A few of my patients – mostly the guys and gals who are more athletically inclined – come to me complaining of what they describe as a nagging “pain in the rear” which often makes it hard to walk, sit for prolonged periods comfortably,  or even continue exercising.  I immediately recognize this symptom as one associated with sacroiliac joint, or “SI” joint dysfunction.  If you do a lot of leg/hip movement exercise – particularly running, bicycling, jumping as with basketball – you may experience SI joint dysfunction and you should know how to prevent it as well as what you can do about it.

What Is SI Joint Dysfunction?  

Your SI joints are amongst the strongest ones in your body.   They sit at either side of your lower spine, between the sacrum and the iliac bones, and create the pelvic girdle of muscles and ligaments that support your hips and pelvis.  The SI joints helps you do twisting and torsional movements when you move your legs in certain exercise or just going about your daily activities.

When you injure your SI joints – from over-extension of your legs, or somehow landing on your buttocks from a fall, or any number of other ways– the trauma causes the SI joint to become either too loose or too tight.   Both extremes cause irritation of the surrounding ligaments and muscles of the hips and pelvis as they have to compensate for the wrong tension in the joint.  The ligaments and muscles in this area then overwork in a way they weren’t meant to and often become inflamed and pain results.  This pain can radiate all over the hip and lower back area and even down into the groin, thighs and knees.  It can make it difficult to find a comfortable sitting position and results in needing to shift your weight constantly to alleviate pain.

As I said earlier, SI joint dysfunction is a result of incorrect tension that doesn’t only affect the athletic – it can also affect pregnant women, or women who have had several childbirths.  Here are some of the most common ways SI joint dysfunction occurs:

• Trauma – falling on the buttocks or overextension of the SI joint and surrounding muscles and ligaments which results in changes of joint tension.
• Biomechanical – these can include issues like unequal leg lengths which puts chronic strain on the ligaments and muscles of the hips and pelvis.  Or, imbalances in muscle strength of the hip and pelvis muscles can affect SI joint function.  Weight lifting, or weight machines, working one set of muscles too much and not enough of another in the hip and pelvis area may contribute to SIJD. Weight/pressure on the SI joint/ligaments from pregnancies, or even mothers holding children balanced on one hip.
• Hormones – this type usually occurs in pregnant women when increased estrogen and progesterone, which help ligaments and muscles get ready for childbirth, can cause too much laxity of the ligaments surrounding the SI joint.  Also weight of the pregnancy itself bearing down on these ligaments can cause them to lose correct tension.
• Inflammation – inflammation often results to surrounding muscles and ligaments from SI joint dysfunction, but it can also cause SI joint dysfunction as well.  Some research points to gluten sensitivity that causes inflammation of joints throughout the entire body.  There is anecdotal evidence from people with SIJD that their symptoms went away when they removed gluten from their diet.  Other sources of inflammation can be irritation of ligaments and muscles through over-exercising and not resting the muscles sufficiently; not stretching muscles correctly before exercising; not enough Omega-3’s in the diet and perhaps too much inflammatory foods in the diet.

What Can You Do About SI Joint Dysfunction and Pain?

Healing from an SI joint dysfunction usually just takes a little time and rest of the surrounding muscles and ligaments.  Rarely, the condition may need surgical readjustment of the SI joint ligaments.  Here are some things I recommend first to my patients with mild to moderate SIJD:

• Rest.  Take a break from exercise that may have caused it (running, bicycling, climbing, jumping).  Switch to swimming for exercise as it heals to take the weight off this area.
• Physical Therapy/Massage/Heat:  Try a course of massage therapy with/without heat to help restore normal tension to SI joint ligaments and muscles.  Heat packs can loosen up tight hip and pelvis muscles but shouldn’t be used if inflammation is present.
• Turn off Inflammation/Pain, Boost Immunity Naturally:  Substances like Quercetin, fish and/or krill oil, gamma linolenic acid (GLA), natural marine-algae source astazanthin,  bromelain, turmeric, ginger root, spices like rosemary can help turn off inflammation and pain. Products like Curamin and Zylamend heal inflammation as well.
• Anti-inflammatory foods:  Try removing gluten sources (wheat) from your diet; add anti-inflammatory foods like red/pink salmon, shitake mushrooms, green tea, papaya, blueberries, olive oil, broccoli, yams, high-hops value beer.
• Prevention:  To prevent SIJD from occurring, exercise regularly to keep muscles and ligaments strong, but avoid over-exercising.  Maintain good postures while sitting – getting up to move around every 2-3 hours.  Use proper bending and lifting techniques.

SI joint dysfunction can be a real side-liner especially if you’re athletically active. However, observing good body mechanics can go a long way to keeping your SI joint pain-free and you active and healthy!

Stay well,

Mark Bromson, M.D.

Natural Health News

10 Best Anti-Inflammatory Foods, http://theconsciouslife.com/top-10-anti-inflammatory-foods.htm

Natural and Safe Anti-Inflammatory Medicines, http://www.foxnews.com/health/2011/05/18/natural-safe-anti-inflammatory-medicines/

photo credit: hackettchiro.com