experiencelifemag.com Print › | Back › The Sacroiliac (SI) Joint By Andrew Heffernan, CSCS July-August 2009 As its name suggests, the SI joint is the intersection point between the sacrum — the bony structure that encapsulates the tailbone — and the ilia, or hip bones. It’s a joint by definition, but it isn’t designed to move much, says Eric Cobb, DC, creator of Z-Health (www.zhealth.net). “If you’re in a car accident, the pelvis will often fracture in multiple places before the SI joint will tear. That’s how strong and stable it is.” And yet, pain and inflammation at the SI joint are fairly common. Once again, dysfunction in the hip joint is often to blame. Like the back and knees, the SI joint is another place the body seeks compensatory movement when the hips don’t move properly. “A lot of the problems with the SI joint occur because of the lack of differentiation between the hip and pelvis — which means people aren’t able to move their hip joints while using the core musculature to stabilize the pelvis,” says Cobb. “If you’re having SI joint problems, you either had a really large baby or you’re doing something wrong,” says Gray Cook, MSPT, OCS, CSCS, a Danville, Va.–based physical therapist. “You’ve been running or lifting more than you should, or you’ve developed one-side dominance from too much tennis or golf, and it’s led to some imbalance in the body. Perpetuate that long enough and you start to put extra stress on the ligaments of the SI joint.” So if this nearly indestructible joint starts to bother you — in the form of pain in the groin, sharp lower-back pain, or pain that increases while sitting — you have probably been exercising too long and hard, or over-taxing one side of the body at the expense of the other. If that’s the case, back off for a while to regroup. When you return to your workouts, focus on functional core strength, find ways to strengthen and develop your non-dominant side, and start including the hip mobility exercises we recommend.

The Sacroiliac (SI) Joint

As its name suggests, the SI joint is the intersection point between the sacrum — the bony structure that encapsulates the tailbone — and the ilia, or hip bones. It’s a joint by definition, but it isn’t designed to move much, says Eric Cobb, DC, creator of Z-Health (www.zhealth.net). “If you’re in a car accident, the pelvis will often fracture in multiple places before the SI joint will tear. That’s how strong and stable it is.”

And yet, pain and inflammation at the SI joint are fairly common. Once again, dysfunction in the hip joint is often to blame. Like the back and knees, the SI joint is another place the body seeks compensatory movement when the hips don’t move properly. “A lot of the problems with the SI joint occur because of the lack of differentiation between the hip and pelvis — which means people aren’t able to move their hip joints while using the core musculature to stabilize the pelvis,” says Cobb.

“If you’re having SI joint problems, you either had a really large baby or you’re doing something wrong,” says Gray Cook, MSPT, OCS, CSCS, a Danville, Va.–based physical therapist. “You’ve been running or lifting more than you should, or you’ve developed one-side dominance from too much tennis or golf, and it’s led to some imbalance in the body. Perpetuate that long enough and you start to put extra stress on the ligaments of the SI joint.”

So if this nearly indestructible joint starts to bother you — in the form of pain in the groin, sharp lower-back pain, or pain that increases while sitting — you have probably been exercising too long and hard, or over-taxing one side of the body at the expense of the other. If that’s the case, back off for a while to regroup. When you return to your workouts, focus on functional core strength, find ways to strengthen and develop your non-dominant side, and start including the hip mobility exercises we recommend.

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August 20, 2009

Dr. Eric Cobb, Z-Health Performance Solutions says:

Great question about a very frequent complaint. The sacroiliac joints (SIJs) are two of the most important supporting joints of the body. They are found in the pelvis and provide tremendous stability as well as a platform for the efficient transfer of force during our gait cycle. Unfortunately, during pregnancy, the SI joints are often under much more significant stress than normal as a result of two primary factors: 1) Carrying an ever-growing baby, and, 2) Hormonal changes that cause significant relaxation of the ligamentous tension designed to hold the joints "together". This relaxation is necessary to allow the pelvis to stretch enough to allow the baby to move through the birth canal. However, this stretching can result in changes to the SIJs, leaving them "overstretched". Woman who carry and deliver large babies often experience this issue which can manifest as pain and discomfort in the low back. Statistically speaking, women are 8 to 10 times more likely to experience SIJ-related pain than men because of both structural and hormonal differences. There is good news, however. SIJ dysfunction does not have to be a life-long sentence to pain and discomfort! As we have learned more about how forces are transmitted in the body, the SIJs have become a huge topic of interest. It appears that one of their primary functions is to transmit the forces that enter the body at the foot during heel strike across the pelvis to the opposite upper extremity. This is a very complex neurological and biomechanical task that creates ongoing adaptation in the body. What this means for us in practical terms, is that if you have lower extremity issues, like significant foot, ankle, knee or hip immobility, this will often cause an INCREASE in SIJ instability. As we explain in our training system, the body wants to maintain a certain level of overall mobility. When one area loses mobility, the natural response is to increase mobility elsewhere to make up for the loss. So, for people with chronic SIJ pain and instability, the key is often to find other areas of the body that are immobile. Increasing mobility in these areas through appropriate exercises can often "magically" take care of SIJ pain when all else has failed. Dr. Eric Cobb, Z-Health® Performance Solutions, 888-394-4198, www.zhealth.net

August 11, 2009

Martha says:

I have been reading this article on joint pain and was surprise to see a connection between having a very large baby and SI joint pain. I had a 10 lb. baby a long time ago but I have had intermittent pain on and off for years. I am 5'1" and have a normal body weight. Please comment if possible. Thanks.