The Sacroiliac Joint and Low Back Pain

The morning after the first storm! My car is in there somewhere.

The morning after the first storm! My car is in there somewhere.

When we set up our practice in East Aurora and decided to live in Elma we knew there would be snow but these last couple days have been crazy! An entire years worth of snow (71 inches) in 2 days! As I was shoveling for hours on end, I was constantly thinking about my form taking care not to lift the heavy snow with my lower back. Snow events like these usually lead to an increase of patients with back injuries and the most common injury tends to be a sprain of the sacroiliac joint. The sacroiliac (SI) joint is located just below the base of the spine on the left and right and can be considered part of the pelvis.  The SI becomes over-stretched spraining the ligament in the joint space. It makes sense that this can happen because of the heavy snow and repetitive nature of shoveling.  More commonly the patient is set up for this injury because the muscle surrounding and supporting the sacroiliac joint are not working properly. Now when the person goes to shovel the SI joint is more likely to sprain because the forces of lifting and turning are going through the joint instead the muscles.  This is the case throughout the body. Inhibited or poorly function muscles cannot move the joints correctly and then the joint itself begins to break down.  Muscle inhibition is often painless and the first symptom you feel is inflammation in whatever joint those muscles are supposed to support.

What to do about a sprained sacroiliac joint beyond ice and rest.

  • His hand is on the top part of the sacroliac pain. The SI joint may extend 1-2 inches below his finger tips.

    His hand is on the top part of the sacroliac pain. The SI joint may extend 1-2 inches below his finger tips.

    Correct the source of of inhibited muscles. The major muscle that helps stabilize the sacroiliac joint are the sartorius, gracilis, rectus femoris and abdominals in the front and glut max and piriformis on the back.  This is where applied kinesiology shines by letting the body tell us what the major source of stress in the body that is causing the inhibition. The most common causes for the sacroiliac joint are blood sugar handling issues, chronic stress and joint fixation. These types of stressors often go unnoticed and when you go to do some strenuous physical activity the joint is no longer supported by the right muscles and becomes sprained. I would say this is more often the case, but it is possible to over do an activity like shoveling and sprain the sacroiliac joint out right. Even then the supporting muscles will be inhibited and need direct attention.

  • See a chiropractor for adjustments! Muscles move bones which is why I tend to address muscle inhibition first.  However, fixations of the joints associated with the sacrum, pelvis, low back and even as far away as the neck can cause pain and muscle inhibition throughout the body. Freeing these joints allows the nervous system to properly communicate with the muscles and the rest of the body. The result is less pain and improved function. The right adjustment, in the right place and at the right time can be one of the most powerful tools for restoring normal tone on the nervous system. It makes sense that a joint should be able to move freely and be in the correct position for optimal healing.
  • I like to use the Serola Belt to help stabilized the sacroiliac joint after it has been sprained. Think of a sacroiliac sprain as a sprained ankle but in your back. With any sprained joint you need to rest and support the joint as it heals.  In general, I am not a fan of supporting joints all the time because it tends to promote weakness around those joints because the muscles become dependent on the brace and start to not do their job. While a joint is healing a brace can be very useful with the idea that you will use it less and less over the course of 3-4 weeks.
  • Avoid re-injuring the sacroiliac joint. Get up from a sitting position every 20-30 minutes and walk around. Watch shearing forces through the pelvis like getting in a car. Instead of putting one leg in at a time instead try sitting your behind in the car first and then bring both legs into the car at the same time. When bending over to pick things up of the floor bend your knee slightly and bend toward the ground at your hips while keeping your low back straight. This engages the big muscles in your low back and the stress is taken off the sacroiliac joints.  If an activity feels like its straining your injured area-Do Not Do It!

Look for Part II of this post where I will cover stabilizing the sacroiliac joint with exercise.

Bonus Owen and Claire Pics!

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