The SI Joint and Pelvic Pain

Pelvic pain and dysfunction are frequently associated with damage or irritation of the nerves, muscles, and connective tissue of the pelvis as well as dysfunction of the digestive, reproductive, or urinary systems. However, another possible cause of pelvic pain that is frequently overlooked is the sacroiliac joint. The sacroiliac joint, or SI joint, is located at the low back and is where the triangular bone at the end of the spine called the sacrum meets the bone forming the top of the pelvis called the ilium. This joint is typically overlooked as a source of pelvic pain because, in a healthy individual, it is assumed to be strong and sturdy. The SI joint is generally less prone to injury due to its limited mobility because of its bony structure and strong supporting ligaments. Many healthcare professionals believe that there is no movement at this joint and overlook this joint as a source of pain. But, at Rebalance Physical Therapy, our therapists disagree with this assumption—they work with the sacroiliac joint every day and know this joint can be a cause for many pelvic dysfunctions.

What Can Go Wrong with the SI Joint?

The sacroiliac joint acts as a shock absorber between the trunk and legs in our body. When functioning properly, it transfers and balances our bodyweight from our upper body down through the legs. Because of its key location and function in the body, proper loading and support of this joint is vital. Sacroiliac joint dysfunction, defined as abnormal motion at the SI joint—either too much movement or too little movement—often manifests as pain in the low back and buttocks that can radiate down through the legs. This pain is similar to the pain caused by sciatica or compressed nerves. SI joint dysfunction can also radiate pain through the groin and pelvis.

When this joint works inappropriately, we often refer to this as “failed loading” of the sacroiliac joint. Failed loading can either be caused by a dysfunction at the SI joint itself or at the joints above or below it. An improperly loaded SI joint can create twisting or torsions in the pelvis, which can, in turn, result in body imbalances and pains. If you suspect that SI joint dysfunction could be causing your pelvic pain and you feel like you’ve tried everything, visit us at Rebalance Physical Therapy for a holistic examination and evaluation of your pelvic pain.

A Rebalance physical therapist will perform a physical exam to discover if your pelvic pain is related to the sacroiliac joint and determine which course of action is best for you. The clinician may perform manual therapy and soft tissue release to relieve pain, realign the SI joint with the pelvis, and restore mobility to the SI joint, pelvis, and lumbar spine. If your sacroiliac joint dysfunction stems from too much motion, known as hypermobility, they may use mobilization to realign the joint and the lumbar spine. The physical therapist will also prescribe specific exercises to keep the muscles supporting your SI joint balanced and maintain proper spine and core alignment. These exercises will focus on flexibility, strength, stabilization, and optimizing the mechanics of your own body based on your lifestyle and schedule. For example, if your job involves prolonged periods of sitting, this could be contributing to your pain and your clinician will suggest quick, simple ways to maintain proper SI joint alignment and movement.

If you are struggling with pelvic pain and SI joint dysfunction, Rebalance Physical Therapy can help stabilize your SI Joint and help you find relief for your pain! The easiest and most direct way is to visit us in-person if you live in or around Philadelphia, PA! If you’re not near Philadelphia, we also offer Telehealth consultations

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