Overcoming SI (Sacroiliac) Joint Dysfunction

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 two sides of the sacroiliac joint normally work together. If one side becomes stiff, movement will be affected and this may cause 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 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 running, squatting, deadlifting, step-ups, or lunging movements.

If you have SI dysfunction, the first common-sense recommendation is to take a short break from the activity that is irritating the SI region. This allows for any inflammation to settle down.  If pain persists, hands-on therapy, or dry needling can alleviate pain faster.  As the pain subsides you can now get to work on the root causes of SI pain.

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 you and bending and lifting with poor mechanics, this may increase stress on the SI region.  The best way way to know what is contributing to pain is to have a movement assessment performed.

If there is weakness, learning activation exercises to activate muscles that are not firing well is important.  Lumbopelvic stability exercises are crucial for those that suffer from SI joint dysfunction.  Some beginner exercises include the angry cat and the bridge with adduction.  These can be found in our video library.

Once muscles engage better, the next step is restoring movement.  The basic function of the spine is to bending forward and backward and rotate.  A healthy spine should be able to do all those things.  Some exercises that restore movement include Superman poses, Jefferson curls, and kneeling rotations.  These can also be found in our video library.

As movement quality improves, the next step is to develop strength.  The best way to develop functional strength is with compound movements under load.  Movements that were once painful, now have their place.  When performed with good technique. hinging, squatting, and lunging with a planned progression will enable you to achieve lasting results.

When addressed with a specialized physical therapy program, overcoming SI pain possible.  However, ignoring pain may result in a more serious spine condition.  If you have concerns about SI pain, the physical therapists at Movement Solutions would be glad to be a resource for you.

We have a free guide on relieving back pain that can give you further insight into back problems and help kickstart your recovery.  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’re considering physical therapy, each month we offer a limited number of back pain consultations.  This is an opportunity to ask questions, obtain clarity about your back pain, and foster confidence that we can help you.  If you want help with your SI problem, request your consultation today.

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.

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