I can offer you some perspectives. First - have you ever noticed the care that an airplane pilot takes before he even begins to taxi his plane to the runway? There is a complete checklist that covers all the possible ways something could go wrong. Compare this to the degree of care that our doctors take when we visit them: there is no checklist. Every doctor has her own way to help a patient. Often our time with our doctor is limited and we feel rushed - they have to get to the next patient. This doesn't mean that our doctor doesn't care, or isn't qualified: I believe all doctors do care, but the big difference is - the pilot is on the plane with you! Your doctor, no matter how caring she is, is not living your life. You are the only one on your plane. You have to be your own doctor and treat everyone else as part of your consulting team. If one consultant does not give you the advice you need, find another one. Don't accept results that are unacceptable: keep working to find a solution that works for you.

Being our own doctor is not easy: doctors are well trained, but they have to be trained in everything, you only need to find what works for your specific current ailment. I would suggest you find another physiotherapist who has experience with possible tears in ligaments or muscles in the sacral area. I would also suggest you try other healing modalities. Doctors are trained in one particular paradigm, and Western medicine is incredibly valuable, but it is not perfect. You may find relief by seeing an acupuncturist or by working with a Rolfer. An experienced Rolfer can watch the way you move and notice where trigger points are, where your fascia may be restricted, how certain habitual movement patterns may be causing seemingly unrelated problems.

Next: if you do have a bulging disk, then forward folds and deep twists could make this problem worse. When we flex the spine forward, we compress the front of the disk, which pushes the liquid in the core of the disk to the back side, which can create the bulging bubble. Ironically, backbends such as Sphinx can help fix this, but for you Sphinx doesn't work. You mention pain when you brush your teeth in the morning: it is in the morning that our disks are the stiffest and leaning over the counter puts your lower back into flexion. Perhaps you can try bending your knees while you brush your teeth can add a little uddiyana bandha to support the lower back. You can still do Yin Yoga, but try to do the flexion poses keeping the spine straight. You may want to work to strengthen the lower back area: if you have the time, money and inclination, a good book to help you understand how to safely work the lower back is called Lower Back Disorders by Professor Stuart McGill. I refer to it in one of the Newsletters.

Finally, the fear you mention is quite normal, but you do not need to feed it or act on it. This is a time to practice mindful awareness. It may be helpful to review the chapter in YinSights that describes the process of AWAKEN. You can see it here. Accept that right now in your life, this is a challenging time: accept it but take appropriate action to resolve it if you can. Try heat, try ice, try other modalities. There is a chance that you have chronic inflammation in this area: if so, you may find the practice of earthing will help reduce the discomfort. I discuss earthing in this Newsletter. You can order straps from earthing.com that may help your sacrum: just put the strap around the hips.

Good luck in your investigation - I am sure you will find your way to wellness with the right dedication and determination.

Cheers
Bernie
milvia martinez
Posts: 6
Joined: Fri Mar 18, 2011 4:38 am

Post by milvia martinez »

Hello Bernie... I was re-reading our posting, wao these 3 past months have been so intense , three months in pain .... I visited a neurologist that thinks I have a good chance to heal without surgery from the 2 bulging disks ...I am not sure how to go about my practice any more , I guess strenghtening and stabilizing my lower back is my main concern for some time ahead so does that mean no yin yoga for me?the plank and cocodrile deep abdominal work and eventually standing postures Inversions is ok ? and to avoid forward bending and in my case back bending because i feek it agravates it and deep twisting.... so many donts!! I miss my yin practice for all I am doing is continuing with sitting practice followed by walking meditation.... At the moment and for the next two weeks or so I wont do anything other than the special exercices from a physical teraphist then some walking in the water swiming ... the doctor also mentioned more protein intake to help the muscles thats because I am a vegetarian .....
I feel close to depression , trying to observe and keep at it , but the negativity is so strong there are such deep trust issues , lack of trust.... doubt a big hindrance... I am surroundig my self as best as I can reading the Tao and planting lettuce in my back yard and drinking St john's Wort tea ... but I miss who I thought I was , I miss all my expectations of what I was going to be doing now instead of being in pain and with out my yoga practice... thank you again for your advice .... I hope I can heal before surgery and find my strengh and metta in my heart...
saludos!
milvia
Bernie
Posts: 1293
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

update

Post by Bernie »

Hi Milvia

I hope you have been finding some improvement in your condition. You are pioneering an area where I am sure many people also share some concerns. Let us know occasionally how you are getting on, so that others may learn from you.

One idea that came to me is - earthing. I discussed earthing in YinSights Newsletter #4 (see the article Earth Chi). You may want to read that and see if it helps at all. It could be that chronic inflammation in your sacrum is contributing to your struggles. Earthing can help with that, if inflammation is the problem.

Cheers
Bernie
milvia martinez
Posts: 6
Joined: Fri Mar 18, 2011 4:38 am

Post by milvia martinez »

Hello Bernie,
It is a coincidence to get a post today !
I will try earthing although I do walk barefooted a lot in my back yard ,I live in a very old house witch has a back yard that limits with a rainforest national park , Its very humid here and sometimes that seems to make things worse. This is in Panama city, central america ,,,,, but I will try to walk or stand consciously aware of the healing it can bring .
I took on a practice more on the Iyengar style I instaled wall ropes and got my self an inversion sling to hang and decompress my lower back 15 minutes am 15 minutes pm and every time I feel tired IT HELPS !!! Its a good thing because I was already loosing hope feeling so tired of doctors , quiropractors, physiotherapists all with their opinions and like you said each of them in their own plane sugesting pilates, meat eating , expensive treatments with machines to decompress the spine, patience, positive attitude, antidepresants, antinflamatory drugs so strong that One day I woke up with my mouth filled with canker sores ..... I have a long list of all the things I should do to get better............... I am so tired of doing and asking outside . I am currently working with an acupunturist , the inversion sling , and trying with my very best effort to keep positive and the one advice I know I must take is patience and a more positive attitude, I am trying my very best..............
Outside of this pain that defenetaly feels inflamed there have been in my life every thing from a new baby, a change of profession, the tragic death of a family member, economic tension in the house ..... I am still teaching but only 3 times a week . And I have had some days pain free but I still have not found what trigers the strong pain.
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