The SIJ is the joint between the sacrum (which is at the base of the spine) and the two halves of the pelvis. This joint allows for a very small amount of movement, which can become painful and unstable if the movement is not well controlled.
The SIJ is believed to be the cause of lower back pain in 15-38% of cases and provides attachment for approximately 30 muscles around the back and pelvis. Dysfunction occurs as a result of failure to transfer load effectively. The important muscles involved in the force closure of this joint includes our pelvic floor muscles, transversus abdominus and the glute max and obliques (which make up the posterior sling).
The following are signs of SIJ dysfunction:
- Pain maps: never above L5, may refer down leg
- Patients may describe as sciatica
- Pain is recurring, triggered by bending, lifting
- Commonly idiopathic
- Initial episodes may be caused by: pregnancy, trauma from fall or motor vehicle accident, hard braking, transverse force on pelvis
- Worse when loaded, eg standing, walking
- Possible changes in bladder habits
In order to manage SIJ pain, it is wise to avoid high load activities such as hopping, jumping and running. Soft tissue techniques such as massage, heat packs, stretching and dry needling can be very effective is releasing tight muscles and decreasing pain. During pregnancy, support belts can also be useful.
It is also a good idea to consult your Physiotherapist who can identify and treat contributing factors including specific muscle weakness, imbalances, leg length differences, postural factors and overall biomechanics and running technique.