my si joint journey

Monika Volkmar Bodywork and Movement Education

Sacroiliac Joint 101: What is the SIJ and How to Self-Assess (in less than 8 mins)

Do you have a deep achey painy thing between your butt and your back, and you’re not sure if it’s lower back pain or butt pain?

That’s probably your sacroiliac joint. And we can totally figure it out 🙂

In this blog post I’m going to share some video clips from my Troubleshooting the SI Joint (part 1) Movement Deep Deep session from Sept 18 2021 help you work with that poor, misunderstood SI joint of yours.

How to be a DIY SIJ Detective

Quick back-story: I became a self-appointed DIY movement detective by sheer necessity.

At age 22 I was broke and broken from my career in dance (marry rich, one prof told us).

I had no money to get physical therapy (literally like $500 in my account, the remnants of my student loan not even my own money), no future as a dancer, and a part time customer service job at the local Goodlife Fitness (when they changed the title “Customer Service Rep” to “Motivator” and I knew I had to get out of there…).

What I did have was time and hunger to understand my body.

The insight struck me as I limped to the physio clinic one day to get yet another ineffective treatment: I have to become my own best therapist. No one can do this for me, or care more about me more than me.

That limp was my victory march, and the beginning of my journey as a DIY movement detective.

As the beloved Buddhist teacher Pema Chodran wrote in her book, When Things Fall Apart, “We’re here to study ourselves. Studying ourselves provides all the books we need.”

I’ve come to see my body is my best textbook. All the info I need is within it.

Saying this because if you’re in a similar place- you’ve realized that only YOU can figure you out, then what I have to share today will help your investigations.

So before you hop on Youtube and do a search for “How to make my SIJ stop hating me”, let’s see if we can help orient you to your SI joint by opening the textbook of You.

Time to get off the lacrosse ball you may be sitting on, cursing your pririformis as the root of all evil, and get to learning 🙂

SIJ Made 10-Year-Old Simple

I’m not claiming I know everything about the SIJ. Not even close…

My hope is that the two video clips in this post will help orient you to 1) What your SIJ is and, 2) Why it might feel like it does from a movement perspective.

From there, you can make better informed decisions about WHAT to do about it.

This first clip covers:

• What the heck is the SI joint anyway?
• How much movement does it actually have?
• What primary purpose does SIJ motion serve in gait?
• What two simple terms can we use to name SIJ movement that even a 10 year old can understand?

Want to see the 60 second version? Check it out here on my Instagram account .

Side note: After editing this video I’ve now heard the word “SI joint” so many times it doesn’t even sound like a real word anymore and I never want to hear it again.

In case you didn’t watch the video, here’s the quick summary:

Gait is my favourite context to observe movement within. All joint motions our bodies can do happen while we walk. Unless they can’t 😉 This gives us a fabulous set of joint interactions to assess movement quality of.

The SIJ has it’s very own role in gait. Is yours performing that role based on its original instructions?

In gait, we’re interested primarily in the ability of the SIJ to compress and decompress at the appropriate times with each footstep to help us with shock absorption.

This is similar to how your foot goes through pronation and supination to give you that “bounce” in your step, but getting stuck in either position all the time can cause trouble.

Let’s move into how to self-assess your SIJ as your pelvis moves in three dimensions..

A Comprehensive Gait-Centric SI Joint Self-Assesssment in Less Than 8 Mins

AKA: The SIJ self-assessment a 10-year-old can follow along with (I hope…)

Here’s the second video clip from my Troubleshooting the SIJ (part 1) session: Dynamic assessments of SIJ compression and decompression in gait.

Here’s a quick recap of what is happening at the SI joint space during pelvis motion:

You should now have a better idea about:

• Which pelvis motions are flagging up your SIJ stuff
• Whether its a compression or decompression
• In which planes of motion it’s happening

So what did you discover? Are you like me: Compression in two planes, and decompression in the other? Compression in all three planes? Decompression causing most of your problems?

Now you know more about your SIJ than most therapists will be able to tell you, beyond, “Your piriformis and hip flexors are tight”. Can you see why this isn’t enough information to change the movement habit keeping you stuck as you are?

So… Now you have your data. What do you do with it?

4 Steps to SIJ Relief

A few important notes.

First, there is no one-size fits all approach. I don’t think its wise or responsible to advise on what exactly to do in a blog post, so I’m not going to 😉

Second, this is only ONE perspective. If it resonates with you and feels useful, that’s great. In the full 90 minute Movement Deep Dive session I shared 5 exercises to try out. Their intention is simply to help you explore and reclaim the triplanar movements your pelvis might be missing, and then integrate these motions into two lunge-y, gaity-y exercises.

The reason I hesitate to share the specific exercises here is not because I’m a selfish jerk…

To fully appreciate them, a fundamental understanding of the body’s movement mechanics through the gait cycle is key. This is why I like folks to go through my Liberated Body Workshop FIRST before attending my Movement Deep Dives sessions. Otherwise, the exercises will have no context, and you won’t get anything useful from them other than a face workshop from making confused faces.

But I can provide a thought process to get you started with right now.

STEP 1: Understand in which planes of motion your pelvis has movement restrictions or discomfort: Sagittal, frontal, or transverse (we already did that).

STEP 2: Note whether or not each of those motions correspond with compression or decompression of the SIJ (we already did that, too).

STEP 3: Experiment with exercises to give your pelvis, as a whole, the experiences of movement, compression, and decompression it is missing in ways that feel safe and comfortable.

For example: Are you missing the ability to posterior tilt your pelvis and could this be why the anterior tilt feels compressive? Explore some posterior tilt exercises and see what happens. Experiment with different body positions. Supine? Prone? Standing? Handstanding?? (just kidding.. kinda).

The HOW is even more important than the WHAT. This means moving slowly, paying attention to details, and valuing quality of movement, such as:

• Is the issue because you’re deviating from the plane of motion you’re trying to move within ? For example: You’re trying to rotate your pelvis, but instead you’re deviating into an anterior tilt, compressing your SIJ. Could finding a way to make that movement more pure, clean, and honest be the solution?
• Is the issue that you think you’re moving your pelvis, but you’re actually moving something else , like your spine, or ribcage, in an attempt to move your pelvis?
• Are you doing the right movements the wrong way? Too intense. Too fast. Too little awareness. Too many reps. Too big. Too small… These are things it helps to have an outside eye with.

STEP 4: Integrate these missing pelvis motions with the rest of the body, the way we should see it in gait, so that the body learns to walk-IN the new movement options, not walk it off.

Show your body how these movements fit back in with your original instructions. Otherwise it’s just another novel experience.

The clips from this blog post are from Troubleshooting the SIJ PART 1. But… There are two more parts, and I’ve compliled all three together into a little workshop for you: Troubleshooting the SI Joint

PART 1:  What is the SI Joint? What movements of the pelvis create SIJ compression and decompression? How can we assess this? And a movement exploration to bring awareness to our pelvis motion and restore all movement possibilities that should be available to it (the topic of this blog post).

PART 2:  What lower body influences could be contributing to SIJ crankiness? How do movements of the feet, legs, and hips impact on how our SIJ feels?

PART 3 : What upper body influences could be related to how your SIJ feels? How do movements above from the spine and ribcage play into how our SIJ feels, in terms of com back. Stipulation: You have to write me a 500 word essay about your experience 😉

I hope you enjoy this guided exploratory series of movement sessions to get to know your pelvis and SI joint better 🙂

If you are an anatomy nerd/movement professional, and want to learn more about gait mechanics, check out Gary Ward’s closed chain biomechanics of the lower limb online course . SO good!

Conclusions?

This is certainly not the definitive guide to SIJ mastery, simply one perspective for understanding what’s up with YOUR SI joint, through the lens of gait mechanics.

Knowledge is power. You deserve better than a generic, glute squeezing, lacrosse-ball-sitting approach. You deserve to understand your body mechanics to make an informed choice.

Decompression isn’t always the answer. Sometimes our symptoms are due to decompression, and we won’t know until we assesss! Could you be compressed in one plane, but decompressed in another? Again, knowledge is power! Before chooseing an intervention, know your specific intent based on your body’s true demands.

This is an investigation of YOU, by you, for you . This is the creed of the DIY Movement Detective. No one can do your work for you, but you don’t need to do it all alone. There are folks like me interested in helping you figure your body’s shit out. I don’t want to tell you what you should do, only to help you think more critically, and give you more avenues to explore so you can find your own answers.

Seek professional help when you’re stuck. Massage, physio, acupuncture, movement coaching. If you have a structural/tissue restriction, or your nervous system is a little too triggered to feel safe enough to do any movement exploration, I strongly recommend finding a practitioner you trust to help you out. Even DIYers like me need a little guidance and support sometimes 😉

What did you discover about your SIJ?

I’d love to hear if you discovered anything new (or remembered something old) through this exploration. Was this useful? Is there anything that you want more clarity on? Shoot me an email or leave a comment on this blog post and let’s chat 🙂

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Common Triggers of SI Joint Pain and How to Prevent a Flare-up

By: shelby elder, dc, chiropractor.

The sacroiliac (SI) joint is crucial to lower back, pelvic, and leg function. This pivotal joint is responsible for supporting the upper body's weight and transferring it to the lower body as well as acting as a shock absorber to control forces transmitted from the legs to the spine. 1 Baronio M, Sadia H, Paolacci S, et al. Etiopathogenesis of sacroiliitis: implication for assessment and management. Korean J Pain. 2022;33(4):294-304. http://doi.org/10.3344/kjp.2020.33.4.294 , 2 Wong M, Sinkler MA, Kiel J. Anatomy, Abdomen and Pelvis, Sacroiliac Joint. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507801/ , 3 Cramer, Gregory D., and Chae-Song Ro. “The Sacrum, Sacroiliac Joint, and Coccyx.” Clinical Anatomy of the Spine, Spinal Cord, and Ans, Elsevier, 2014, pp. 312–39. http://doi.org/10.1016/B978-0-323-07954-9.00008-6 Acute trauma and repetitive microtrauma contribute to 88% of SI joint pain cases. 4 Dydyk AM, Forro SD, Hanna A. Sacroiliac Joint Injury. [Updated 2022 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557881/

In This Blog:

Physical activities that flare-up si joint pain, si joint pain due to poor posture, si joint pain due to physical inactivity, footwear that can trigger si joint pain, foods that can flare-up si joint pain, physical changes that can trigger si joint pain, lifestyle modifications to prevent si joint pain from flaring, activities to strengthen the si joint: preventing future pain flare-ups.

Most commonly, SI joint pain is triggered by activities that involve the lower back, pelvis, and legs moving together, such as sitting, walking, climbing stairs, and standing. Incorporating lifestyle modifications and therapeutic activities that protect and strengthen the lower back and pelvis can help prevent future flare-ups.

See  2 Little-Known Treatments to Relieve Sacroiliac Joint Pain

Show Transcript

Sacroiliac joint dysfunction is improper movement of the joints at the bottom of the spine that connect the sacrum to the pelvis. It can result in pain in the low back and legs, or inflammation of the joints known as sacroiliitis .

The sacrum is a triangular bone at the bottom of the spine, below the lumbar region of the spine and above the tailbone. It consists of five fused vertebral segments. The sacrum is connected to the pelvic bone, also known as the iliac crest, on the right and left sides at the sacroiliac joints. These joints act as shock-absorbing structures and typically only move a small amount.

Sacroiliac joint dysfunction refers to pain in these joints when they move either too much or too little. Hypermobility, or too much movement in the sacroiliac joints, is a result of loose ligaments supporting the joints. Hypermobility has many causes, including pregnancy or injury to ligaments.

Hypomobility, or too little movement in the joint, can be caused by degenerative joint diseases such as arthritis. When the sacroiliac joints overcompensate for problems in nearby joints, they may become painful. For example, many lumbar spinal fusion patients have sacroiliac joint pain due to reduced motion in lumbar spine segments.

Sacroiliac joint pain usually manifests as pain in the lower back or buttocks, but pain can spread to surrounding muscles that may spasm in response to joint dysfunction.

Sacroiliac joint dysfunction is a condition that is may be misdiagnosed as a herniated disc , so it is important to be aware of the specific symptoms associated with sacroiliac joint pain.

This blog outlines the common triggers of SI joint pain and useful tips on how to modulate daily activities to prevent this pain from worsening.

The SI joint can become inflamed from overuse, leading to joint changes and painful symptoms.

Certain physical activities can stress the SI joint through overuse or repetitive microtrauma, causing the inflammation within the joint to flare-up. These triggers are discussed below.

• Certain occupations. Jobs that require frequent standing, sitting, and walking, such as teachers, store clerks, and restaurant jobs, may cause SI joint pain. Heavy manual labor that involves frequent lifting of heavy objects can also increase stress on the SI joint, leading to pain and discomfort.
• High-impact exercises. High-impact exercises, such as running, jumping, and plyometric exercises (such as lateral jumps and burpees) can stress the back and pelvis, leading to an increased risk of triggering SI joint pain. 5 Peebkes R, Jonas C. Sacroiliac Joint Dysfunction in the Athlete: Diagnosis and Management. Current Sports Medicine Reports. 2017;16(5):336-342. http://doi.org/10.1249/JSR.0000000000000410
• Cycling. Sitting in a forward-leaning position on a bike for long periods can cause the pelvis to tilt forward, leading to increased stress on the SI joint.
• Sports. Sports involving repetitive twisting motions, such as golf and gymnastics, and sports with repeated lateral movements such as tennis, soccer, ice skating, and basketball, can place significant stress on the lower back and pelvis, triggering SI joint pain. 4 Dydyk AM, Forro SD, Hanna A. Sacroiliac Joint Injury. [Updated 2022 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557881/

Frequently engaging in these activities can cause repetitive microtrauma to the joint and the surrounding structures, making the joint weak and painful over time.

Poor posture can trigger SI joint pain by placing stress on the lower back and pelvis, leading to SI joint misalignment or irritation. When we sit or stand with poor posture, the spine's natural curves can become exaggerated, causing the pelvis to tilt forward or backward, affecting the orientation of the SI joint, and leading to discomfort or pain in the lower back and buttock. 6 Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV. Sacroiliac Joint Pain and Its Treatment. Journal of Spinal Disorders and Techniques. 2016;29(2):42-48. https://doi.org/10.1097/BSD.0000000000000359

Being inactive can weaken the muscles that support the spine and pelvis, leading to decreased spinal stability and increased stress on the SI joint. When we are inactive, the muscles that support the lower back and pelvis may become weak and stiff, making it harder for the body to maintain a supported posture. 3 Cramer, Gregory D., and Chae-Song Ro. “The Sacrum, Sacroiliac Joint, and Coccyx.” Clinical Anatomy of the Spine, Spinal Cord, and Ans, Elsevier, 2014, pp. 312–39. http://doi.org/10.1016/B978-0-323-07954-9.00008-6

Certain types of footwear can trigger SI joint pain by affecting the body's orientation and how we walk or stand. Wearing shoes that do not provide proper support can cause the feet to roll inward or outward when walking, leading to misalignment of the pelvis. 7 O’Leary CB, Cahill CR, Robinson AW, Barnes MJ, Hong J. A systematic review: The effects of podiatrical deviations on nonspecific chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation. 2013;26(2):117-123. http://doi.org/10.3233/BMR-130367

Some common types of footwear that can contribute to SI joint pain include:

• High heels. High heels can cause the pelvis to tilt forward, increasing stress on the lower back and SI joint.
• Flats with little arch support. Wearing flat-soled shoes that do not provide adequate arch support can cause the feet to roll inward or outward, increasing the stress on the SI joint.
• Flip-flops or sandals with no arch support. Similar to flats, sandals that provide little-to-no arch support can increase the stress on the SI joint.

Over time, the stress caused by wearing these types of footwear also contributes to repetitive microtrauma to the SI joint—leading to pain and dysfunction.

Specific foods that trigger arthritis-related pain include:

• Sugar. Consuming too much sugar can trigger inflammation throughout the body, including the SI joint. Sugar can be found in many processed foods, such as candy, sweet beverages, and baked goods. 8 Jamar G, Ribeiro DA, Pisani LP. High-fat or high-sugar diets trigger inflammation in the microbiota-gut-brain axis. Critical Reviews in Food Science and Nutrition. 2021;61(5):836-854. http://doi.org/10.1080/10408398.2020.1747046 , 9 Ma X, Nan F, Liang H, et al. Excessive intake of sugar: An accomplice of inflammation. Front Immunol. 2022;13:988481. http://doi.org/10.3389/fimmu.2022.988481
• Processed food. Processed food is often high in sugar, salt, and unhealthy trans fats, all of which can trigger inflammation. 10 Remig V, Franklin B, Margolis S, Kostas G, Nece T, Street JC. Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation. Journal of the American Dietetic Association. 2010;110(4):585-592. http://doi.org/10.1016/j.jada.2009.12.024 Examples of processed food include fast food, frozen meals, and packaged snacks.
• Fried food. High-heat cooking methods, such as frying, use cooking oils high in trans fats that increase the production of inflammatory compounds. 11 Song J, Park J, Jung J, et al. Analysis of Trans Fat in Edible Oils with Cooking Process. Toxicol Res. 2015;31(3):307-312. http://doi.org/10.5487/TR.2015.31.3.307
• Red meat. Red meat such as beef, veal, pork, and lamb are high in saturated fat, triggering inflammation. 12 Wang X, Lin X, Ouyang YY, et al. Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies. Public Health Nutr. 2016;19(5):893-905. http://doi.org/10.1017/S1368980015002062

Frequently consuming inflammatory foods, especially for individuals with arthritis-related conditions, can increase overall inflammation in the body, flaring up arthritis-related SI joint pain. 13 Khanna S, Jaiswal KS, Gupta B. Managing Rheumatoid Arthritis with Dietary Interventions. Front. Nutr. 2017;4. https://doi.org/10.3389/fnut.2017.00052

Physical changes in the body that may trigger SI joint pain include:

• Pregnancy. The hormonal and physical changes caused by pregnancy can trigger SI joint pain. As the body prepares for childbirth, the ligaments and joints in the pelvic region become more relaxed and flexible, increasing the risk of SI joint pain. 1 Baronio M, Sadia H, Paolacci S, et al. Etiopathogenesis of sacroiliitis: implication for assessment and management. Korean J Pain. 2022;33(4):294-304. http://doi.org/10.3344/kjp.2020.33.4.294
• Obesity. Excess body weight can place extra stress on the SI joint, leading to inflammation and pain. Obesity can also lead to poor posture and weakened muscles, which can place additional stress on the SI joint. 1 Baronio M, Sadia H, Paolacci S, et al. Etiopathogenesis of sacroiliitis: implication for assessment and management. Korean J Pain. 2022;33(4):294-304. http://doi.org/10.3344/kjp.2020.33.4.294
• Age. Although the SI joint is relatively mobile in young persons, it can stiffen with age. 3 Cramer, Gregory D., and Chae-Song Ro. “The Sacrum, Sacroiliac Joint, and Coccyx.” Clinical Anatomy of the Spine, Spinal Cord, and Ans, Elsevier, 2014, pp. 312–39. http://doi.org/10.1016/B978-0-323-07954-9.00008-6 Decreased mobility in the joint leads to inflammation and pain, and changes in the pelvic musculature and stability. 1 Baronio M, Sadia H, Paolacci S, et al. Etiopathogenesis of sacroiliitis: implication for assessment and management. Korean J Pain. 2022;33(4):294-304. http://doi.org/10.3344/kjp.2020.33.4.294

Certain medical conditions can also contribute to SI joint pathology. Ankylosing spondylitis is the most common rheumatic arthritis that causes inflammation and stiffness in the SI joint and spinal ligaments. 1 Baronio M, Sadia H, Paolacci S, et al. Etiopathogenesis of sacroiliitis: implication for assessment and management. Korean J Pain. 2022;33(4):294-304. http://doi.org/10.3344/kjp.2020.33.4.294 Over time, this inflammation and stiffness can lead to the fusion of the SI joint and other spinal joints. 14 Ebrahimiadib N, Berijani S, Ghahari M, Pahlaviani FG. Ankylosing Spondylitis. J Ophthalmic Vis Res. 2021;16(3):462-469. http://doi.org/10.18502/jovr.v16i3.9440

Additionally, after certain spine surgeries, such as a lumbar spinal fusion , increased mechanical loads are transferred to the SI joint, which may trigger pain within the joint. 15 Yoshihara H. Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge. Eur Spine J. 2012;21(9):1788-1796. http://doi.org/doi:10.1007/s00586-012-2350-8

Several strategies can help prevent SI joint pain. Here are some useful self-care tips to keep in mind:

• Practice good posture. Good posture can help reduce the strain on the SI joint. Make sure you sit and stand up straight, with your shoulders back and your hips aligned.
• Exercise regularly. Regular exercise can help improve the strength and flexibility of the muscles surrounding the SI joint. Aim for at least 30 minutes of exercise daily, such as walking, swimming, or using an elliptical trainer.
• Practice proper lifting techniques. When lifting heavy objects, bend at the hips and point both knees straight ahead, keep the weight close to the body, and straighten the knees to stand up.
• Maintain a healthy weight. Excess weight can put extra strain on the SI joint. Aim to maintain a healthy weight through regular exercise and a balanced diet.
• Using supporting pillows. Using a lumbar support pillow while sitting and a wedge pillow while reclining on the bed can help support the lower back and maintain its natural curve.
• Wear supporting footwear. To prevent SI joint pain caused by footwear, wearing shoes that provide proper support and alignment for the feet and body is important. Orthotic inserts may also help provide additional support and reduce stress on the SI joint, especially when there is a difference in leg length. 1 Baronio M, Sadia H, Paolacci S, et al. Etiopathogenesis of sacroiliitis: implication for assessment and management. Korean J Pain. 2022;33(4):294-304. http://doi.org/10.3344/kjp.2020.33.4.294
• Eat a healthy, anti-inflammatory diet. To prevent SI joint pain caused by dietary inflammation, avoiding inflammatory foods, such as saturated fats, trans-fats, and refined sugar, is beneficial. 16 Pahwa R, Goyal A, Jialal I. Chronic Inflammation. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/

By implementing these strategies, individuals can reduce the strain on the SI joint and prevent or manage ongoing SI joint pain.

Hello, everyone. I'm Natalie. And today Veritas Health is bringing you four easy stretches for SI joint pain relief. The first stretch I'm going to show you is a hip adductor stretch, which should be performed sitting on the edge of your chair with your legs out straight in front of you. You will lean forward towards the ground until a gentle stretch is felt in the inner thighs. Work up to holding for 30 seconds performing three times total.

The next stretch you can perform for SI joint pain relief is a seated hamstring stretch. You will put one leg out in front of you with the knee straight. And you will lean forward until a gentle stretch is felt through the back of the thigh. You can hold this stretch for up to 30 seconds working up to three times on each leg.

The next stretch I'll show you is a standing quadricep stretch. This will be performed with your hands on a chair or a wall for balance. You will take the ankle of the thigh you want to stretch and pull it towards your buttocks. A gentle stretch should be felt in the front of the thigh. You can hold this stretch for 30 seconds working up to three times on each side.

The final stretch I'll show you is a single knee-to-chest stretch. This will be performed laying on the ground or on your bed with your back flat on the floor. You will straighten one leg and take the other knee pulling it towards your chest. You will hold this stretch for 30 seconds working up to three times total.

If you have any pain or discomfort with these stretches, please consult with your provider. To learn more about SI joint pain, please visit Spine-health and subscribe to our channel for more videos like this. Thank you for watching.

Therapeutic activities to improve the health of the SI joint and reduce future pain flare-ups include:

• Low-impact aerobic exercise. Low-impact aerobic exercises, like walking, jogging, and using an elliptical trainer or stationary bike, can help improve cardiovascular health and effectively distribute essential nutrients throughout the body to help recover from injuries. Aerobic exercise is generally considered most beneficial when done for a minimum of 20-30 minutes a day but depending on the severity of the SI joint pain, it’s recommended to start slow. 17 American Heart Association Recommendations for Physical Activity in Adults. American Heart Association. July 27, 2016. Accessed January 13, 2023
• Swimming and water aerobics. Swimming and water aerobics are low-impact exercises that can help improve cardiovascular health, reduce pressure on the SI joint, and strengthen the surrounding muscles. 18 Barker AL, BHeallth Sci JT, Morello RT, et al. Effectiveness of Aquatic Exercise for Musculoskeletal Conditions: A Meta-Analysis. Archives of Physical Medicine and Rehabilitation. 2014;95(9):1776-1786. https://doi.org/10.1016/j.apmr.2014.04.005
• Stretching. Stretching exercises targeting the lower back, hips, and thighs can help improve lower back and pelvic flexibility and reduce stress on the SI joint.
• Physical therapy. Physical therapy can help alleviate SI joint pain by improving muscle strength and flexibility, reducing inflammation, and promoting healing.
• Yoga. Yoga is a low-impact exercise that can help strengthen and tone the muscles around the SI joint, reducing pressure on the joint and relieving pain. Yoga can also be easily performed at home.
• Ice and heat therapy. Applying ice or heat to the low back and pelvis can help reduce inflammation and may alleviate pain and discomfort associated with the SI joint.

SI joint pain can be debilitating and significantly affect the quality of life. Understanding the common triggers and avoiding activities that can aggravate the symptoms can help prevent future flare-ups and keep the pain under control. Any concerning symptoms or signs in the lower back or pelvis must be evaluated by a physician.

Learn more:

Treatment options for sacroiliac joint dysfunction.

Surgical Treatment for Sacroiliac Joint Pain

• 1 Baronio M, Sadia H, Paolacci S, et al. Etiopathogenesis of sacroiliitis: implication for assessment and management. Korean J Pain. 2022;33(4):294-304. http://doi.org/10.3344/kjp.2020.33.4.294
• 2 Wong M, Sinkler MA, Kiel J. Anatomy, Abdomen and Pelvis, Sacroiliac Joint. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507801/
• 3 Cramer, Gregory D., and Chae-Song Ro. “The Sacrum, Sacroiliac Joint, and Coccyx.” Clinical Anatomy of the Spine, Spinal Cord, and Ans, Elsevier, 2014, pp. 312–39. http://doi.org/10.1016/B978-0-323-07954-9.00008-6
• 4 Dydyk AM, Forro SD, Hanna A. Sacroiliac Joint Injury. [Updated 2022 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557881/
• 5 Peebkes R, Jonas C. Sacroiliac Joint Dysfunction in the Athlete: Diagnosis and Management. Current Sports Medicine Reports. 2017;16(5):336-342. http://doi.org/10.1249/JSR.0000000000000410
• 6 Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV. Sacroiliac Joint Pain and Its Treatment. Journal of Spinal Disorders and Techniques. 2016;29(2):42-48. https://doi.org/10.1097/BSD.0000000000000359
• 7 O’Leary CB, Cahill CR, Robinson AW, Barnes MJ, Hong J. A systematic review: The effects of podiatrical deviations on nonspecific chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation. 2013;26(2):117-123. http://doi.org/10.3233/BMR-130367
• 8 Jamar G, Ribeiro DA, Pisani LP. High-fat or high-sugar diets trigger inflammation in the microbiota-gut-brain axis. Critical Reviews in Food Science and Nutrition. 2021;61(5):836-854. http://doi.org/10.1080/10408398.2020.1747046
• 9 Ma X, Nan F, Liang H, et al. Excessive intake of sugar: An accomplice of inflammation. Front Immunol. 2022;13:988481. http://doi.org/10.3389/fimmu.2022.988481
• 10 Remig V, Franklin B, Margolis S, Kostas G, Nece T, Street JC. Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation. Journal of the American Dietetic Association. 2010;110(4):585-592. http://doi.org/10.1016/j.jada.2009.12.024
• 11 Song J, Park J, Jung J, et al. Analysis of Trans Fat in Edible Oils with Cooking Process. Toxicol Res. 2015;31(3):307-312. http://doi.org/10.5487/TR.2015.31.3.307
• 12 Wang X, Lin X, Ouyang YY, et al. Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies. Public Health Nutr. 2016;19(5):893-905. http://doi.org/10.1017/S1368980015002062
• 13 Khanna S, Jaiswal KS, Gupta B. Managing Rheumatoid Arthritis with Dietary Interventions. Front. Nutr. 2017;4. https://doi.org/10.3389/fnut.2017.00052
• 14 Ebrahimiadib N, Berijani S, Ghahari M, Pahlaviani FG. Ankylosing Spondylitis. J Ophthalmic Vis Res. 2021;16(3):462-469. http://doi.org/10.18502/jovr.v16i3.9440
• 15 Yoshihara H. Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge. Eur Spine J. 2012;21(9):1788-1796. http://doi.org/doi:10.1007/s00586-012-2350-8
• 16 Pahwa R, Goyal A, Jialal I. Chronic Inflammation. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/
• 17 American Heart Association Recommendations for Physical Activity in Adults. American Heart Association. July 27, 2016. Accessed January 13, 2023
• 18 Barker AL, BHeallth Sci JT, Morello RT, et al. Effectiveness of Aquatic Exercise for Musculoskeletal Conditions: A Meta-Analysis. Archives of Physical Medicine and Rehabilitation. 2014;95(9):1776-1786. https://doi.org/10.1016/j.apmr.2014.04.005

Dr. Shelby Elder is a chiropractor at North Texas Brain and Spine Institute. She believes in providing evidence-based, patient-centered, and holistic care through non-surgical treatments. Dr. Elder is experienced in practicing several chiropractic techniques. Her special areas of interest include the treatment of spinal conditions and back pain.

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Sacroiliac Joint Fixation Minimally Invasive Surgery – Recovery A Year Later Update

• March 24, 2014
• Return To: My Medical Journey , Sacroiliac Joint Surgery

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A year in reflection – My minimally invasive  bi-lateral percutaneous sacroiliac joint fixation without fusion is still a miracle!  Sacroiliac (SI) Dysfunction, Instability and Pain are gone. The transformation and the excellent results I’ve had from this surgery has been praised by my  Dr. PZ Pearce of Champion Sports Medicine, Spokane, WA. He will now recommend this surgery to his other patients that suffer with Sacroiliac Joint Dysfunction that has failed to resolve with conservative measures. Along with Dr. Pearce, Dr. Soto (my pain management specialist at Northwest Medical Rehab) has witnessed the positive changes in me as I have set my course to eliminate chronic pain at its source. Dr. Soto has already posted his professional comment to my website.

However, it has been a horrendous last year in other ways after my SI surgery on 1-17-13. What I mean is that I faced  3 more surgeries and one more in the making as I post this blog update. I faced a total of 16 weeks of non-weight bearing off of my left leg and a week off of my right leg with those surgeries during this past year. Without the screws holding my SI Joints in complete neutral, I would have never tolerated standing and weight bearing on one leg only. My SI Surgery gave me a firm foundation from which I could go on and accomplish my left Proximal Tibiofibular Joint Fixation for its chronic partial dislocation/posterior subluxation. See www.fibularpain.com for all those related blog stories. I proceeded then to heal a fracture in my left foot Talus bone/subtalar joint and then do my HyProCure Stabilization surgeries for both my left and right subtalar joints of my feet to eliminate partial dislocation of the TaloTarsal complex (hyper-pronation). Here is link to all the Subtalar and HyProCure Surgery Blogs: Subtalar Joint Instability

On the anniversary date 1-17-14, I was not up to writing about my SI post surgical status at that moment because I was between the two HyProCure Surgeries on my feet.  I was having a temporary issue going on in the soft tissue over my right SI Joint, specifically  the Posterior Sacroiliac Ligament. I was having an increased anterior drop of my right pelvis due to the excessive pronation of my right foot and instability of my right proximal tib-fib joint. This drop was more exaggerated as I increased walking during the 4th week post op recovery from my  11-15-13 left foot HyProCure Surgery.  I was fine with physical therapy but excessive walking would aggravate it. Here is an excellent  blog article “The foot bones’ connected to the hip bone” by Dr. Geoff Lecovin that contains the picture on the left. I did not realize how bad my feet had been affecting my SI joints, created pubic symphysis dysfunction and played havoc on my proximal tib-fib joints with life long hyper-extended knees.

Now as I write this blog after doing my right foot HyProCure Surgery, my right foot arch Navicular bone is not dropping any more. As a result I have less torque and tension in my pelvis and over my Posterior Sacroiliac Ligament.   During the last two months while attending physical therapy for my feet, Joanna my therapist at Peak Performance would use Dynamic Tape over my SI Joints to support the tissue. This tape did not irritate my skin and stayed in place far superior to Kinesio Tape.  Staying taped alleviated my symptoms.  It was never a deep pain of the joint where the screws are placed but a surface stretch/traction type of soreness.

My walking problem should be resolved with my next Proximal Tibiofibular Arthrex Tightrope Dynamic Stabilization Surgery for my right tib-fib joint taking place on 3/27/14 when I return to Moberly, Missouri to see Dr. Main again for the 2nd time around. Even with all this going on, I still am 100% better than before my SI Surgery as far as sitting and doing office work. I can sit for many hours and not have any pain going up the spine like I had before the SI Surgery.  Life in general is so much better regardless of my other surgeries this past year.  I look back with absolute satisfaction regarding my SI Fixation without Fusion Surgery . I had to start somewhere unraveling the physical mess of chronic pain. The order that my entire medical journey has taken me on has been with God’s leading each step of the way and I have no regrets.

From my experience, here is a summation of my patient to patient advice:

• If you have chronic SI Dysfunction issues as discussed here on my website and not a direct acute trauma to the SI Joints, then simultaneously please rule in or out your feet/subtalar joint instability aka excessive pronation. If custom orthotics have not helped your feet and stability, then please seek out a foot doctor trained in the HyProCure Surgery such as my Dr. Gent as they understand the far reaching benefits of this surgery in helping the alignment of your entire body. For the nationwide HyProCure doctor provider directory see this  link .
• See this blog article link  written by Swodeam Consulting Inc. about how excessive pronation does contribute to posterior subluxation of the Superior(Proximal) Tibiofibular joint. Chronic subluxation and the fibula bone being stuck out of neutral position causes pain down the leg and into the ankle which does affect your walking and all the soft tissue that connects to this bone both proximally and distally; however like my case, this did not show up on any diagnostic imaging. See my www.fibularpain.com blogs for help on this subject or contact my surgical specialist, Dr. Main .
• It is great to enjoy extra flexibility while you are young and in sports; however, don’t overlook chronic hyper-extended knees as they do contribute to pelvic mal-alignment and lumbar issues.
• If you are strong and stable on neutral feet but had a fall/car accident that may have directly impacted/injured your SI joints (or the ligaments holding the joints) then I would suggest immediate diagnosing of these joints by your medical professional along with a thorough hands on evaluation via a chiropractor and/or physical therapist trained in SI Joint Dysfunction. Like my case, SI Dysfunction does not necessarily show up on MRI or CAT Scans unless a major trauma caused a fracture and/or major dislocation of the pelvis.  A positive SI joint diagnostic injection is a step in the diagnostic  algorithm to surgical consideration.
• My best conservative recommendation is Prolotherapy a/o PRP Therapy injections into the ligaments of the SI complex provided that adjustment or mobilization of the pelvis and sacrum has occurred first and you are in true neutral before the injections. Then taping a/o SI belt for support along with physical therapy. I strongly recommend to not do major low back exercises if your ilium/sacrum or not in neutral first. See this link on the iliolumbar ligament to understand its relationship from the lumbar to ilium.  My life experience has taught me that a disc bulge a/o disc annular fissure especially in the L4-L5-S1 region was a direct result of SI Dysfunction as the underlying contributing cause of my lumbar disc issues. 
•   My team of primary medical providers in the greater Spokane, WA region understand that Extra-articular (meaning outside of the joint) SI Joint Dysfunction is a hands on diagnosis. Untreated extra-articular SI dysfunction can lead to the wear and tear of the actual joint itself. With too much wear and tear and significant DJD, a fixation surgery like I had done a year ago, may not be sufficient and you could be facing a minimally invasive fusion( see si-bone.com ) instead which is actually  much more invasive and constricting your life in its post operative protocol than my fixation only surgery.  If you are not in my region, then please contact the national experts in Gainesville, Georgia via this website link: www.sidysfunction.com

For further insight or just a listening ear, I’m available to help any patient seeking information on the subjects contained herein on my website. Please see my contact page . I will do an SI Blog update again later this year when I am fully walking and I have finished my rehabilitation after my next surgery.  From here my blog stories will continue in my www.fibularpain.com blog section of my SI-Instability website.

Stay tuned! To avoid wondering when I post again, please just subscribe to this blog (form in the below footer) to receive automatic updates whenever I post a blog story about my medical and spiritual journey.

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Christy Collins

The end of my si joint problems is officially in sight..

Update, Jan. 2018: Hi everyone– I’ve learned a ton since I wrote this post.  Be sure to check out my other site,  My Sacroiliac Joint Saga ! 

And now, the original post :

I’ve held off on writing this post until I was absolutely sure, but the time has come for me to make my official pronouncement.

In my post at the end of this past June , I explained how my SI joints were unexpectedly doing better following my 3 weeks in California. At first, I had thought it was something different about my routine, or being distracted by being around friends. However, once I got home and attempted to resume my regular chiropractic visits, I found myself feeling less stable. Maybe it wasn’t Boston, it wasn’t the East Coast weather, it wasn’t my routine… it was the chiropractor.

Now, let me back up. When I first developed my SI joint problem 5 years ago (God, has it really been that long?) my chiropractor was literally the only medical professional who could even begin to explain what was going on, much less free my leg when one side of my pelvis locked-up.

I saw several medical professionals, including two physiatrists and an orthopedist. I also saw a total of seven different physical therapists. No one could tell me with any clarity what was wrong.

I saw one misguided physical therapist who specialized in “manual therapy,” meaning she actually put her hands on my hips and lower back and tried to use pressure to re-align me. This resulted in absolutely no change.

The ONLY person who seemed to be able to help me at all was my chiropractor. I walked into his office with my pelvis completely locked up, feeling as though someone had tied a belt around my legs– that’s about how well I could move them– on the verge of tears. “Oh,” he said calmly. “It’s your sacroiliac joint.”

And with a few clicks of his “activator” tool, my legs and I were free.

I wanted to give you this backstory so that you can see how, at one point in time, I was so grateful for the help of my chiropractor. He truly helped me at a time when no one else was able to; when all anyone else gave me were strange looks and exercises I was unable to do– followed by more strange looks when I tried to explain that it’s not that I didn’t want to do the exercises, it’s not even that pain was stopping me — it’s that I literally did not have control over my legs. When my hips were stuck, my legs were stuck.

My chiropractor was able to explain to me the anatomy of the joint, and how this mysterious pain on the sides of my lower back could actually be related to me being unable to move my legs. He made me feel that I wasn’t a freak– he told me that this problem was actually quite common– and on top of that– he could make the problem (temporarily) go away.

It’s also my chiropractor who convinced me to finally work out in a pool. Despite all of my hesitations, and insistence that I really just wanted to work out on land… he repeatedly did his best to convince me that this problem was probably going to be permanent unless I found a way to strengthen my muscles without putting more stress on the joint. The adjustments were only going to be a temporary fix, he explained, until I created more muscle strength to hold the joints in place.

He was right about that, too. I didn’t really start to get better at all until I finally joined a pool. Up until that point, my land exercises just seemed to make things worse. (The pool was turning point #1).

I got even better, still, when I truly began to follow a thorough stretching routine. For a while I didn’t know how to stretch because the simple act of getting down on the floor was enough to throw my SI joints out of whack. Undoing my entire chiropractic adjustment just for the sake of stretching seemed backwards; like undoing the foundation of the building in order to adjust something on the roof.

However, I eventually found this really awesome stretching table on Amazon, and honestly– it changed my life. Finally I was able to lie down and do all of my stretches in a way that didn’t impact my hips. So that was turning point #2.

That was my life for a few years: pool, stretching, chiropractor. My life revolved around this problem, because there didn’t seem to be much of an alternative. Once my hips locked up, all else ground to a halt. As I said before, when my hips were really locked, it was as though my whole body was in chains. It honestly felt as though someone had tied a belt around my upper thighs; it was sometimes really difficult to put one foot in front of another.

But it wasn’t a permanent disability either. It made no sense to just give up, accept that I couldn’t walk, and sit in a wheelchair. Because I could walk, when my hips were aligned. During those first few moments after I left the chiropractor, I felt totally perfect and free. It’s just that things never stayed that way.

So I did my best, doggedly. I was afraid to drive– afraid that if something went wrong and I had to slam my foot on the break, I’d hurt my hip. So I had my parents drive me to the pool at the gym. Almost every night, I’d go just before closing, trying to find a time when the water wasn’t so choppy. I was so weak and out of shape when I first started going that everything hurt, if I went at at time when there were tons of lap swimmers.

So I’d try to go right before closing, when most people had already gotten out to shower. I’d stay in until the very end and then more or less have to rush outside, with my hair still wet.

There are a lot of pictures of me taken during that time period, of me out with my friends in downtown Boston. All of them are dressed up– high heels, makeup, straightened hair. And there I am– my outfit is cute, but my hair is still wet. (It sounds like a small thing, but honestly– I think my inability to keep up appearances actually affected some of my “friendships,” which I later realized weren’t really friendships.  More on that later).

I was willing to make sacrifices for the sake of getting over this problem. But now I am so frustrated, looking back, because the whole thing seems so pointless.

Turning point #3 came when one of my physical therapists finally showed me how to adjust my SI joints myself using the Muscle Energy Technique . As I’ve mentioned in previous posts, this was also life-changing, because now I did not need to depend on my chiropractor. When my leg got stuck, I was able to free it myself.

That brings me up to where I was in February , when I wrote my post about how I was doing better and things were feeling more stable. I had a feeling the end was sort of in sight, because I was starting to be able to do more and more. But I wasn’t out of the woods yet; I still had to check my SI joint and do my self-adjustments several times a day.

Then, this summer I realized that, after going all of June without having a chiropractic adjustment to my SI joints , I was actually doing better. I decided to experiment with not having any further adjustments to the area, to see what happens.

Here it is: turning point #4.

I can honestly tell you that my SI joints have not locked up once all summer. Things have not necessarily felt perfect, but I can tell it’s just muscle imbalance; it’s not the joint.

That same horrible dull ache at the intersection of my spine and pelvis? Gone. Just a memory at this point.

That awful, painstaking feeling of not being able to move my legs, of having a belt wrapped around my upper thighs?  Gone.  I’m almost starting to forget what it felt ike.

It is at once exhilarating and frustrating to realize that I think the very thing which got me started on my road to healing– the chiropractic adjustments– actually became detrimental in the end.

I have seen at least one bad chiropractor who I don’t trust, and would never for a million dollars allow to touch me again.

I don’t see my chiropractor that way.

I think he was, actually, able to correctly diagnose the problem, and I also do think his adjustments were putting my joints into proper alignment.

It’s just that, to an extent, I think my body also needed to be able to find an equilibrium.

The adjustments became too much, somehow.  Perhaps they were too much force for my ligaments, or perhaps they overly disrupted the pattern my muscles were used to holding everything in.

I definitely don’t feel that I was permanently injured by them, or anything like that.

It’s just that, at some point, my body just wanted to be able to locate some sort of homeostasis.  For my muscles and nervous system to have a chance to adapt to the way things were– even if, alignment-wise, it wasn’t “perfect.”

Now, I am certainly not suggesting that I would have gotten better if I had just left my SI joints alone, and allowed them to stay “stuck.”  That absolutely 100% would have failed.  When I think back to that horrible, dull, aching, grinding sensation, of two parts of the joint rubbing together in a way they were never meant to rub together… no.  Absolutely not.  There was no way any form of healing could have come out of that.  You can’t build muscle and get stronger when you can’t even move one of your legs.

But the chiropractic adjustments were just too rough.

I wish I had been shown how to do the self-adjustments from the beginning.  As I’ve learned in all of my PT prerequisite classes, your body has built-in reflexes that keep you from injuring yourself during normal movement.  When you perform a self-adjustment for the SI joint (which involves contracting certain muscles around the joint in a particular way), your nervous system will use these special reflexes to ensure that you don’t injure yourself, or put unhealthy levels of strain on the joint.  There is a level of precision here that no chiropractic adjustment can re-create.

Now, to be fair: I don’t know that I would have been able to develop the skills necessary to identify which way I needed to actually adjust my SI joints, without all of the feedback I’d gotten in my chiropractic visits over the years.  Compared to my PT, I actually think my chiropractor is better at diagnosing exactly what’s happening in the joint.

It’s just that his actual method of fixing that problem ends up backfiring.

Now that I know what I know, I have a lot of ideas for how someone like me could have been helped out of this situation a lot more quickly.

For example, having a PT who really took the time to teach about the SI joint, rather than just prescribing exercises.

Not just about the anatomy of the joint, but how to self-diagnose which way your pelvis is rotated, as in my experience, the self-adjustments have been the way to all healing.

Of course, as I write this,  I also reflect back on the fact that I was lucky to find a PT who knew about the SI joint at all.  Back in 2011, it didn’t seem that most physical therapists were aware that it could cause problems (although thankfully, that seems to be changing).

I am going to continue to talk about the SI joint– both in terms of chronicling my own healing, as well as just to hopefully raise awareness.

I’m also now working on a second site,  My Sacroiliac Joint Saga , where I will be talking about everything I’ve learned.

Looking back, all of the tools exist that would have allowed me not to suffer for so long.  It was only ever a matter of finding them.

27 Comments

lifeinslowmotion

I am so happy for you!!!!

sunlight in winter

Thank you so much 🙂 I really appreciate your support!

rachelmeeks

Love love love! What a journey this has been, thank you so much for sharing your story. It’s brave to share a story like that when you don’t know for sure that it’s going to have a happy ending. Congrats to you! I hope you’re celebrating!

Aw, thank you so much!! 🙂

Bless you, amazing lady for you surely are a gem and deserve nothing less 🙂 *gentle hug*

Thank you so much Jo!

Thank you for your story. I feel like I am at the beginning of my saga. Pelvic joint pain during pregnancy. I have been aeeing the chiropractor twice a week for four weeks. While I appreciate it so much bc of the initial improvement I felt I am starting to feel I might get “addicted”. I find myself wishing the next adjustment came sooner. I know my lower body is weak. Things have to tighten up but how. The adjustments are a short term fix until 48 hours later when things slip out of place. So here is my question: how do you know how much is too much? When do I stop going to the chiropractor and hop in the pool?

Hi Meghan, I’m happy to hear my blog has been helpful for you. I think it can really be a process of trial and error, and keeping careful observations over time. I highly recommend keeping a diary of how you feel from day to day, and what you did on a given day (did you go to the chiropractor, did you work out, etc.). This can help you keep track of changes, or notice things that help or hurt you over time.

I didn’t wait to stop going to the chiropractor before I started going to the pool, because my chiropractor himself told me I wasn’t going to see long term improvement until I built up the muscle strength to hold my joints in place better. And he was right– once I did start to build up some strength, I found that I was able to space my chiropractor visits farther and farther apart over time.

The key is to start out with exercises that are really gentle. Ideally, you would find a pool that isn’t too hard to get in and out of (some pools have accessible ladders which make it easier if you have trouble walking). I always preferred to go during non-peak times of the day, so the water was calm and I could do my own thing without worrying about people swimming into me. Little things like this can help make it easier to start out if you’re in a lot of pain.

Here are a few posts I wanted to make sure you saw:

The goal of strengthening is to build up your body’s own support system: https://sijointsaga.com/2017/10/04/heal-sacroiliac-joint/

Some gentle core exercises you can do on land: https://sijointsaga.com/2017/09/14/core-exercises/

Should you exercise when your SI joints are out of alignment? https://sijointsaga.com/2017/12/28/exercise-si-joints-alignment/

Hope this helps!

Thank you for sharing your SI story. I am sitting at my computer searching for help. I am completely new with this thing. About 2 weeks ago I guess I started with some lower back issues. To the left of my spine, if I would sit and arch my back or stretch in a certain way it would just grab and cause pain. My kids would wonder when I bent over why I would yelp in pain. So hubby said I ought to get in to see my fav chiropractor. She worked me over good and hard. She is the one who informed me of this being SI joint. One thing she did do was fix my knee which is not what I even went for. But after I told her I’d had knee pain for at least a year, she found my knee cap wasn’t in place. Thank God, I had foreseen surgery coming. Nope. Better now. But my back….my HIP! Honestly I am scared. I went to her on Thursday afternoon. She said to call in a couple days if I wasn’t feeling better. Sat and Sun nights was not sleeping good….feeling pressure in my hip area. Something doesn’t feel right. I don’t know if I should call her today (Monday) and have her see me again, only to ruin me more or what. I don’t know even if she ruined me. Am I having this pain because of the adjustment and need to just get through it until it calms down? Maybe the adjustment this way was needed and needs to now just heal. I don’t know. I am scared. Taking ibuprofen allowed me to sleep last night. Any thoughts? Kind of desperate to know what I should do….seeking out information on internet. That’s me… Just watching 2 chiropractors on youtube showing how to do stuff to myself. I don’t even know if my joint is out of place or what. I don’t know that it ever was. I feel like crying.

Hi Lori Ann, I’m so sorry to hear what you’re going through, but take a deep breath! It’s going to be okay!

From everything I’ve been through personally, and from talking with other people, I don’t think your chiropractor could permanently “ruin” you with one adjustment. If she had, you would have known sooner– it would have hurt a lot more immediately afterwards.

However, if you are this sore for so many days afterward, it is possible that the adjustment was too forceful for you. As you know from my story, chiropractic adjustments in general turned out to be too forceful for me– but they didn’t permanently injure me. I was able to recover pretty quickly once I stopped receiving them.

I would recommend that you keep a very detailed journal about your symptoms. If you choose to go back to this chiropractor, tell her what happened and ask if she has more gentle adjustments she can use.

I personally would only recommend that people get adjusted by chiropractors who use something called the Activator tool– it allows for more gentle adjustments than the adjustments people do by hand. https://www.spine-health.com/treatment/chiropractic/activator-method-chiropractic-technique

I think it’s a lot to expect yourself to be able to adjust your own SI joints, based on watching Youtube videos. I have seen many of these videos myself, and I think they are a bit unrealistic. I’m glad there are so many chiropractors and PT’s out there trying to share their knowledge, but I think sometimes they don’t have a great sense of what the average person is actually going to be able to understand.

It sounds like you definitely need to be seeking out a second opinion. I’d highly recommend that you try to find a doctor or a physical therapist with experience in treating the SI joint. I do think chiropractors have something to offer, but based on my own experience, I don’t think that seeing a chiropractor alone is necessarily enough to heal SI joint dysfunction.

Here are a few posts from my SI joint blog I think you might find helpful:

A type of specialist you might want to see: Physiatrists (they are doctors who specialize in musculoskeletal disorders) https://sijointsaga.com/2017/09/29/sacroiliac-joint-doctor/

An awesome video where a physiatrist explains SI joint dysfunction in detail– gives you a sense of what’s going on and possible treatment methods https://sijointsaga.com/2017/07/24/physiatrist-si-dysfunction/

I hope this is helpful! Let me know if you have any questions!

Your story is giving me so much hope! I have been in pain for almost a year and am starting another round of physical therapy. The therapist evaluated me and found the SI joint out of alignment and will treat me for muscular imbalance, and core strength. I am glad to hear about the aquatic therapy and will research that and see if I can add this as well. It is so depressing when there is no definitive diagnosis and things just get worse. Even the bottom of my feet now hurt after standing for a while. Sure hope I can report such good results as you got. Again, thanks for giving me hope!

Hi Karin, thank you so, so much for your comment! It really means a lot to me to know my blog is helping people. And yes, I totally hear you about the bottom of your feet hurting– having the SI joint out of alignment can sort of feel like knocking over the first in a row of dominos, when you start to develop pain in other places too. But yes, there is absolutely reason to believe that you can heal! Wishing you the best of luck going forward– feel free to reach out with any questions!

So I had my first session of therapy today. My therapist reset my joint very gently and then went on to the first exercise. It put a huge smile on my face. Why? Because it was how to find and engage your transverse abdominals!!! Your story not only gave me hope, but also confidence in my therapist and excitement about the weeks to come. Your blog is an absolute blessing to me!

That’s awesome! Sounds like you may have found the right person to help you!!

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Grateful to be okay, how a physical therapist helped me through my lowest point, part 5, the piece that didn’t fit.

5 Steps to Addressing SI Joint Pain | the Truth About SI

Do you suffer from sacroiliac (SI) joint pain and you’ve been told that your SI joint is out of place? Maybe you are trying to put it back in or wearing an SI joint belt? Perhaps you just can’t seem to resolve it. Let’s discuss the anatomy of the SI joint and how you can help to address your SI joint pain.

The SI joint comprises the triangular bone, the sacrum, with the two ilium’s, pelvic bones. It is also reinforced with a lot of ligamentous structures. All of these connective tissue structures and the SI joint are primarily responsible for shock absorption between the upper body, and the pelvis and legs.

Rather watch or listen than read?

The sacroiliac joint has very little motion. It has approximately four to six degrees range of motion, so there is a subtle forward bending and back bending even just with our breath alone. However, just as much as it needs to be stable and have proper sequencing and coordination of all the deep stabilizers of the pelvis, it also needs proper mobility. We need the pelvis to be able to move freely in forward bending, backward bending, side bending, and rotation. This is crucial for gait.

Speaking of gait, how we interact with the ground influences our SI joint. Walking is one of the best assessments of movement efficiency. It tells us how well we can load forces and unload forces, and how well we can transfer energy through the body. We do that through our fascial tissue, and we have different fascial lines that are transferring this energy through our body, crossing over the SI joints.

One of the primary subsystems o the SI joint is the deep longitudinal line. This starts at the bottom of the foot comes up the lateral side of the leg, up into our hamstring, or biceps femoris, into our sacrotuberous ligament, which is one of the ligaments of the SI joint, and then right into the SI joint and up along the spine. This is where we’re transferring energy and this line is mainly responsible for shock absorption. When our breathing is compromised, and we’re not able to have proper sequencing and pelvic control of our gait, then we will see SI joint pain and dysfunction.

Now let’s talk about five different things that you should consider with your SI joint. 

1) Breathing

More specifically, diaphragmatic breathing. That means as we’re inhaling through the nose and breathing all the way down to the base of the pelvis. This will assist us to get the proper relaxation of the pelvic floor. As we exhale, we get the proper contraction of the transverse abdominus, our natural weight belt. Our abdominal muscles contract, returning the diaphragm back to its resting position. This will allow for proper sequencing, timing, and coordination of the deep stabilizers of our core. If we’re breathing from the neck, that will not happen. 

2) Pelvic Mobility

As I mentioned, the pelvis needs to be able to move freely in our gait cycle. We have to integrate the breath with this and coordinate into pelvic patterns. We want to be able to forward bend, backward bend, rotate, and side bend the pelvis. Evaluating those movements lying down and standing will be very valuable. Notice where the restrictions are and notice if that reproduces the pain. Remember if the pelvis isn’t moving properly as we are walking, then we are not transferring force efficiently. That is exactly what can contribute to SI joint pain.  

3) Rotational Stability

This can take on lots of different forms, although the bird dog is a great exercise to develop tensioning and coordination in a rotational pattern. This dials into a lot of other fascial lines and connections that all pass through the SI joint. It is important to stabilize basic patterns and then progress them to higher-level patterns.

4.1) Foot to Core Sequencing

Use dynamic patterns such as forward lunging, reverse lunging, side lunging, and rotational lunging. The goal is to perform all of these with proper alignment and connecting the foot to the core with intention. So, you’ll want to use a short foot, rooting the toes into the ground and connecting it to your breath, to be able to maximize how you’re sequencing from the ground up.

4.2) Foot Type

Different foot types will contribute to how we are loading and unloading force. If we have a more everted foot type for example, where the arch is flattened, this can contribute to the stability in our foot and how we transfer energy towards our pelvis. Conversely, if we have a more inverted foot type, which means we are a little higher arched, that can put a lot of stress and force on the SI joint as well. Our goal is to bring our foot back into neutral. Whether we are strengthening the feet and connecting them to our core or creating more mobility in the foot, calf, and lower leg to bring our foot back into neutral, how we load and unload the ground is going to directly impact the SI joint. 

5) Total Rotation

Lastly is addressing your total rotation. If we are in a standing position doing a full rotation, are there asymmetries side to side? Can you focus on specific thoracic spine mobility to create and emphasize more rotation in your gait? Ultimately, we need optimal rotation in our pelvis and thoracic spine for efficient gait. We walk on average 6000 to 8000 steps a day and that is our best assessment of movement efficiency. 

There you have it, a new way to look at your SI joint, and perhaps not seek out muscle energy techniques and ‘put it back into place.’ The SI joint only moves about four degrees so it is likely not out of place. You might have pain and dysfunction, but looking at why that’s happening, looking at it from an integrated perspective of how we are interacting with the ground, and get to the root of the issue is key. 

Reach out for a 15-minute FREE discovery session to see how we can help you on your journey.

For more content, make sure to subscribe to our YouTube channel here.

Other things that may interest you:

Understanding Your Pain

How Sugar Affects Your Pain

What Should You Eat for Chronic Pain?

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Hollywood appears nervous about joe biden’s chances in debate’s aftermath, breaking news.

• ‘The Bear’: Ayo Edebiri Weighs In On The “Journey” Of Sydney & Carmy’s Business Partnership In Season 3

By Katie Campione

Katie Campione

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SPOILER ALERT! This post contains details from Season 3, Episode 2 of The Bear .

While it was assumed last season that Sydney ( Ayo Edebiri ) would be an official partner in her and Carmy’s ( Jeremy Allen White ) burgeoning restaurant, Season 3 confirms that she won’t be forgoing six months of her salary for nothing.

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“I think she’s always balancing his validation and his style of communication, because he will do a gesture but not necessarily say what he’s thinking or feeling,” she explained. “So I think even though he does [assure she’s a partner], it’s actually quite complicated. She’s sort of like, ‘Is that true? You’re offering me this thing. But what does it actually mean?'”

The actor says Sydney trying to decode Carmy’s actions in this way will be “a part of the journey of the season.”

Edebiri also steps into the directors chair in Episode 6, saying during Wednesday’s premiere event that she cried when reading the script for the first time.

RELATED: ‘The Bear’ Can Be Overwhelming For Viewers And Even Its Actors, Chris Witaske Says

“It’s written very beautifully,” she said. “I was just so moved by it and really, really touched that Chris [Storer] had me in mind to direct it. I could see it as soon as I read it.”

All episodes of The Bear Season 3 are now streaming on Hulu.

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Tilman J. Fertitta Family College of Medicine

College of medicine.

• News & Events

Empowering Change: Fertitta Family College of Medicine's Journey to Honduras

By Taylor Collins

June 26, 2024

For the second year in a row, Tilman J. Fertitta Family College of Medicine students have made the arduous journey to provide medical care to a remote village in rural Honduras. True to the mission of the College of Medicine, the journey offered the opportunity to provide integrated, evidence-based, high-value care delivered by our interprofessional teams. Many of the students have participated in medical trips to Central America before their time at the College of Medicine, but for most this is the first occasion they were able to put the skills learned during their medical training to the test, in a setting where medical care is scarce.

Blanca Morales, MS1 , was especially excited to exercise her background in case management and community health work. “It marked my inaugural venture into the integration of clinical care with social and community development. I've long been committed to addressing the intricate interplay between social and medical needs. Honduras presented a unique opportunity to deepen my understanding in this domain.”

Houston is one of the most diverse cities in the United States, and with the College’s focus on primary care in underserved communities such as the Third Ward or East End, the need for strong communication skills is integral. Medical Spanish is quickly becoming more and more important at the College, with many students expanding on their own native Spanish language skills to provide enhanced care to those in our underserved communities that experience language barriers. Edgard Castillo, MS1 , saw the trip to Honduras as “a valuable opportunity to give back to a community in need”.

Leading up to their departure, Castillo was anticipating the personal growth, medical decision making and use of his Medical Spanish that he expected to improve upon in real world situations. “I was also looking forward to the patient interactions and new situations I would see that I wouldn’t normally experience in a clinic here in the states. This gave me a lot of room to practice my Spanish, and I got a chance to see many clinical examinations that aren’t very common to see in the US.”

The medical trip had busy days, beginning at 6 a.m. and often going well into the evening. The clinic in Santa Ana opened at 8 a.m. and the students helped provide care for up to 100 patients a day. Unique to this excursion, they were joined by a fellow University of Houston alum, Dr. Rebecca Swicegood. With the aid of optometrist Swicegood, patients with a range of varying eyecare maladies, from glasses, eye infections and glaucoma, metallic and other foreign bodies embedded in corneas, were able to receive life-changing care. The medical students were able to gain optometric training with Swicegood that adds to their overall medical training as physicians through this integrated care experience that they wouldn’t have been able to attain elsewhere.

In addition to working with an optometrist, they were able to gain valuable experience and work with clinic leadership such as Dr. Gregorio Yanez. Yanez grew up in the Santa Ana community, but through determination and perseverance, became the town’s first medical school graduate. After working with Yanez, Jasmin Ali, MS1 , had high praise for the invaluable physician. “This man is a gem, his story alone is inspiring. He is a pillar in the Santa Ana community and gives back well beyond what many of us will ever be able to do. Through him, I truly believe the community is advancing.”

Castillo, after spending just one day working with Yanez, “was reminded and given a new perspective of how fortunate I am to be doing what I’m doing with all the resources and opportunities at my disposal.”

After their clinic hours, the group heavily interacted with the community and was immersed in the rich Honduran culture. From playing games with the local children to attending meetings led by community leaders, the medical students were able to have once in a lifetime experiences.

One unforgettable moment of the trip for many students took place during a turbulent storm. The town had gathered for a women’s soccer scrimmage, and being short on players, recruited some of the medical students to participate. In a heartfelt and selfless offering, one of the players gave her soccer cleats to Morales to help her from slipping and falling on the mud-soaked field. According to Morales, “the gesture spoke volumes about the unity and generosity within the team, and further the entire Santa Ana Community.”

The students are forever changed by their time in Honduras. Morales summed up the advice of her fellow travelers to future students on the trip as “go in with an open mind. Take advantage of the time you are spending there to learn, but also to get to know the community and your classmates better. It’s a huge opportunity to use what you’ve learned in medical school and to see just how much you truly know.”

Morales’ passion is shared by many others at the College. According to her, this trip “definitely reinforced my aspirations in medicine. I have always wanted to help underserved communities, but I will now be expanding that to beyond my own city and state. I look forward to participating in more medical trips in the future!”

All in all, the journey was another resounding success. Hundreds of people were able to receive much needed medical care. Fertitta Family College of Medicine students were able to utilize and grow their medical expertise, in a real world setting that not many others can claim to also experience. The College was able to live up to its mission and values during this trip and helped improve the overall health and health care of a remote village in a far-off land. Further inroads were made between the College and the community of Santa Ana, with life-long memories and new opportunities created along the way.

Minnesota governor shares personal IVF journey: 'No one's business but your own'

If Minnesota's support for protecting reproductive freedom wasn't already clear, Democratic Gov. Tim Walz just made it so: His family used IVF, and he's proud of it.

During Walz's sixth State of the State address, the former teacher briefly shared his own family's painful struggle to conceive.

Why hasn't he shared this before? "Your personal decisions about your family are no one's business but your own," he said during the just over 23-minute speech .

Throughout his administration, Walz has been an outspoken advocate for access to reproductive care and assured Minnesotans in the wake of the overturning of Roe v. Wade that the state would protect their access to abortion.

Sign up for Your Vote: Text USA TODAY reporters and the elections team by joining our SMS service.

"If you have never personally gone through the hell of infertility, I guarantee you someone you know has," Walz said.

More: "We will continue serving our neighbors": One year of Minnesota's abortion rights bill

Protecting Minnesotan's reproductive freedoms

Earlier this month, Vice President Kamala Harris made a historic visit to an abortion clinic in the state's capitol city while highlighting the work of Minnesota to become a safe haven for those seeking medical care.

In 2023, Walz codified reproductive freedom by signing the Protection of Reproductive Options (PRO) Act, effectively carving the rights into state law. This decision directly counteracted the language of the Supreme Court Decision that overturned Roe v. Wade.

"Every individual has a fundamental right to make autonomous decisions about the individual's own reproductive health, including the fundamental right to use or refuse reproductive health care."

READ: Full PRO Act Law here

Since 2022, the state has seen a 100% increase in out-of-state patients, according to Planned Parenthood North Central States.

The fight over IVF

In February, an Alabama Supreme Court ruled that embryos created through the in-vitro fertilization process had the same legal rights as children, resulting in hundreds of fertility clinics around the state shutting down, and families left reeling about their futures of reproductive care.

More: A victory for reproductive rights? Democratic candidate Marilyn Lands wins Alabama special election

"What those judges [in Alabama] did was a direct attack on our family," Walz said. "It was a direct attack on my children."

Earlier this month, Alabama's Republican Gov. Kim Ivey signed into law a bill that grants civil and criminal immunity to these fertility clinics performing IVF care for the "death or damage to an embryo" during the process, paving the way for clinics to re-open.

Despite Alabama's reversal of these effects on families, Walz said in his address that he and Minnesotans will not forget.

"You have my pledge as long as I am governor, IVF will continue to offer a lifeline of hope for Minnesota families," he said.

— Sam Woodward is the Minnesota elections reporting fellow for USA Today. You can reach her at [email protected] , on X @woodyreports, or on Threads @samjowoody

My Sacroiliac Joint Saga

How I healed from SI Joint Dysfunction

Physical Therapy

Hey everyone!

My goal is to give you all the knowledge and insight I gained on my own journey with SI joint issues.

I know that many of you have struggled to find a physical therapist who can help you. I went through this process myself— it took me nine attempts at physical therapy, back in the day.

I do think that finding the right physical therapist to show you how to correct your SI joint alignment is one of the first steps. Once that part’s in place, all of the other things you do — strengthening, stretching, etc. — are building on top of a stable foundation.

That’s why I’ve made it my mission to help you understand the goals of successful treatment. After all, you need to know what to look for, in order to find it!

How to find a good physical therapist:

• Persistence
• Thinking creatively
• Find someone with experience in treating the SIJ
• Search tips

SI joint adjustments by a physical therapist:

• Why correcting your alignment can be the missing piece of the puzzle
• When a Physical Therapist performs an SI joint adjustment, you should feel an improvement right away.
• Why a PT should always be clear about what they’re adjusting, and why

Stabilizing the SI joint ligaments:

• Ligaments of the SI joint
• Ways to stabilize your ligaments: strengthening, SI joint belts, and belting techniques  (these are some things a physical therapist might show you).

Cool examples of physical therapy for the SI joint:

• Evidence-Based Examination and Treatment of the Pelvis with Dr. Alexis Wright (a fascinating-looking continuing education course for PT’s who want to know more about the SI joint).

For further info:

If you’d like personalized feedback on your treatment plan or help finding a physical therapist near you, these are things I help my coaching clients with all the time! And I’d be happy to help you, too.

Be sure to check out my Coaching page for more!

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An MIT Alumni Association Publication

• Alumni Life
• Campus Culture

Search | Slice of MIT

A year of growth and gratitude: reflecting on my journey as mitaa president.

• Jun 27, 2024
• Slice of MIT

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A reflection by R. Robert Wickham ’93, SM ’95, president of the MIT Alumni Association

It’s remarkable how quickly time flies. It feels like it was just yesterday that I accepted the gavel from Steve Baker ’84, MArch ’88 at the Alumni Leadership Conference (ALC). And alas, my term as the MIT Alumni Association president is fast drawing to an end. At the beginning of my tenure,  I reflected on how MIT is a magical place —and this year has only served to reinforce that belief. MIT will always be a place where brilliant minds conjure innovations that are nothing short of magical. Indeed, MIT transforms lives so that we can, in turn, transform the world. 

Strengthening Connections, Across the Planet 

This past year, as I engaged with alumni worldwide, I witnessed firsthand the transformative effect of MIT. As an international alum now residing in Australia, I made it my mission to connect with alumni wherever my travels took me, whether for work or leisure. This journey led me to meet a remarkable array of individuals: from innovators revolutionizing life sciences and machine intelligence to entrepreneurs launching ventures in space commercialization, planet decarbonization, and the distribution of plant-based meats to restaurants. I even met an author who wrote a book about rocks and minerals. I am profoundly grateful for these interactions with such inspiring individuals and am eager to see how their groundbreaking efforts will continue to shape our world.

A Year in Review 

My journey, which began on July 1, 2023, was marked by several key events and collective achievements: 

-The  Alumni Leadership Conference : ALC is one of the cornerstone events on the Alumni Association calendar. This past year’s ALC felt electric as attendance returned to pre-Covid levels.

-Nobel achievements: The Nobel Prize was awarded to Professor Moungi Bawendi, a member of our chemistry faculty, serving as a reminder of the extraordinary intellectual environment that MIT fosters.

-Presidential Welcome Tour: Following her inauguration in May 2023, President Sally Kornbluth kicked off a series of events in New York City; San Francisco; Washington, DC; and London to connect with alumni. I even had the opportunity to host the fireside chat with the president in London. It was such a pleasure to see alumni from all over Europe come together for the occasion. 

- The Climate Project at MIT : MIT announced a new plan following President Kornbluth’s call to the MIT community to mount a “bold, tenacious response” to the global threat posed by climate change. The plan states: “The goal is for MIT to become, within the next decade, one of the world’s most prolific and collaborative sources of technological, behavioral, and policy solutions for the global climate challenge.”

-The power of community: This year’s MIT 24-Hour Challenge , held on Pi Day, truly made history. The event not only surpassed previous fundraising records but also demonstrated the extraordinary generosity and engagement of our alumni community. The overwhelming support on this day highlighted the collective impact we can achieve when we come together.

-2024 Commencement: Serving as the chief marshal at this year’s Commencement was a distinct honor. I especially enjoyed the  remarks of Noubar Afeyan PhD ’87 and his charge to the Class of 2024, saying “My wish for you, my fervent hope, is that you not only choose to accept impossible missions, you embrace them. Welcome long odds. Embrace uncertainty, and lead with imagination. Approach the unknown with the courage, the confidence, and the curiosity of an immigrant.”

-A celebration of lifelong bonds: This year’s 2024 Tech Reunions were a vibrant celebration, bringing together more than 3,300 alumni and guests on the MIT campus. It was a truly special experience to be part of this gathering. The highlight for me was the Cardinal & Gray Dinner Dance, where I had the joy of mingling with alumni who graduated over 50 years ago. Dancing with my wife, Kristin, among friends old and new, I was reminded of the enduring connections we share with MIT and each other—bonds that indeed last a lifetime.

-Navigating challenges with empathy: This year, like many other institutions, MIT felt the profound impact of the crisis in the Middle East, which resonated across our campus and throughout our alumni community. It was a privilege to listen to the diverse perspectives within our community and to facilitate open, respectful dialogues. Our constant aim has been to create a space where dialogue bridges differences, fostering a culture of mutual respect and learning. While there is still much to accomplish, these conversations are vital steps toward understanding and progress.

Looking Ahead with Gratitude and Hope

As I look to the future, I am filled with confidence that Natalie Lorenz Anderson ’84 will carry forward the presidency with distinction. Reflecting on a conversation with Dean of Admissions Stu Schmill ’86, I’m reminded of how MIT values excellence, resilience, and intellectual curiosity in its students. These qualities are not merely admirable traits; they are the essence of what it means to be an MIT alum.

This year has shown me that the relationships we forge through MIT are not fleeting but are lifelong bonds that sustain us, challenge us, and inspire us to keep reaching for those impossible missions. As I pass on this role, I carry with me not just memories of a year well spent but a renewed commitment to live out the values that MIT has instilled in us all.

Photo (top): Toasting to an amazing year during reunions weekend. Credit: Mel Musto. 

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