Rehabilitation of the Sacroiliac Joint

The sacroiliac (SI) joint is a very irregularly shaped joint located where the ilium (hip bone) and the sacrum (tail bone) meet. The joint has very little motion; however, the limited motion it does have is very important to the proper functioning of the lumbar spine, as well as the hip.

The SI joint is susceptible to traumatic (sudden, forceful injury) and inflammatory conditions. Common causes of injury are slips or falls; however, it also can be injured by overuse. Overuse can result from frequent and prolonged bending or sitting for extended periods of time. Occasionally, intense pain can arise from doing something as simple as bending over to pick up a pencil or tie a shoe.

How is SI joint dysfunction treated?
Treatment of SI joint dysfunction actually begins with an examination by a physician to rule out any disorders that may be serious enough to warrant surgery. Once the physician has eliminated the possibility of any serious ailments, a referral to a skilled manual physical therapist is in order to restore normal range of motion. Once normal mobility has been attained by appropriate and specific manipulation and mobilization techniques, stretching exercises are begun to maintain the mobility of the joint. To stretch, recline on your back with both legs straight. Then slide your left heel up toward your buttocks, raising the left knee. Slowly lower your bent knee to the outside, keeping your left heel against your right knee (Fig. 1). After the SI joint has been free of pain for a short period of time, specific strengthening exercises can be started (Figs. 2 & 3).

Although SI joint dysfunction is a relatively common ailment, it is frequently misdiagnosed and mistreated. Most low back problems related to joint dysfunction or weak muscles can be treated conservatively and effectively by a skilled manual physical therapist.

William D. Jones, PT, CSCS
Columbus, Georgia