SI Joint Dysfunction

Sacro-iliac joint issues can be a real pain in the rear.

This small join sits right at the bottom of the spin, where your pelvic bones (ilia) meet your sacrum. Protected by several sturdy ligaments and designed to be extremely stable, the SI joint is not capable of much movement. However, that teensy bit of movement is super important.

When it’s not working right you will definitely feel it!

The SI joint can be damaged by direct impact (falling hard on your butt), arthritis, or become unstable due to connective tissue conditions like EDS and even pregnancy.

One of my teachers once said “if you have SI joint issues, you know it.” Because there’s so much connected to this area (the sciatic nerve, the glutes and the piriformis, the connective tissue of the low back, not to mentions a bunch of ligaments) SI joint dysfunction tends to be very painful. It may focus on the low back, be deep in the hip, or radiate down the leg. Wherever it may manifest, it’s often intense.

If this sounds like your experience and you’d like to treat it, read on. If you aren’t having these issues, don’t worry, you’re fine.

Making it Better

In normal activities the sacrum is able to nod forwards and backwards (nutation and counter-nutation). Additionally the pelvic bones can nod forward and backward in opposition to each other, with the sacrum remaining stable.

If you have SI joint issues these movements are likely unbalanced or not present. The best thing to do is to find exercises that help restore proper movement here.

How to deal with SI issues varies depending on what’s causing the problem. Most of those causes fall into one of two categories: too stiff or too loose.

SI TOO STIFF?

If you’re very sedentary, have persistent low back pain, or had a heavy impact on your sacrum it’s likely that the affected SI joint is too stiff. You want to focus on exercises that mobilize the lower spine and hips. Good options include:

  • Self-massage of low back and glutes
  • Cat/cow pose or pelvic tilts
  • Figure 4 stretch

SI TOO LOOSE

If you’re very flexible, have a connective tissue disorder, pregnant or recently been pregnancy your SI joint dysfunction is likely due to instability. Your best bet is to focus on exercises that get you back into alignment and stabilize the surrounding area.

  • GENTLE self-massage of low back and glutes
  • Pelvic tilts or cat/cow
  • Pelvic list (standing on one leg with control)
  • Isometric squats

In general you want to avoid movements that destablize the pelvis, like having your legs too wide or the figure 4 stretch. I discuss this in detail, with some good strengthening exercises in the video below (which WordPress will NOT let me embed!)

https://youtu.be/M4bGAA4gFkk

In case you couldn’t tell, SI joint issues are near and dear to my heart. If you have any questions or need to talk about it, feel free to drop me an email.