A painful sacroiliac joint (SIJ) is one of the more common causes of mechanical low back pain. The sacroiliac joint is the joint that’s made by the wedging of the lowest portion of your spine (sacrum) in between the bones that make up each side of your pelvis (ilium). Sacroiliac joint dysfunction is a term that is used to describe the general condition – because it is not fully understood why this joint becomes painful and leads to low back pain. Sacroiliac joint dysfunction can be a nuisance but it is seldom dangerous and rarely leads to the need for surgery. Most people who suffer from this problem can reduce the pain and manage the problem with simple methods.
The SI joint is one of the larger joints in the body. The surface of the joint is wavy and fits together similar to the way Legos® fit together. Very little motion occurs in this joint. The motion that does occur is a combination of sliding, tilting and rotation. The most the joint moves in sliding is probably only a couple of millimetres, and may tilt and rotate two or three degrees.
The SIJ is held together by several large, very strong ligaments. The strongest ligaments are in the back of the joint outside of the pelvis. Because the pelvis is a ring, these ligaments work similarly to what hoops that hold a barrel together do. If these ligaments are torn, the pelvis can become unstable. This sometimes happens when a fracture of the pelvis occurs and the ligaments are damaged. Generally, these ligaments are so strong that they are not completely torn with the usual injury to the SI joint.
When movement of a joint is limited, the pain and symptoms of SI joint dysfunction may worsen. Getting more motion can give you the relief you need for daily activities. If you don’t have full range of motion, your Exercise Physiologist has several ways to help you get more movement including joint stretching, mobilisation and strength exercises. Active movement and stretching as part of a structured program can also help restore movement and get you better faster.
The Exercise Physiologists at Optimum will prescribe a set of stretches to improve flexibility in the muscles of the trunk, buttocks, and thighs. These exercises usually require that you position your hip and pelvis in a certain way and either stretch or contract and relax specific muscles. You may have the opposite issue and your SI joint may have too much mobility and a different course of exercise treatment would be prescribed.
In addition to stretching exercises, you will need a set of exercises to build strength, muscle control, and endurance in the muscles that attach around the SI joint. Unfortunately, few muscles actually connect to both the sacrum and the pelvis. Key muscles to work are the gluteus maximus, as well as the abdominal and low back muscles. As your rehabilitation program evolves, you’ll begin doing more challenging exercises. The goal is to safely advance your strength and function. Ring your local Optimum studio for an individualised exercise prescription program.