The Sacroiliac Joint

If you have pain at the SI joint, you know exactly where this joint is. If you don’t, you may not know where this is or why it’s such a hot topic. The diagram to the right is of a pelvis and that circle is a sacroiliac joint, where the sacrum and the ilium connect. To find it in your own body, take your fingers from the very middle and top of the pelvis and palpate down a half inch and apart to the right and to the left about a half inch until you feel an indention on each side. In the mirror you may find that dimple there on each side. Those are you SI joints.

Why Do We Get Pain at the SI Joints?

People get pain for several reasons. Usually there is a root cause of the pain, not the SI joint alone being the one and only issue. Mine was due to a labral tear and osteoarthritis in the left hip plus scoliosis. Regardless, the nature of SI joint pain is a mechanical problem. Here are some of the most common reasons the SI joint starts to hurt:

Misalignments in the hips that cause too much pressure in the SI joint(s)
Misalignments in the lower back that cause too much pressure in the SI joint(s), i.e. reversal of the natural lumbar curve, scoliosis, herniated or bulging disks, etc.
Weakness in the smaller glute muscles and transverse abdominus that cause recruitment of the SI joint to do the work of those muscles because, instead of doing their job, they are asleep.
Pelvic Floor Dysfunction, or the inability of the pelvic floor to relax, causing too much pressure in one side or the other of your SI joint

Your SI joint has a jigsaw puzzle-type fit similar to the image above.

Here you see what it looks like when there is a tugging on the joint, or sacroiliitis.

In addition…we are adding to our own pain by doing these everyday tasks without knowing it.

In addition to the misalignments described above, there are some movements that may be exacerbating this pain in the SI joint. These movements might include:

Twisting incorrectly
Practicing lunges and warrior postures and forcing the hips into an alignment that tugs on the joint
Exercises that ask you to squeeze your glutes together
Prolonged periods of standing
Prolonged period of sitting
Running

A lot of additional pain comes from everyday activities like sitting at a desk for a long time and then bending down to take something out of the desk drawer. Taking dishes out of the dishwasher and doing laundry can be painful too. I worked someone unable to pick up their sweet baby out of the crib because of this pain. Talk about limitations!

Twisting incorrectly is a huge culprit as well. In fact, SI joint dysfunction is one of the most common yoga injuries because many time twisting can be cued incorrectly, causing tugging on the joint. (Hint: Please twist your hips in the same direction as your spine.)

What happens if it goes uncorrected?

SI joint pain will get worse if it’s not corrected, unfortunately. Some of the ordinary treatments include pain blocking medicine, pain blocking injections and, in the worst cases, joint fusion surgery.

These methods aren’t effective long-term because these remedies don’t correct the root problem. When the SI joint malfunctions, other parts of the body will be called on to do the job of the SI joint and absorb shock when you walk, sit, stand, etc. And here’s what can be down the road without a biomechanics resolution:

Chronic low back pain and other misalignment issues in the low back
Chronic hip pain and other hip alignment issues, leading to osteoarthritis
Weakening of the smaller gluteal muscles and weakening of the transverse abdomens (the core)
Piriformis syndrome
Pelvic floor dysfunction, leading to incontinence, sexual dysfunction and more
The other side SI joint may become an issue if not resolved

So you definitely want to correct the root cause of your sacroiliac joint dysfunction!

Even if injections and meds are an option you choose, the underlying issue(s) remains the same. When the medications and injections wear off, you are left with the same issue and now the pain is getting worse and these other root causes and secondary issues are showing up more and more over time, causing more pain, more frustration and limiting your quality of life and robbing you of your joy and freedom.

It’s a mechanical problem and a way to really resolve it is with a mechanical solution.

A Real Solution

The way to resolve this pain and stop any other primary and/or secondary issues in their tracks is through biomechanics and corrective alignment-based movement and education. First, we move to get the sharp, edgy acute pain to come down a notch so we can then get to the root of the pain. We can use a quick SI joint reset exercise to do this.

Now that there’s a little relief, we can better do this very gentle realignment exercise.

Next we are ready to learn how to develop more strength in the glutes, the transverse abdominus and we can begin to discover what areas need realignment and which lesser-used glutes need strength.

These realignments and muscle activation techniques cause the SI joint to be supported, to do its job and its job alone.

You learn how to do those movements in your daily life like sitting with good alignment, unloading the dishwasher in a way that doesn’t tug or grind in the joint and doesn’t cause additional pain.

The result you get is feeling great and enjoying the body for the long-term. You can get back to the life you enjoy, unlimited.

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