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Understanding SIJ Pain: Causes, Impact, and How Pelvic PT at COPE Can Help


The sacroiliac joint (SIJ) plays a vital role in connecting your spine to your pelvis. It is responsible for transferring the weight between your upper body and lower limbs, ensuring balance and stability. However, when this joint becomes dysfunctional, it can lead to pain that radiates from the lower back to the hips, buttocks, and even down the legs. SIJ dysfunction can be particularly troubling for both non-pregnant and pregnant individuals, with specific challenges during pregnancy. Let’s explore the causes, relation to the pelvic floor, and how pelvic physical therapy (PT) at COPE can provide effective solutions.


SIJ joint

What Causes SIJ Pain?

SIJ pain occurs due to dysfunction or instability of the sacroiliac joint, where the sacrum meets the ilium. Some common causes of SIJ pain include:

  1. Trauma or Injury: Accidents or falls can cause direct damage to the SIJ, leading to inflammation and pain.

  2. Repetitive Stress: Prolonged standing, walking, or improper lifting can strain the SIJ over time.

  3. Muscle Imbalances: Weakness or tightness in the muscles around the SIJ can lead to misalignment and instability.

  4. Pregnancy: Hormonal changes, particularly the release of relaxin, can loosen the ligaments supporting the SIJ. The weight of the growing baby and changes in posture can increase pressure on the joint, making pregnant women especially vulnerable to SIJ pain.


The Relationship Between SIJ, Pelvic Floor, and Hip

The SIJ, pelvic floor, and hip muscles are intricately connected. Dysfunction in one area can trigger issues in others, creating a chain reaction of pain and instability:

  • SIJ and Pelvic Floor: The pelvic floor muscles play a critical role in stabilizing the SIJ. Weak pelvic floor muscles can cause SIJ instability, leading to discomfort. Similarly, SIJ dysfunction can disrupt the pelvic floor muscles, leading to pelvic pain or issues like incontinence.

  • SIJ and Hip: The SIJ shares a close relationship with the hip joint. When the SIJ is out of alignment, it can cause compensatory movements in the hip, resulting in hip pain and decreased mobility.


Pelvic PT at COPE: Addressing SIJ Pain

Pelvic physical therapy is an effective solution for managing SIJ pain. At COPE PT, our specialized pelvic therapists use a holistic approach to address both the causes and symptoms of SIJ dysfunction. Here’s how we help:

  1. Comprehensive Assessment: Our team will thoroughly assess your pelvic floor, SIJ, and hip mobility to identify the root cause of your pain.

  2. Manual Therapy: Hands-on techniques, including joint mobilization and soft tissue release, are used to realign the SIJ, reduce muscle tension, and improve joint stability.

  3. Corrective Exercises: Targeted exercises are prescribed to strengthen the pelvic floor, hip, and core muscles to enhance SIJ stability.

  4. Postural Education: We teach proper posture and movement mechanics to reduce strain on the SIJ and prevent future issues.

  5. Pregnancy Support: For pregnant patients, we offer specialized care to manage SIJ pain caused by hormonal and postural changes, ensuring comfort throughout the pregnancy journey.


SIJ Treatment Options

Treatment for SIJ pain often involves a combination of therapies, including:

  • Pelvic Floor Strengthening: Strengthening the pelvic floor muscles helps provide better support to the SIJ, reducing pain.

  • Core Stabilization: Strengthening the deep abdominal muscles, such as the transverse abdominis, creates stability around the SIJ and reduces pressure.

  • Hip Mobility and Strengthening: Exercises that target the hips improve flexibility and strength, balancing out the surrounding muscles.

  • Postural Training: Maintaining proper posture throughout daily activities can prevent unnecessary stress on the SIJ.

  • Manual Therapy: Gentle manipulations and soft tissue work can realign the SIJ and reduce pain and inflammation.


Effective Exercises for SIJ Pain

Before attempting any of these exercises, it’s important to see a pelvic PT professional to ensure you’re performing them safely. Here are a few exercises that may help relieve SIJ pain:

1. Pelvic Tilts


pelvic tilts

Pelvic tilts are a great way to engage the core and gently mobilize the SIJ.






  • How to Do It:

    • Lie on your back with knees bent and feet flat on the floor.

    • Gently tilt your pelvis backward, flattening your lower back against the floor.

    • Hold for a few seconds, then release.

    • Repeat 10 times.

2. Bridge Exercise


bridge

This exercise strengthens the glutes and core, providing stability to the SIJ.






  • How to Do It:

    • Lie on your back with knees bent and feet hip-width apart.

    • Engage your core and lift your hips toward the ceiling, creating a straight line from shoulders to knees.

    • Hold for a few seconds, then lower your hips back down.

    • Repeat 10-15 times.

3. Cat-Cow Stretch


cat cow

This stretch improves flexibility in the spine and relieves SIJ pressure.












  • How to Do It:

    • Begin on all fours with hands under shoulders and knees under hips.

    • Inhale, arching your back and lifting your head and tailbone (cow position).

    • Exhale, rounding your back and tucking your chin (cat position).

    • Repeat 10-15 times.

4. Hip Flexor Stretch


hip flexor stretch

Tight hip flexors can contribute to SIJ pain. This stretch helps relieve tension in the hips.










  • How to Do It:

    • Start in a kneeling position, with one foot forward and the other knee on the floor.

    • Gently push your hips forward until you feel a stretch in the hip of the back leg.

    • Hold for 20-30 seconds, then switch sides.



Self-Correction Techniques for SIJ Pain

While it’s always best to consult a professional, some gentle self-correction techniques can provide temporary relief. Remember, these techniques should be used under the guidance of a healthcare provider.

1. SIJ Belt

A sacroiliac belt can provide external support to stabilize the SIJ, reducing discomfort.


si belt

2. Positioning

Simple adjustments like placing a pillow between your knees when sleeping on your side can alleviate pressure on the SIJ.



Why COPE PT is Your Solution for SIJ Pain

At COPE PT, our pelvic physical therapy specialists understand the complexity of SIJ pain and its relationship with the pelvic floor and hips. Whether you're dealing with SIJ pain during pregnancy or due to other causes, our tailored treatment plans, comprehensive assessments, and expert care can help you find relief and restore your quality of life.

We encourage you to consult with our highly skilled team before attempting any self-correction techniques or exercises. Let us help you regain control of your body, reduce pain, and strengthen the pelvic floor to support long-term stability.



By working closely with our team at COPE PT, you’ll receive the compassionate, expert care you deserve. SIJ pain doesn’t have to control your life — let us help you move forward with confidence.

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