Sacroiliac Joint Dysfunction
The sacroiliac (SI) joints link the pelvis and lower spine. These two joints are made up of a triangle-shaped bone called the sacrum, which is located above the tailbone, and is connected with the two top halves of the pelvis, known as the ilium. The SI joints support the weight of the upper body when standing (Mayo Clinic Staff, n.d.).
The SI joint:
is a small yet strong joint that is reinforced by very tough ligaments surrounding it (Cedars Sinai, n.d.)
does not have much motion (Cedars Sinai, n.d.)
transmits all the forces of the upper body to the pelvis and legs (Cedars Sinai, n.d.)
acts as a shock-absorber (Cedars Sinai, n.d.)
(Duvall & Hammond, n.d.)
Sacroiliac Joint Dysfunction
Sacroiliac (SI) joint pain is thought to contribute to low back pain with 20% of the population suffering with it chronically (Prather et al., 2020). Often, SI joint pain presents as a progressive problem with fluctuations in symptoms that may be experienced with specific activities of daily living, sports, or certain exercises (Prather et al., 2020). One day you can be pain free, whereas the next you may experience painful symptoms.
Focusing on muscle imbalances and corrective exercises help to decrease SI joint pain. (Prather et al., 2020). Sometimes we need to down regulate muscle tone and tightness to decrease tension, whereas other times we need to increase tone and strength to promote tension (Prather et al., 2020). This varies from muscle to muscle and person to person. SI joint pain is an individual issue: for some it may be from one-sided tightness, for another it may be from lack of abdominal control, and for others it may be from deep hip rotator tension (Duvall & Hammond, n.d.). It is recommended to visit a physiotherapist to receive a proper diagnosis to build a concrete treatment plan.
A recent randomized control trial investigating the effectiveness of manual therapy vs exercise therapy for sacroiliac joint dysfunction demonstrated that manual therapy helped early on for treatment, but by the 12 week mark both manual therapy and exercises were equally helpful with the treatment of pain (Negate et al., 2019). Doing a handful of pelvic stabilization exercises have been proven to help alleviate SI joint pain, amazing!
One of the exercises performed in the study was the abdominal drawing in exercise we do all the time at the studio. You know the one: our hands on our low belly -on the right and left of the midline two inches or so below the belly button- gently pull in and up our low abdominals while separating our tuna fish cans (lumber vertebrae) at the low back :)
Bridging, front and side plank, criss cross (abdominal twist), baby swan, and bird dog were other exercises performed during the study. So many Pilates exercises! All supported by evidence to be helpful to build a strong and stable pelvis.
If you are feeling tightness or tension around your SI area, here are three exercises you can do at home. They are subtle, but important first steps if you are experiencing painful symptoms. Click each picture to view quick video.
After performing these three exercises, try doing your regular workout routine to discover if you have less tension and more ease of movement around your SI area. I bet you will! I suggest adding abdominal draw ins, bird dogs, swan, bridging, and dead bugs, which will contribute to strengthening and stabilizing your pelvis, thus providing support to the SI area.
