This is a story that I hear all too often… “I was out in the garden all day” or “I was
golfing all afternoon”… when all of the sudden I felt this stabbing pain in my low
back. If this sounds familiar, you may be dealing with SI Joint Pain.
This affliction can be described as a sharp pain in the lower part of your back.
This pain can also affect your buttocks, groin, or thigh and may travel down your
leg creating weakness and making it difficult to lift on one side. Many times, the
pain is only on one side of your back, low down where your belt would be. Pain
may be worse in the morning and then settle later as the day progresses. If you sit
for a long period of time you may notice that the pain worsens when you stand
up. SI joint pain affects about 30 percent of older adults and is one of the more
common back problems.
What is an SI Joint?
The full name is sacroiliac joint and there are two of these joints in your lower
back. They are where your sacrum joins to your hip. The sacrum is a triangular
bone at the base of your spine. The sacrum is located between your lumbar
region and your tailbone. It is jagged and fits together with the hip like two
pieces of a jigsaw puzzle. You can see these joints on the outside of your body.
They appear as two dimples or divots on each side of your low back. The two
depressions lie on each side of the spine and connect the pelvis’ iliac bone to the
spine’s sacrum. Usually the SI joint is stable with very little movement as it is
held together with several strong ligaments in much the same way that old
wooden barrels were strapped together by metal hoops. This part of the back is
prone to exertion. People who have lower back pain often experience it here
where the lower spine and hips meet. If ligaments are torn due to a fall or
become jarred loose because of misalignment, the pelvis can become unstable.
Pregnancy is another cause of instability for the SI joint as ligaments around the
pelvis loosen up to prepare for childbirth.
For many older adults, poor posture is the cause of SI joint related problems.
How often do you find yourself leaning on one leg when standing in line or sitting
heavier on one sit bone when driving your car? If we mix poor posture with weak
stabilizing muscles and then add a day of golfing or gardening into the mix, we
have created a recipe for low back instability. And, as a result, that jigsaw puzzle
may come slightly out of place resulting in SI joint disfunction.
There has been a common theme to many of my articles lately. I can’t emphasize
enough how important proper posture is to minimizing joint strain. The good
news is the right type of exercise added with body awareness can help you enjoy
doing what you love while minimizing the risk of being hurt in the process. For
example, take notice during the day whether you are leaning on one leg. We
usually lean on our stronger leg or dominant side. Notice when you are in your
car or watching television if you are centered. Try to avoid leaning heavier on one
of your sitting bones than the other. Noticing bad habits and correcting yourself
is the first step to positive change. Imagine having a flashlight glued to both hip
bones on the front. When you are working on the computer or watching
television try to imagine both lights shining straight ahead. This will place your
back in good alignment. We tend to sit with our hips slightly turned but over
time this slight malalignment can destabilize the SI joint.
Do you remember the toy boats that had a rubber band around the propeller?
You would wind up the rubber band to get energy for the propeller to move the
boat. Imagine having the rubber band twisted for 10 years. One side of the
rubber band would lengthen and eventually break down. In general, we should
avoid twisting or torquing the low back as much as possible. Twist a jigsaw
puzzle, even one glued together, and eventually there’s a good chance it will fall
apart. Therefore, it’s important to think about initiating movement from the hips.
This is a concept golfers have known for years. When we turn our body, one
strategy that may help is to think of turning the flashlights on your hips towards
the direction you are turning and let the body follow.
The older we get, the higher the probability that we could experience joint pain.
Prevention helps! Below are a few gentle exercises. Always check with your
physician before starting an exercise program and if anything doesn’t feel good,
trust your body and avoid that exercise.
Door Way Release: This is my favorite release for SI joint pain. Sometimes
we can put everything back in place with this one move. The trick is to find a
doorway wide enough to accommodate the movement with a solid surface to
place your low back against. Simply anchor your sacrum or low back solidly
against the door frame. Lift the leg that is on the painful side and push against
the opposite door frame. Make certain you are breathing as you press as hard as
you can.
Pelvic Tilts: If your SI is out of place you might find small movements of your
pelvis to be difficult. Start by lying on your back with your knees bent. Imagine
you have a marble on top of your left hip bone, lift your left hip bone to roll the
marble to your right hip bone, now lift your right hip bone to roll the marble back
to the left. Try to keep your legs relaxed and relatively still as you rotate the
pelvis from left to right. Level the hips to finish and your marble will be in the
centre below your navel. Next try to slightly lift your tailbone off the floor and
then let it become heavy and lower down again. Repeat each exercise 10X
One Leg Hip Stabilizing Exercises: When we walk, we lift our leg. If we
have SI joint instability however, we may find that when we lift our leg our hip
drops. We want to practice lifting our leg without hip movement. We can start
by placing our hand on our hip joint and trying to keep the hip as still as possible
while lifting the leg. When you get comfortable with that practice, try lifting one
side then the other, walking on the spot while keeping the hips as still as possible.
Be safe and have a countertop nearby for support, as needed. When you perfect
that, lift your arms and continue the exercise concentrating on hip stability.