The SI joint, or sacroiliac joint, is a joint made up of the pelvis and sacrum. The sacrum points about 35 degrees downward towards the ground. To locate the SI joint, feel the area where your tailbone and sacrum are on your backside. Next to that, at the pelvis, is the SI joint. There are two SI joints, one on each side of the sacrum.
The SI joint has been widely misunderstood in the past. For the longest time, researchers thought that it was very immobile and static. Research has now shown that it actually needs to have a fair amount of mobility to perform optimally. The SI joint is primarily stabilized by many strong ligaments. Secondarily, there are several muscle groups such as the piriformis that provide additional stabilization. (The piriformis is a muscle that is located deep within the buttocks.) The big glute muscles, part of the hamstring, and other muscle structures all play a part in stabilizing the SI joint.
The purpose of the SI joint is to act as a shock absorber and remove stress from walking, running, and other similar activities we perform throughout the day. If the joint is working properly, it will remove stress from the low back and transfer it throughout the SI joint and down into our extremities.
What happens if the SI joint has a problem?
If the SI joint gets stuck or tight, the force isn’t transferred properly into the extremities. You might start to develop discomfort or pain in your backside and down into your legs. Problems with the SI joint are caused by one of two things: hypermobility or hypomobility. Hypermobility just means that the joint is moving too much. Hypomobility means the joint is not moving enough.
Symptoms
Patients are often referred to us with some type of SI joint dysfunction or sacroiliacitis. Presenting symptoms are typically pain on the backside down the back of the hip. The pain isn’t so much lateral or the outside part of the hip where the ball and socket joint is. Instead, this pain is focused towards the backside where your tailbone or sacrum is located.
You might notice irritation while sitting due to the compressive load being placed on this region. Running, walking, or similar physical activity may result in localized pain in this area. In some cases, patients can have so much inflammation or irritation that they develop pain deep into the butt muscle or potentially down into the leg.
Treatment
To reduce inflammation, ice or anti-inflammatories such as ibuprofen are often suggested. Sometimes the pain management physicians we work with here in town will apply a steroid injection to reduce swelling. Typically, SI joint problems can be managed through simple exercises such as stretching the hip flexor and stability exercises on the backside.
Conservative and long-term treatment options would consist of some form of rehabilitation. For hyper-mobility, we’ll work on stabilizing the muscles to decrease the excessive range of motion. This includes hip stability exercises, gluteus medius exercises, and gluteus maximus (large butt muscle) exercises. We’ll also work on stabilizing the rectus femoris, which is the big muscle in the thigh.
For hypo-mobility, manipulation is a great treatment option. Manual therapists, osteopaths, chiropractors, and even physical therapists will mobilize/adjust the joint to increase motion. The goal is to reduce irritation in the joint and increase mobility.
To learn more about the SI joint, contact us online or give us a call at (918) 743-3737.
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