Why does this joint become painful?
SI (Sacroiliac) Joint plays an important role connecting your spine (Sacrum) and pelvis with a number of supporting ligaments. This joint has lots of stress from the above and below since body weight and ground reaction force are passing through this spot. The below information is about the main causes creating pain in SI joint.
1. Joint mis-alignment: if joint is not in a good alignment, supporting ligament can be stressed due to being lengthened or shortened improperly. Brain sends a pain signal when it detects this positional fault by communicating with receptors in the joint and ligaments.
2. Trigger point and scar tissues in muscles and ligament: muscles and ligaments can develop tight non-functional tissues due to being overused without proper stretching & releasing.
3. Imbalanced muscles can distort the pelvis causing pain in SI joint: For example, too tight psoas (Hip flexor) muscle and weak antagonist (Buttocks and Hamstring) can cause pelvic anterior tilting which can increase pain.
How to fix SIJ (Sacroiliac Joint) Pain and Restore Normal Alignment?
1. ASSESSMENT TIPS
– Check leg length difference, hip joint range, pelvis and low back rotation alignment
– Check the tight & shortened muscles causing the asymmetry of Pelvis: Psoas, Hamstring, piriformis
– Find trigger points on the key spots: Lower Back, Sacrum Base, Apex, SI Joint line, Piriformis, Gluteus Medius, Psoas, iliacus
2. MANUAL THERAPY
Manual Therapy is the key to success in the treatment program. Properly applied Manual Therapy can release trigger point and correct joint alignment, resulting in decreased pain level and improving exercise performance.
– Joint adjustment: restoring joint symmetry, decrease ligament stress, activating joint receptors
– Trigger point release: decrease main source of pain, activates muscle performance
– Advanced myofascia release: decrease tensions in the body, improve sacrum mobility
3. SACRUM-PELVIS RESTORATION EXERCISE PROGRAM
After decreasing pain with Manual Therapy, exercise program can facilitate healing process. The focus of exercise program is to improve core stability in lower back, pelvis and sacrum complex. Once muscle groups around pelvis become more balanced and stronger, pain level will be progressively decreased.
* Treatment Tips: when the patient has pain with movement such as standing back flexion or extension, try to rotate the pelvis posterior manually while doing the movement. If pain decreases with this technique, SI joint is painful due to pelvis anterior rotation.
Try using adjustment (manipulation technique). Even if this joint requires more stability then flexibility, properly applied adjustment decreases pain level and activate joint receptors increasing more range of motion.
Exercise program should begin ASAP after decreasing pain level with manual therapy. If patient feels mild pain with exercise, use SI joint belt while doing exercise. I use a theraband tying up around the SI joint level instead of the belt. It decreases discomfort due to stabilization effect.
What if it is painful while doing exercise?
You can use pelvis / SI joint belt while doing exercise. It will decrease your discomfort level by stabilizing the joint. If you still feel pain, try Manual Therapy for Trigger point therapy, muscle release and joint alignment correction.