Issues with the sacro-iliac joint (SIJ) have been a point of contention in the physiotherapy world for a while now. It’s hard to find research that explains or backs up the phenomenon that has been SIJ pain. It used to be thought that pain (often unilateral) along the (SIJ) line was due to a jarring of the leg or a weakness of ligaments postpartum or during pregnancy that resulted in one side of the sacrum ‘slipping’ or moving slightly out of position. Research shows that IF there is any movement at all that it is minor and that the ligaments are so strong that it is unlikely that any laxity will have any actual effect on the support of the SIJ. Another train of thought is that this presentation occurs due to a lack of strength in supporting musculature- gluteals and core specifically. Whether myofascial, neuromuscular or joint-y in nature, this is what currently stands out when we consider SIJ pain and what we do to ‘treat’ it.
Signs and Symptoms
Unilateral, deep, diffused pain along one side of the buttock (along the SIJ line)
Often referring into the front of the hip or down the back/side of the leg
Difficulty or discomfort with rolling over in bed, getting out the car or doing single leg activities. Walking or side-lying can also be uncomfortable.
Weak inner core/gluteals/hamstrings
Heaviness with an active single leg raise
Tenderness with palpation/mobilisation over SIJ line
Hands on techniques to help modulate neuromuscular structures
Strengthening of gluteals (bridges, squats etc) and core
Progressive SIJ loading activities
What can YOU do at home?
If you think you have SIJ pain and you want to try some things at home first, try the following:
Simple Double leg Bridge
In lying, bend both knees and place your feet on the floor.
Squeeze your bottom and push your heels into the ground as you lift your bottom up off the floor. Hold for 2 breaths and lower.
Stop if you get any pain, and lower back down.
Initially, you may get some pain at a certain point in this range, work up until that point and lower and repeat 10 times. Try concentrate on feeling your bottom/gluteals turning on rather than your hamstrings.
This is quite a generic exercise but one of the most basic ones to try teach yourself to turn on your gluteals. If you’re unsure whether you do have SIJ pain or whether the above exercise itself is too painful to do, then I’d suggest seeing your health professional for some pain relief first.
Do you have any aches or pains that you want to get checked out? Book in online here to see one of our Physio's today, or call us (08) 9448 2994.