Northern Michigan
Physical Therapy Blog

Guide to Sacroiliac (SI) Joint Dysfunction

by | Aug 19, 2020

How long have you noticed yourself sitting down into a chair differently? You used to be able to pop right up from a chair, now it’s a chore. 

You’re out on the beach, and bending forward to pick up a Petoskey stone is out of the question, in fact, all bending motions have become very calculated.  

You’re on the sandbar and your little one wants you to pick them up and throw them in the air, but you haven’t been able to squat and lift any weight without pain in a long time.  

Sitting is not as comfortable either, you have to find the perfect pillow to put behind your back for good support.  

Riding your mountain bike on the VASA is no longer enjoyable as it once was.  

If any of these activities cause pain in your lower back and you find yourself avoiding these types of activities, chances are you are experiencing SIJ dysfunction or sacro-iliac joint dysfunction.  

We hope this article offers some guidance and assists you in your pursuit of returning to activities that bring you joy.

And we hope it starts the process of you getting rid of that sacroiliac joint (SIJ) pain for good! 

What is SIJ dysfunction?

The sacroiliac joint (SIJ) is a joint between the sacrum (a large bone at the base of the spine) and the ilium (a bone in the upper part of the pelvis).  It has a very important job. It helps to connect our lower extremities to our trunk and upper body!  It transmits tremendous amounts of force between our lower body and our upper body.  With any motion we make, our SIJ is involved!

There are two sides to the SIJ, and normally they work together. 

Dysfunction and pain can occur when one side of the joint becomes too stiff, or too lax.  This results in the ligaments and the joints becoming chronically irritated and painful.

This can occur in one or both sides.  

Image of back side of pelvis with colored areas being sacroiliac joints and ligaments

Common Signs and Symptoms

If you have SIJ dysfunction, you may experience sharp, stabbing, or dull pain on one side of your lower back, groin, or tailbone.  This can occur on both sides, but more often it is one sided.

You may notice pain radiating down to the knee.  

Symptoms commonly worsen with transitional movements going from sitting to standing, or standing to sitting.  

Bending, squatting, lifting, and twisting activities usually cause the pain to increase.  

The pain commonly eases with lying down.   

Sound Familiar? (link to schedule page) 

What causes SIJ pain?

We call this the million-dollar question, and one we take very seriously.

You now know that SIJ dysfunction is caused by the ligaments of the joint becoming either too stiff or too lax over time, chronically irritating the joint and ligaments, causing pain.  The real question is, what causes this laxity or stiffness?

Sometimes SIJ dysfunction can be a direct result of something.  For example, a woman who is pregnant or recently has given birth could experience SIJ dysfunction as a result of increased laxity in the ligaments surrounding the SIJ.  Another direct cause could be sudden traumatic injury, perhaps a fall or landing awkwardly on one foot.

However, as with most other injuries, most the time, SIJ dysfunction is a result of gradual, and repeated micro trauma and stress over time.  This results in pain and less tolerance for activity.

This leads us to the next question, what contributes to this repetitive, chronic stress of the SIJ and ligaments surrounding the joint? 

Remember, it transmits tremendous amounts of force between our lower body and upper body.

So, in order to effectively diagnose the causes of SIJ pain, we need to look above and below the joint.  

This is often where the “cause” lies.  

We all know how important core strength is, and it plays a role in SIJ health.  But the truth is, the powerful muscles down the kinetic chain including our glutes, hamstrings, calf muscles play an even larger role. They absorb shock and supporting our pelvis every time we take a step, bend, squat, jump, run, and lift.  The more mobile and stronger these muscles are, the less likely the SIJ will become irritated.  

Here are some of our favorite hip opener exercises to relieve stress at the SIJ by improving freedom in the hips.

How will we Diagnose?

Each person who comes to Pursuit Physical Therapy for a diagnosis will notice our unwavering desire to remove the guesswork.  We will perform a detailed and customized examination to accurately diagnose.  Our formula is as follows: 

  1. Q&A – we listen to your story – This will guide our next steps
  2. Detailed observation and analysis of the pelvis and SIJ region.
  3. Detailed observation and analysis of the hip and upper trunk flexibility and strength.

Based on our findings from the customized examination, we will have a good understanding of why the SIJ is in pain, what likely caused it, and what we can do about it.  

I want to find out why my SIJ hurts and what I can do about it. 

How can we help?

The process we follow here at Pursuit Physical Therapy is simple and effective.  

  1. First and foremost – reduce the pain
  2. Find the true cause and fix it – No Guesswork
  3. Implement a long-term solution, so you can return to your activities

Using our training from the world-renowned Gray Institute, we have learned how to assess and diagnose from the best in the world.  

We are very confident in our ability to find the true cause of your pain and implement strategies to fix it for good. 

We’re committed to being honest, detailed, and personalized.  

You deserve a plan that applies to you as an individual, not a cookie cutter program.  This is our promise, and this is how we achieve optimal outcomes. 

I want a personalized plan for fixing my SIJ dysfunction.

What is my next step?

In order to know how to fix it, you need to know what caused it! 

Once we have an idea of what caused it, we can streamline your time and energy on what you would most benefit from. 

I want to get started. 

If you’re sick of the pain and want to address it now, give us a call.  We love this stuff and we would be honored to help.  We guarantee to get back to you within the same business day.

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