SACROILIAC JOINT DYSFUNCTION
The sacroiliac joint (SIJ) is located in our lower back at the base of our spine. It is made up of our tailbone (the sacrum) and each half of our pelvis (the iliums). Therefore, we have two SI joints, one on each side. This is often where the little dimples in our lower back are located. This joint is a load bearing joint as we walk and load each limb. There is some rotational movement that occurs at this joint as we swing each of our legs. The hip joints on each side sit within a “socket” on each ilium, thus as our hips move in all directions, the SIJ accommodates with some twisting and rotational motion.
When we have an injury to our SIJ, we typically call it an “SIJ dysfunction”, which can be associated with it being “stuck” or “loose”. In the case of HYPOmobility (stuck), this can happen with a misstep (ie. an unexpected step off a curb), bending and lifting, or a slip and fall. When we have HYPERmobility issues (loose), this may be due to hormonal changes (during or after a pregnancy, weight gain), trauma, or genetic conditions or auto-immune disorders. Both scenarios can lead to a wide range of symptoms throughout the lower back, buttocks, thigh or groin.
The pain can range from a low-grade ache to a sharp, shooting pain and movement may be restricted. Typically, the focus of the pain is located quite specifically in the SIJ area. However, there can be referred pain, or radiating pain, that can travel down the buttocks, outer thigh, knee or shin. Often movements such as rolling in bed, bending forwards, standing on that leg to get dressed, and getting in/out of a car become difficult. Walking can become achy in that area and prolonged sitting can become stiff throughout the lower back.
Upon assessment, your physical therapist will help to identify biomechanical imbalances in your movement patterns and muscle tone and length. We also aim to re-establish proper activation of the stabilizing muscles in the lower back and pelvis. This is important for proper load transfer and motion of the SIJ. In the case of medical or pharmacological intervention, a referral to your family doctor may be required. Typically, SIJ dysfunctions manage well with joint mobilization, muscle re-education and modalities such as IMS/ needling techniques or electrical muscle stimulation to restore proper muscle length and relieve trigger points. An SIJ belt can be beneficial for added stability during a time of recovery. Specific exercises and stretches are incorporated to restore proper mechanics of the abdominals, lower back, pelvis and hips.
If you think you may have SIJ issues, our physiotherapists, massage therapist and personal trainer are here to educate you and help you get back to your optimal function.
Jennifer Gordon (BSc.PT, GunnIMS, AFCI)
Physiotherapist – Bragg Creek Physiotherapy
www.braggcreekphysio.com
