What is the SI joint and can Pilates help?

What is the SI joint? 

The SI joint, or sacroiliac joint, is the joint between the sacrum and ilium of the pelvis joined together by ligaments. Refer to the diagram below. The sacrum supports the spine and is supported by the ilium on each side. The joint is a strong, weather bearing synovial joint with irregular elevations and depressions that produce interlocking of the two bones. Humans have two sacroiliac joints, one on each side, left and right, that while would seem to match each other, are highly variable from person to person. 

The sacroiliac joint is not designed for a whole lot of motion. This is where the problem lies, the SI joint becomes stiff and can “lock” as we age. Because of the location of the SI joint, at the base of the spine, it absorbs all the shock and compression from years of bad posture, weak muscles, disc degeneration and life. Pain in this SI joint may be caused by various reasons, ie.twisting or bending in such a way that triggers SI joint pain, infection of the SI joint, osteoarthritis, trauma, stress fractures or inflammation of the SI joint.

 

Causes of SI joint dysfunction: 

• Osteoarthritis: cartilage layer covering the bones begins to degenerate; bones have no protective layer so they start to rub against each other. This causes osteoarthritis and leads to sacroiliac joint dysfunction
• Trauma injuries: Sudden jolt or movement that affects the joints and leads to damage of the ligaments 
• Pregnancy: Hormonal changes in the body during pregnancy can have an effect on the sacroiliac joint. Added pressure put upon the sacroiliac joint due to increased weight.
• One leg shorter than the other puts unequal pressure on the joints and bones. 
• Certain muscle imbalances. 
• Gout, psoriasis and other forms of arthritis. 
• Incorrect placement of the bones while sitting and walking over a period of time. 

The treatment for SI dysfunction ranges from medication, steroids and exercise to surgery. Exercise can involve physical therapy, Pilates, myofascial or deep tissue therapies, somatic exercises, yoga, physiotherapy and other exercises for the sacroiliac joint. 

Coping with the pain from SI joint dysfunction: 

Lying in bed sleeping can be difficult for some. Lying on the sore side is not possible in most cases, lying on the back or stomach can also be painful because rising from these positions can send sharp pains to the sore hip. To make sleeping a little more comfortable add a couple of inches of foam to the bed. Sleeping on the uninjured side is an obvious solution. Sleeping on a couch where you can press you back against the back of the couch can help. Placing a thin pillow or folded towels between your knees down to your ankles to lift the injured side slightly, keeping it more aligned with your spine can help reduce the pain.

Learning exercises that are best for you to help tone back and abdominal muscles can be helpful. A physical therapist can be helpful. There are many exercises in Pilates that can help strengthen the ‘core’ muscles and pelvic floor muscles. If an exercise hurts, don’t continue with it. 

Sometimes driving in a car, the jiggling of the car, especially a sudden turn or driving over bumps can be painful. Using seat pads and a passenger using pillows on both sides of your body to help reduce and cushion movement can help. Using a heat or cold pack and of course pain medication can help minimize pain. 

Other ways of coping with the pain are joint injection. This is the injection of a numbing solution and anti-inflammatory in to the joint. This is done by a specialist. A joint restraint can be used. This is a sacroiliac belt that can be worn when performing chores and may help reduce overextending the joint. Heat and cold therapy may be used. Pain medication can be extremely helpful to reduce pain and inflammation giving you more mobility. 

How Pilates can help SI joint pain: 

Pilates helps to correct muscle imbalances in the body that result in pains, strains and injuries, and improves poor posture. 

Exercises that stretch the muscles of the lower back and strengthen the muscles that support the pelvic floor or the deep, lower abdominal muscles will be part of a program aimed at help with SI joint pain. Many exercises in Pilates are available to help strengthen muscles around the pelvic area. Even as simple as breathing with the principles of Pilates in place with help strengthen the deepest layer of the abdominals as well as the pelvic floor all contributing to treatment to SI joint pain