Sacroiliac (SI) joint pain is located in the lower part of the back, a small joint on both sides of the spine at the pelvis junction, supporting the spine and hips. Often leading to pain radiating down the buttocks or back of the thigh, females are more susceptible to sacroiliac joint pain by a 2:1 ratio. The Si area has very little movement to it, if any, with the hip points often causing pain in the individual’s groin or disc pain mimicking SI pain.
Any injury or sacroiliac joint inflammation in this area tremendously affects body movement as it is a joint that transfers the upper body weight to the lower body. Simple activities such as walking up-and-down the stairs or reaching overhead in cupboards can become severely affected. Current evaluations or treatments of any sacroiliac dysfunctions are controversial – ranging from surgery to exercises.
Too often patients with painful SI joint problems are told their pain is coming from the SI joint, instead of the real culprits – the sacroiliac joint ligaments and surrounding highly innervated tissues. For this reason, surgery fuses the joint because of a misdiagnosis of “abnormal joint mobility.” However, pain is still felt by 50% of all patients who have had the SI joint surgery.
Neutralizing the spine to begin SI exercises
As an alternative to surgery, it has been found that conservative therapy or special exercises work well with SI joint’s inflammation or injury problems. Before beginning any strengthening exercises for sacroiliac joint pain, it is necessary to do a warm-up and neutralize the spine to avoid further pelvic alignment. If not, the faulty alignment will become even more misaligned and cause more pain.
• Standing – Check the status of the lower back by placing the shoulder blades and buttocks and against a flat wall to check on the position of the lower back, as an arch between the lower black and the wall – which is the normal position. To neutralize the spine, stay in the same position but push the centre of the back toward the wall.
• Lying down – lie down on a soft mat with knees bent. Arms should be at the side with feet placed apart about a hip width. Create an arc by moving the body upward, drawing the middle back area down while keeping the spine in a normal position. On the mat, the blades of the shoulder should be pushed flat while drawing the chin downwards toward the chest while leaving a size of the fist.
• Sitting – press the buttocks toward the seated chair’s back with the spine placed directly on top of the seat area. Directly in line will be the collarbone over the hip bones, with the breastbone over the tailbone/pubic bone area. Draw the navel gently inward.
Sacroiliac joint pain exercises
The wall squats are simple exercises for working with sacroiliac (SI) joint pain. The basic position is to stand in neutral (see above) while learning on the wall – feet placed at a distance of a thigh length. Bend the knees at an angle of no less than 90 degrees, keeping the body’s weight evenly on both heels. The kneecaps need to be lined with the 2nd toe of each foot. Remember that the shoulder blades, buttocks, middle back, and shoulder blades should be kept flat on the wall at all times while bending and lifting. Repetition: 8 to 12 times, three times a week.
Another exercise for sacroiliac joint pain is the pelvic clock, practised while on the mat with a neutral spine (see above) and bent knees. Imagine the hours of a clock (3 o’clock and 9 o’clock are the hips; 6 o’clock is the tailbone; 12 o’clock is the navel). Moving the pelvis only while keeping the knees immobile, move the centre of the body clockwise and then repeat counter-clockwise. Repetition: 8 to 12 times every other day (do two to three sets on those days).