SACROILIAC JOINT (SIJ) PROBLEMS & PREVENTION

Whenever  you lie flat on your back, you are resting on the sacrum and the two flat bones either side, the ilia.  The sacroiliac joint is where they meet and can be identified by the two dimples below the waist, either side of the spine. 

The joint, supported by very strong ligaments, has a limited range of motion – 2mm or 3mm.  The main function of the joint would seem to be as a shock absorber for the pelvis and spine.  Hormones released during pregnancy allow for a little more movement to aid delivery, but otherwise, movement may become even less as we get older. 

SIJ problems can be referred to as inflammation, dysfunction, strain, syndrome, but all mean more or less the same thing: pain and aching around the joints/back of pelvis and sometimes referred pain in the groin and legs, together with stiffness.

Pilates will help stabilise the pelvis and sacroiliac joints

CAUSES

Apart from a trauma of some kind, the most common causes are:- 

• Pregnancy:  Although hormones during pregnancy soften the ligaments and allow for greater movement during delivery, the joint is being taken beyond its normal range of motion.  Multiple pregnancies and hypermobility will add to the strain.  The additional weight gained and the change in posture and gait can all contribute to problems later on.
• Posture and walking:  The way you hold yourself and move is sometimes an issue.  Different leg lengths or relying on your “good leg” in the event of an injury to the other (leg/hip/foot) will create imbalance in the pelvis, leading to inflammation.
• Osteoarthritis:  The two bones – the sacrum and the ilium – are connected with a layer of cartilage which can be worn down over time causing the bones to rub together. 

Once a diagnosis is made treatment consists of pain relief – orally or by injecting the joint with something like novacaine and cortisone – and with physiotherapy.  Occasionally, surgery is performed, but with a little bit of effort and luck, this can be avoided.

PREVENTION 

Obviously avoiding the causes would go some way to preventing SIJ problems!  Improving your posture, your gait and maintaining a healthy weight is paramount to keeping your joints in good health.   Pilates will improve your posture by addressing muscle imbalances and improving your core stability which will help stabilise the pelvis and therefore your SIJ.  There are many Pilates exercises aimed at keeping the hips mobile and strengthening all the muscles that support your pelvis and lower back.  This short, very simple video consists of 3 exercises: a basic core strength exercise and heel beats to strengthen the core and gluteals (buttocks) and a spine twist to ease out the hips and lower back.   Also this weeks featured video.  If you find it works for you, learn Pilates from the very beginning with our Pilates video downloads.

It is vital that you get a correct diagnosis as the wrong exercises will do more harm than good.