The sacroiliac joint is one of the joints in the pelvis which is formed by two bones, the sacrum and the ilium. There is a small amount of movement allowed at the SI joint, but its major function is stability. The SI joint transfers the downward weight of standing and walking into the lower extremities.The SI joint often becomes misaligned in women due to increased loads, stresses, pelvic ligament strains, and greater instability at the SI joint due to hormonal changes versus the male pelvis. Women are 10 times more likely to suffer from SI joint dysfunction/instability.

What Triggers Sacroiliac Joint Pain?

Sacroiliac pain can be aggravated with prolonged sitting or standing, standing on one leg, stair climbing, going from sit to stand, and with running. Women’s wider hips influence the amount of force required to maintain stability during everyday activities. For example, when walking, as each hip joint alternately moves forward and backward with each step, an increase in hip width causes an increased torque (force) across the SI joint. Some other potential causes of sacroiliac pain include arthritis, traumatic injury, pregnancy and post-partum and systemic inflammatory conditions.

The hormonal changes of menstruation, pregnancy and lactation can affect the integrity of the ligament support around the SI joint, which is why women often find the days leading up to their period are when the pain is at its worst.

The reason why pregnant and postpartum women often have SI joint dysfunction is a result in the increase of the relaxin hormone that softens the structure of the lower spine and the pelvis, resulting in laxity in the ligaments, which leads to instability and ultimately discomfort or pain, especially in the SI joint.

What Does Sacroiliac Joint Pain Feel Like?

The signs and symptoms of SI joint pain start in the lower back and buttock, and may radiate to the lower hip, groin or upper thigh. While the pain is usually one-sided, it can occur on both sides. Women may also experience numbness or tingling in the leg or a feeling of weakness in the leg.

How Can Physical Therapy Help Sacroiliac Dysfunction?

Physical therapy and exercise is typically an essential part of the treatment plan for sacroiliac joint dysfunction pain relief and recovery. At Prime Orthopedic Rehabilitation we evaluate which SI joint is dysfunctional and we treat it with a combination of manual techniques and therapeutic exercise to improve the mobility and stability of the SI joint.

Once correct motion has been restored to the SI joint, a series of stretching and strengthening exercises will be prescribed to help reduce sacroiliac joint pain. These exercises will relax tense muscles and ligaments that limit natural motion at the joint; and also strengthening exercises to support the SI joint so exercises will target the pelvis as well as the abdominals, lower back, groin, hamstring and thigh.

Some exercises that would be beneficial to stabilize SI joint:

1. Transverse Abdominal

Lie on your back with knees bent. In supine with knees bent and feet flat on the floor you want to activate your transverse abdominal muscle. Visualize tilting your pelvis back just slightly and drawing in your belly button toward your back bone. (Basically like trying to zip up a tight pair of pants.)

You should feel the transverse ab muscle pull in and away from your fingers. Hold for 5 seconds and repeat 10 times.

2. Clam (hip abduction)

Lie on your back with knees bent. Place a resistance band around the thighs. Keeping core muscles engaged, gently separate knees apart to strengthen outer thighs and buttocks. Hold for 5 seconds; return your knees together and repeat 10 times.

3. Ball Squeeze (Hip adduction)

Lie on your back with knees bent. Place a ball or pillow between your knees. While keeping your core engaged, squeeze the object for 5 seconds; hold then release and repeat 10 times.

4. Bridge

While lying on your back with knees bent, tighten your lower abdominal muscles, squeeze your buttocks and then raise your buttocks off the floor/bed as creating a “bridge” with your body. Hold for 5 seconds and then lower yourself and repeat 10 times.

If you are having difficulty with your lower back, sacroiliac joints or experiencing pelvic pain, call Prime Orthopedic Rehabilitation for an appointment at
201-503-7173.

Jessica Lowy, DPT, CMTPT, DN, McKenzie 1-4, Schroth Therapist; and Michal Porath, MPT, McKenzie 1-4, Schroth Therapist are owners of Prime Orthopedic Rehabilitation in Tenafly, New Jersey. They treat posture disorders in their clinic, in addition to general orthopedic and post surgical patients. Call (201) 503-7173 for an appointment.

By Jessica Lowy PT, DPT, CMTPT,
McKenzie 1-4, Schroth certified;
Michal Porath PT, MPT, McKenzie 1-4, Schroth certified