Injury of the Week #4: SI (Sacroiliac) Joint Dysfunction

Sacroiliac Joint Dysfunction

What is it?

The sacroiliac (SI) joint is the junction where the tailbone (sacrum) meets the pelvis. We have a left and right SI joint.  The dysfunction commonly results from a hypomobility in the SI joint (does not move well) and pain. When people experience chronic low back pain, the diagnosis may be SI joint dysfunction, however there are other causes of low back pain as well.

When do you notice the pain?

You may notice the pain with long periods of sitting, when you squat or bend over to pick up something or with certain one sided activities such as kicking, a golf swing etc.

Where does it hurt?

It will be painful in the low back, and may be localized to the left or the right. Can also feel pain into the glutes as well.

How does it happen?

In my practice I experience SI joint pain in individuals who sit for long periods: this could result from very tight (shortened) hip flexors from this sitting. The tension from the hip flexors can tilt the pelvis forward, putting stress on the SI joints.

In sports, it appears in those who perform repetitive, one-sided movements such as kicking, swinging, throwing, single leg stance.

It can also occur in people with a leg length discrepancy (one leg longer then the other).

Also hypomobility in the lumbar spine and tailbone (sacrum) can contribute to this.

How can I help it go away?

There is an SI belt you can buy to help increase the space among the SI joint. But as is the theme with the Injury of the Week, there are proper therapeutic exercises and stretches coming to you this week!

If you are experiencing SI dysfunction as described above, feel free to book a virtual appointment and we can delve into your specific symptoms and proper rehab techniques for you!


Wall Glute Stretch

You all probably have experience with the glute figure 4 stretch: it is a very popular stretch that can be done seated, standing and laying down!

I want to add a variation of this stretch to help you get the most effectiveness from it!

Lay on the ground with your butt close to a wall. Put both legs on the wall with a 90 degree bend in the knees

Cross one ankle over the opposite knee and flex your foot. IMPORTANTLY: push your tailbone into the ground. This should be a strong stretch in the glute on the side that your leg is crossed.

If the stretch is not strong enough, inch yourself closer to the wall. If the stretch is too strong, move away from the wall. If you are having trouble with this, make sure that the tailbone is flat to the ground. This may mean moving back away from the wall to achieve this.

Hold for 20-30 seconds and repeat 3 times each side. This is a post-exercise stretch and your SI joints and low back pain will thank you. 


Core Exercise: Dead Bug

Can you properly fire your core? If so, this is a great exercise to begin building some core endurance. It is especially great for SI joint dysfunction as your back is protected as it is flat against the ground.

When you do this exercise, do not hold your breath. How I teach core firing is to take a deep breath in, breathe out and then pull your belly button to spine and hold in your pee. Once you have fired the core, then the movement begins.

With your legs up at 90 degrees and your arms straight in the air, you will lower your opposite arm/opposite leg and bring them back to neutral. You will alternate each time for a goal of 20 reps (and 3 sets).

If you get pain prior to reaching 20 reps, STOP THERE! This is an exercise you can gradually build up in endurance. It takes some coordination at first but will become a core favourite.

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Psoas (Hip Flexor) Stretch

This is a first for me to have a stretch as a rehab exercise, but the hip flexors are commonly SO tight in people, I wanted to have to include it!

As I mentioned in my first post on SI joint dysfunction, the hip flexors can become so tight with sitting at our desk all day. This can tilt the pelvis forward and tension in the low back can result.

Find a pillow to kneel on for comfort, bring the opposite leg forward (so you are in a kneeling lunge position). Push both hips forward and whatever knee is down raise that arm in the air.

For an added stretch: whatever knee is down, squeeze that glute. You should feel this stretch in the front of the hip.

Use a timer here, as 30 seconds will go by very slowly for those of you with tight hip flexors! Try this stretch 3 times each side (post-exercise)!

Therapeutic Workout Thursday (TWT):

Therapeutic Workout Thurs for SI joint dysfunction:

 It’s all about the core and gluetes for this therapeutic workout!

1)   Table Top: raise opposite arm and leg. It is important to keep your hips level during this! Make sure your hips stay pointed straight towards the ground. If you find it too difficult to raise the arm and leg, try one at a time. 3 sets of 20 

2)   Monster Walk: With the mini band wrapped around your ankles, side step 3 sets of 20 steps each direction

3) Static Bear Crawl: On all fours, lift the knees up about 1-2 inches and hold. Use a timer and see how long you can hold for and repeat it 3 times. Very challenging core exercise, so make sure you activate your core by puling the belly button in and holding in your pee! 

4)   1 leg squat: Focusing on strengthening 1 leg at a time. Stick your butt back and ensure you can see your toes the entire movement! 3 sets of 10

If you are experiencing symptoms or pain like SI joint dysfunction, book in your virtual Athletic Therapy session today!

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