Sacroiliac Joint Dysfunction occurs in one or both of the sacroiliac joints where the flat, triangular shaped sacrum bone at the base of the spine interconnects with the pelvis.
The symptoms of sacroiliac pain can be similar to those of sciatica – pain in the buttocks and down the leg – but sacroiliac joint dysfunction is a different problem from sciatica.
We have two sacroiliac joints, one on each side of the sacrum. The most common problems I see in my practice are hypo-mobility and hyper-mobility.
The most common cause of SI joint dysfunction is pelvic torsion.
This will often result in one SI joint becoming stuck and immobile, while the other becomes unstable and too mobile.
The pain that can arise in a stuck and tight SI joint usually has a deep aching quality that responds positively to vigorous movement and the body getting warmed up.
On the other hand, the pain that can arise in an SI joint that's too mobile and unstable tends to feel sharp and pointed -- my clients have described it as, "like a knife stabbing the area" -- and does NOT respond positively to vigorous movement. In fact, such movement can aggravate an overly mobile SI joint.
A fairly reliable way to self-evaluate whether you pain is primarily rooted in a stuck SI joint or an overly mobile SI joint is to ask if one of the above descriptions fits.
Either way, when SI joint problems are rooted in pelvic torsion, the restoration of pelvic balance is the only way to resolve the pain and problems long term.
When the SI joint is stuck it will likely have a restricted, tight feeling. You feel you want to stretch it out all the time, and may twist your body into various contortions in an attempt to gain relief.
In such cases, the fascia, the muscles, and even the deep ligaments around the joint may have adapted to a shortened state.
Various influences can cause tissues to shorten including a sedentary lifestyle and trauma (such as a fall where there’s impact to the tailbone). I also see a high incidence of tightness in the sacroiliac ligament and the surrounding tissues in women post-partum.
Near the end of pregnancy, hormonal changes cause the sacroiliac joints to relax in preparation for delivery. But a rebound effect can occur in which the tissues around the sacrum tighten up again to the point of creating restriction.
The result can be the hypo-mobile version of Sacroiliac Joint Dysfunction.
A stuck sacroiliac joint can be an uncomfortable thing. Relieving it, however, can be relatively easy; no more difficult than lengthening the restricted tissues by applying direct, myofascial or deep tissue therapies to the area.
Mobilizing the area in as many ways possible is recommended. For a complete range of extremely effective stretching techniques see my Stretching Videos page.
I also recommend a daily routine of Somatic Exercises, which are slow gentle movements that mobilize the deep, intrinsic muscles and ligaments. This is essential for maintaining sacroiliac flexibility.
A more challenging problem is when pain is coming from a sacroiliac joint that is hypermobile, too loose. Pain from an SI joint that’s too loose will not usually feel like it wants to be stretched.
The pain can be sharp, or piercing. The pain can radiate across the buttocks and down the leg.
My clients have described it in various ways such as a zinging feeling, or a hot feeling. Some have described it like this:
It’s like there’s a knife stuck in there.
The more extreme pain of a hyper-mobile or loose SI joint (as compared with a stuck SI joint) is the result of the tissues being strained, overstretched, often to the point where the nerves are irritated.
Hyper-mobility means the joint is unstable, and that the ligaments intended to secure it in place and restrain it’s motion have become lax.
This laxity can be the result of:
Direct stretching, in this case, will not relieve the pain because the area is already overstretched and strained. In fact, stretching a hyper-mobile joint will worsen its state.
To treat the pain of a hypermobile sacroiliac joint: