For starters the SI Joint refers to your Sacroiliac Joint. It’s the joint between your Sacrum or tailbone, and your Ilium or Pelvic bone. Hence the name SacroIliac. When I started practice years ago medical doctors didn’t believe the SI joint moved and if it didn’t move then it couldn’t be the source of pain.
Guess what? It’s now well accepted that it does move. It doesn’t move in the same way as most other joints but it does move. And, movement of the SI joint is critically important.
SI joint pain is frequently a sharp stabbing pain that can radiate up from the pelvis into the lower back or down into the thighs. This is one reason most primary care physicians completely misdiagnose SI joint pain.
The Purpose of the Sacroiliac Joint
Healthy function of the sacroiliac joints is critically important. A healthy properly functioning pelvis dissipates the forces from your legs. The sacroiliac joints act like a shock absorber for the spine.
Your pelvis is your foundation, supporting the weight of the entire upper body above and a connection to the legs providing movement below. There is a very delicate balance of movement of the Sacrum (tailbone) within the pelvis.
Not enough movement and there is too much shock and stress to both the hips below and the lumbar spine above.
Too much movement and instability results with walking, running, climbing stairs, and lifting that causes a series of adaptations and compensations in an attempt to stabilize.
The Sacroiliac Joint is Unique
The SI joint is unlike any other joint in the body. It has an odd shape and is actually composed of two very different types of joints in one. This is one reason that for many years the medical profession did not believe the SI joint moves while the chiropractic profession was busy correcting SI joint problems.
The purpose of joints is to provide for movement. That’s pretty obvious, hopefully. Those movements are initiated by muscles that cross the joint from one bone to the other. In the arm at the elbow the biceps and triceps both cross the elbow joint. One muscle (biceps) bends or flexes the elbow and the triceps straightens out the elbow.
THE SACROILIAC JOINT IS DIFFERENT! The SI joint is formed by 2 bones, the sacrum and the ilium. Unlike every other joint there is no muscle that crosses from the sacrum to the ilium.
This adds to the challenge of both identifying and correcting SI joint problems. There is no muscle to stretch or strengthen that is going to solve a Sacroiliac joint problem.
3 Critical Signs an SI Joint is “Out of Whack”
In case you didn’t know, that’s a technical term, “out of whack”! Not only are these signs critical but correcting a Sacroiliac Joint problem is critical if you want to feel good and function in normal daily activities like walking, climbing, and lifting.
Ask any woman who’s had SI joint problems in her last trimester of pregnancy or after giving birth.
It will help if you have someone to assist you on these tests.
Critical Sign #1: Pelvic Imbalance Sign – When the SI joints are moving and functioning properly the pelvis is balanced. Have someone help you and stand facing a full length mirror if possible. With your assistant behind you have them put each hand on top of your pelvis on each side.
Can you see in the mirror that one hand is higher than the other? Are they able to determine if their hands are unlevel?
Any imbalance is a really good sign your SI joints are not functioning as well as they should. This is a great sign to use if you are not in pain or not experiencing constant pain from your SI joints.
When the SI joints get misaligned and lose proper mobility there is almost always an unleveling of the pelvis.
Critical Sign #2: Stability Sign – This sign is also easier with an assistant. Stand with one hand touching the wall or on top of a counter to provide a little balance. Lift one knee up to waist height as though you were marching in place. Then do the same with the other leg.
Pay attention to a couple of things as you do this:
- Does the movement feel smooth on both sides or does it take more effort on one side?
- Does your pelvis stay level as you lift each leg? Or, does your pelvis hike up on one side and stay more level on the other side.
Your assistant can help by observing whether your pelvis hikes up or shifts to the side with one leg more than the other. The pelvis should stay level. It is possible to have both SI joints locked, in which case the pelvis will hike up and shift on both sides.
Critical Sign #3: SI Stress Test Sign – Start by sitting on the edge of a bed with your butt half on the bed and half off. Lie back down and pull one knee to your chest as far as you can. Let the other leg fall to the floor. This works best with a high bed.
Do you feel any significant discomfort, pain, or stiffness in the low back or pelvis on the side of the leg going to the floor?
Do the same on the other side to compare.
Rarely do I encounter someone who doesn’t have imbalance in their SI joints. Sometimes it is the primary problem causing their pain but often it is what I find is a secondary compensation to a problem somewhere else.
It really doesn’t matter because properly functioning Sacroiliac Joints are essential for you to be able to function in the world. That’s true as long as you want to walk, climb stairs, bend and lift.
SI joints that are stuck or misaligned don’t always cause pain. But they do always cause problems. If your pelvis is locked or misaligned it will transfer stress to your hips below and to your lumbar spine above. Over time this is a significant contributor to degenerative arthritis.
Simply restoring balance and movement to the SI joints is a game changer. It often releases significant tightness and tension up the entire spine. Even if someone comes to me with issues of neck pain or headaches I always look to the pelvis to restore balance as part of their care.
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