Sacro-Iliac Joint Health

We all have two Sacro-Iliac joints on each side of the sacrum. This is where our spine connects to our pelvic bowl. Needless to say, S.I. joints are critical for injury prevention and stability.

Sacrum is the base of the spine. It looks like a downward-pointing triangle. 

The Iliac bones (they look like elephant ears in the image) attach to the sacrum via the S.I. joints and form most of the pelvic bowl. The whole structure is supported by/bound by various ligaments. See the image. 

What is the job of those ligaments? 

As with all ligaments in the body, it is to keep this structure stable - to prevent movement. 

How does the S.I. joint get hurt? 

When the ligaments are too loose, by overstretching or by genetic predisposition, the S.I. joint can move out of alignment. Or, when there is trauma  - like falling on the sacrum - then the S.I. joints may get displaced, torqued, and get out of alignment.

If the ligaments are not thick or strong enough to prevent the misalignment, we experience S.I. pain and dysfunction. This can be excruciating and debilitating because it involves the nerve tissue - primarily lumbar and sacral spinal nerves. 

Is it good to stretch the S.I. joint ligaments? 

Absolutely not. Stretching them will make the S.I. joint more loose, destabilize it, and make it more injury prone. 

Surprisingly many people try to stretch their S.I. joint and around sacrum. Twists, deep forward bends, and hip openers such as the Pigeon Pose in yoga pull on the S.I. ligaments and make the S.I. joint more loose and unstable. 

If you have a history of S.I. pain, please avoid any of those stretches. 

What to do to treat S.I. pain? 

1. Get it checked. See an Orthopedic doctor, or an Osteopath, or a good Chiropractor to determine if your S.I. joints are misaligned.

If they are, you'll need to put them back into alignment with manual adjustments and S.I. stabilization exercises

2. Strengthen it.

If aligned well, the best thing for S.I. joint is strength. The sacrum is the foundation of the spine. It has to be strong to support any activity and movement.

Strengthening will tighten those ligaments and stabilize the sacrum. There are many exercises to strengthen the S.I. joints - all mainly to do with leg extension as the exercise in the photo (Donkey Kicks). 

3. Get a massage.

Hands-on treatment of the surrounding muscles (Glute Maximus, Piriformis, deep rotators, and paraspinal attachments of Erector Spinae) relieves pressure on a misaligned S.I. joint. While as massage therapists we are not trained to 'put the joint back into place,' we can help guide it there. 

Treatment of the ligaments will also help smooth out any bunched up/glued up tissue and adhesions. 

Word of caution: go see a therapist who has had experience treating S.I. joint dysfunction. Ideally, someone with Neuromuscular Therapy training and experience like some of our therapists at East West Massage.

by Slava Kolpakov


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