Rehabilitation Services Blog

April 16, 2018

From Dysfunction to Function: Tips, Tricks, and Fixes for the Sacroiliac Joint

Have you ever heard someone mention their SI joint and had no clue what they were referring to? No worries, today’s blog post will provide information about what the SI joint is and how we can implement exercises to strengthen and stabilize this joint to optimize daily activities and keep them pain free! 
 
Where is the SI joint? The sacroiliac joint (SIJ) is the joint is the connecting point between the spine and pelvis. The SIJ connects the sacrum, the triangular shaped bone AKA the tailbone, with the pelvis, specifically the iliac bone in the hip, on each side of the spine. There are many ligaments and tendons located at the spots where the bones meet to help keep the pelvis sturdy. 
 
 
The SIJ is known to be a stiff or rigid link where the spine and pelvis meet with limited degrees of movement to promote stabilization for our bodies. In some cases, our bodies may have increased or decreased mobility to one of both SIJ joints leading to SIJ dysfunction. This can occur for many reasons from trauma or excess mobility and lead to more stress to the joint. It is also important to note that discomfort of the SIJ joint doesn’t also mean it’s solely related to the SIJ, it may be occurring because of deficits in mobility or strength in other areas of your body. It’s important see a Physical Therapist to help discern where the SIJ discomfort could stem from. 
 
Let’s review the different types of SIJ dysfunction:
  • Hypomobility = stiffness
  • Hypermobility = laxity, loose
Both can be lead to discomfort or negatively impact our day to day movements such as walking, sitting and stairs if irritated. It is common for pregnant women to experience SIJ pain or discomfort due to the increased ligament laxity during pregnancy due to hormonal changes. Also, people who favor one side in standing or have job requirements placing their body, specifically pelvis and hips in compromised positions can also be at risk.
 
Don’t worry though, we, Physical Therapists, are here to help! There are many ways to strengthen and stabilize the SIJ to successfully function. Included below are some helpful tips to promote safe body mechanics and positioning for daily activities to promote SIJ stability. Our intention is to provide you with the tools and information to make your SIJ joint bulletproof so you can feel empowered to pursue your daily activities safely with confidence and pain free. 
 
Standing: 
  • Bend your knees slightly
  • Distribute your weight evenly on both legs, avoid favoring one side
  • Point your toes slightly outward
Rolling Over in Bed:
  • To roll over from your back to your side, bend one knee, placing your foot on the bed. Push the heel down, slightly lifting your bottom and turn towards the side on which the leg is still extended straight. The top arm helps the turning motion.
Sitting:
  • When sitting (whether you are driving a car, riding a bicycle or sitting on a chair), press your chest upward and let your shoulder blades relax and drop.
  • Sitting crossed legged with your feet crossed underneath your legs on the floor or on a very firm bed; use your hands to pull your knees gently back towards your hips and lift your chest, and keep your shoulders low.
I frequently tell my patients, the next posture is the best posture, for example, if you have been sitting in this position for a while, stretch forward as far as you can and touch the floor in front of you while keeping your spine straight. At the same time, look up. Practice this stretch as often as it feels necessary and good.
 
Static Sitting Positions:
  • Sit on a chair with your knees apart and slightly turned out.
  • Sit in positions that relax your lower back while it remains supported, using a cushion or a rolled towel behind your back; sit upright when the back is not supported.
  • You can also stretch your hips by sitting high enough so that your knees are lower than your hips or by crossing your feet under your chair.
  • Use a ball cushion while you are sitting, or sit on a therapy ball; sitting on a ball cushion allows your tailbone to be free. When you use a ball cushion or ball, you develop active stomach and back muscles over time as a result of trying to maintain your balance.
  • A good posture for resting is lying on your back on the floor, putting your feet up on the couch or bed, with a small pillow to support your back and/or head.
Now that you’ve learned some tips for safe positions for the SI joint with standing and sitting postures, we’ll go over five exercises to improve stabilization of your SIJ for stabilization and strengthening to promote active lifestyles with daily activities, hobbies and job duties.  
 
5 exercises to improve stabilization of your SIJ:
1. Hip ABD isometrics 
2. Glute bridges with band 
3. Quadruped hip extension
4. Clamshells
5. Bridge with alternating march
 
*Exercises and photos courtesy of MedBridge Education*
To access videos and further descriptions please go to medbridgego.com 
Enter in the Access Code: LTHF3CWC

Lindsey Paczkowski, PT, DPT
Lindsey graduated in 2016 from Carroll University in Waukesha, WI with her Doctorate in Physical Therapy. She is a LSVT BIG certified clinician and specializes in treatment of musculoskeletal and neurological diagnoses, in addition to an interest in women's health patient population. Lindsey currently works as a Physical Therapist at Palomar Health Outpatient Rehabilitation in San Marcos California. In her free time, Lindsey enjoys spending time at the beach and hiking with her husband, cooking new recipes and learning to surf.

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