WHAT IS THE SIJ?
The sacroiliac SI joints are formed by the connection of the sacrum and the right and left iliac bones. The sacrum is the triangular-shaped bone in the lower portion of the spine, centrally located below the lumbar spine. While most of the bones (Vertebrae) of the spine are mobile, the sacrum is made up of five vertebrae that are fused together and do not move. The iliac bones are the two large bones that make up the pelvis. As a result, the SI joints connect the spine to the pelvis. The sacrum and the iliac bones (Ileum) are held together by a collection of strong ligaments. These joints do need to support the entire weight of the upper body when we are erect, which places a large amount of stress on them. This can lead to wearing of the cartilage of the SI joints and arthritis.
HOW DID I GET SIJ DYSFUNCTION?
The most common reason for SI joint dysfunction is an imbalance in the pelvis. This can be from wearing a Wallet in the back pocket too often to tighter than normal Hamstrings. When the pelvis is rotated or stretched, the body compensates by rotating the other side. While this is a great mechanism for keeping the weight distribution even, it can lead to injuries and minor aches and pains.
Another common cause of SI joint dysfunction is Pregnancy. During pregnancy, hormones are released into the woman’s body that allows ligaments to relax. This prepares the body for childbirth. Relaxation of the ligaments holding the SI joints together allows for increased motion in the joints and can lead to increased stresses and abnormal wear. The additional weight and walking pattern (altered gait) associated with pregnancy also places additional stress on the SI joints.
Any condition though that alters the normal walking pattern places increased stress on the SI joints and is a risk factor for SI joint dysfunction. This could include a leg length discrepancy (one leg longer than the other), or pain in the hip, knee, ankle, or foot. Patients with severe pain in the lower extremity often develop problems with either the lower back (lumbar spine) or SI joints. Most of the time, if the underlying problem is treated, the associated lumbar spine or SI joint dysfunction will also improve.
A Chiropractic adjustment is the most effective tool to mobilize the fixated SI joint. This is because the thrust can immediately increase the range of motion, reduce nerve irritability and improve function. Additionally, many of the soft tissue devices used at the office (i.e. Graston therapy, rapid release and ultrasound) can help reduce inflammation and mobilize fixated joints. If symptoms persist or are too severe, SI joint Injections might be recommended for relief. Ice is the preferred therapy for home use and heat will only inflame the joint more.