What is sacroiliac pain or dysfunction?
Intense pain in the pelvis, deep part of the buttocks, low back and/or leg can be caused by your hip, spine or Sacroiliac joint (SI) joint or all three.
Anatomy of the Sacroiliac Joint
Your 2 sacroiliac joints (SI) are located in the pelvis and link the sacrum (triangular shaped bone at the base of the spine) to the ilia (hip bones). Your pelvis divides the weight of the upper body between the legs, therefore these joints are functionally important for the control and distribution of force between the upper body and the legs.
Think of them as shock absorbers, mitigating gravitational forces as well as those generated by standing and walking.
They are true joints, lined with articular cartilage and stabilised by strong ligaments. Unlike other joints they have a very limited range of movement. Muscles such as your buttocks (gluteus maximus) and deep rotator (piriformis) also support these joints.
Causes of SI Joint Pain
Common causes of SI joint pain include:
- Trauma such as a fall on the buttocks
- Vigorous exercise such as running & jogging
- Lifting and/or twisting
- Pregnancy & childbirth
- Degeneration due to spine surgery or fusion
- Stresses created by leg length differences, joint replacement or scoliosis
There two mechanisms that I often see in my studio:
Too much Movement (hyper mobility or instability) can cause the pelvis to feel unstable and result in pain in the lower back and or hip that may radiate into the groin .
Too Little Movement (hypo mobility or fixation) can cause muscle tension, pain and limit mobility. Pain is typically felt in the low back or buttocks and can radiate down the back of the leg.
What can you do?
There are 3 possible approaches :
- DTY – Done to you, for example Chiropractic fixes, injections, surgery
- DWY – Done with you, such as physical therapy, hands on bodywork
- DIY – Do it Yourself (Homework)
My preferred approach is to improve the function of the joint, and stabilise it in order to alleviate pain. This involves: combining the DWY & DIY approaches to
- Improve posture
- Improve the symmetry and balance of the pelvis
- Improve muscle strength to stabilise the SI joint
- Improve the mobility of the SI joint if that is appropriate
- Improve the mobility of the joints above and below the SI joints
- Modify the walking pattern
Provide external support for the SI joints if necessary.