Sacroiliac joint dysfunction is a lower back/pelvic condition that can result from joint stiffness (hypomobility) or slackness (hypermobility) at the sacroiliac joints in the pelvis. The condition can affect both men and women of all ages, but is more common in females. Symptoms typically are present on 1 side of the back, and affect 10% to 25% of patients with complaints of low back pain.
The sacroiliac joint is a joint between the sacrum and the ilium, or pelvic bone. The 2 sides of the sacroiliac joint normally work together. If 1 side becomes stiff, they will not move together and this causes pain or muscle stiffness in the area. Pain is often made worse with walking and bending activities. It is also possible that one side may become too loose (lax) as well, resulting in SI joint dysfunction. This may occur during the menstrual cycle or pregnancy due to hormonal changes that cause the ligaments to become more lax. SI joint dysfunction can occur with injury, such as when a person falls and lands on one side of the body and alters the position of the joint, or when an athlete overtrains. Sacroiliac pain is also related to some types of arthritis, such as ankylosingspondylitis, an inflammatory process most often affecting the lower back, which may cause the vertebrae to fuse.
People with SI joint dysfunction may experience pain that may be sharp, stabbing or dull, localized to one side of the pelvis/low back, groin, or tailbone. The pain that may radiate down to the knee and can be exacerbated with movements, such as standing up from a sitting position, turning in bed, or bending/twisting. There is often muscle tightness and tenderness in the hip/buttock region. Day to day activities that are painful include walking, standing, and prolonged sitting. Pain is usually worse when standing and walking, and eases when sitting or lying down. Some exercises in the gym and that can be painful with SI joint dysfunction include squat, deadlift, or lunge movements.
In our physical therapy office, the first recommendation that we usually make is to take a short break from the aggravating activity. This allows for an environment for the inflammation to settle down and the SI joint to heal. While taking a break usually helps with pain, we know for our patients to get back to the activities that they enjoy, we have to address the root of the issue.
In many cases, SI joint dysfunction is correlated with poor mobility of the hip muscles and the lumbar spine. This can be combined with weakness of the core, lower back, and gluteal muscles. In addition, if there are technique errors with exercise, this may lead to faulty spine mechanics. However, the only way to know what is contributing to pain and injury is to perform a complete assessment.
When pain and stiffness is found via the assessment, our approach includes manual mobilization to alleviate pain and improve mobility. Improvements can be made very quickly if the right regions are targeted. If weakness is found, we teach activation exercises to help our clients better engage muscles that are not firing well. Lumbopelvic stability exercises are crucial for those that suffer with SI joint dysfunction. Once pain is controlled and muscles engage better, our next step is teaching our patients to develop stability of the hips and spine with resistance exercise. We slow begin to reintroduce movements and exercises that were once painful. We teach proper technique with all loaded movements (e.g. hinge, squat, lunge).
When addressed with a through physical therapy assessment and plan of care, SI dysfunction can resolve relatively quickly. However, ignoring symptoms and continuing with repetitive activity with poor mechanics can develop into a more serious issue. If you feel like you may be developing an SI joint problem, the physical therapists at Movement Solutions would be glad to provide a thorough assessment and give you a diagnosis for your condition. We are available for a free 15-minute phone consultation to talk about how your pain is affecting you and discuss your treatment options. If you prefer an in person consultation, we offer a limited number of free Discovery Visits at our office. This type of appointment of for those who are considering booking an evaluation. It is an opportunity to ask questions, obtain clarity about your condition, and develop confidence that we can help. If you’re in pain and unsure about what your next steps should be, call us at (864)558-7346 and ask how we can help.