Sacroiliac joint (SIJ) region pain is one of the most common things I see amongst my patients, especially in the pregnant and newly postpartum populations. The SIJ is the connection between the spine and the pelvis. People often describe an aching or sharp sensation at their low back near the top of the pelvis (think the back dimple region). The SIJ is very stable despite people often being told the joint is “out”.
There are many muscles and ligaments that overlap across the joint which can sometimes be a source of pain. Additionally, poor strength and endurance of the glutes, pelvic floor and trunk muscles can contribute to this pain or cause a functional change to pelvic positioning that contributes to pain or discomfort. Luckily, PT can provide relief.
Step 1: Reduce the irritation.
- Identifying what movements and postures exacerbate your pain is the first step. We will find ways to modify these tasks in order to reduce the pain in the beginning. This can often mean reducing wide leg and single leg tasks for a short period of time, however this is not a long term solution. You may also benefit from external support such as an SIJ belt. The pressure of this belt mimics what your muscles should be doing and can be used while you work to address the root cause of your pain.
Step 2: Address proper breathing mechanics.
- People who experience low back pain will often adopt a more shallow breathing pattern. Learning core 360 degree breathing to improve expansion into your rib cage, low back and pelvic floor can help to release tension in your muscles and allow you to move through fuller, pain-free ranges.
Step 3: Release tension.
- Pelvic floor muscle tension is often present in someone with SIJ related pain. If this is overlooked, SIJ pain can take a longer time to improve. Release techniques include manual pressure to these muscles as well as teaching you the proper breathing and contract/relax positions to reduce tension on your own.
Step 4: Strengthen what is weak.
- We will do a full assessment of your core and hips and address where there may be weaknesses. Often the adductors (groin muscles) and hip internal rotators and extensors need to be addressed with SIJ pain.
Step 5: Reintroduce movements that were previously painful.
- This may mean moving through smaller ranges of motion or using less weight for a period of time. However, we don’t want to avoid the movements we’re afraid of. This means progressing back into single leg and wide stance exercises.
If you are experiencing pelvic or SIJ pain, reach out to schedule your free consultation so we can get you back to doing things you love without pain.
Dr. Jaclyn McCullough, PT
Physical Therapist
