The sacroiliac joint, also called the SI joint, sits at the bottom of your spine and makes up the rear portion of your pelvic girdle. The human body actually has two -- one sits at the left side of the pelvis and the other sits on the right. Sacroiliac joint dysfunction is a possible cause of lower-back pain. Physical therapists design therapeutic exercise protocols based on the type of SI joint dysfunction.
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SI Joint Dysfunction
The term sacroiliac dysfunction refers to joint hypo- or hyper-mobility. Hypermobile SI joints have too much movement, and hypomobile SI joints are locked and immobile. Traumatic injuries, biomechanical muscle imbalances, inflammatory diseases or hormonal issues may affect the sacroiliac joint. Pregnancy causes joint laxity in preparation for the birthing process and this laxity may cause SI joint hypermobility.
After an initial sacroiliac joint assessment, your doctor may prescribe some preliminary, non-surgical treatments for symptom relief. In cases of extreme pain, these allow you to perform the exercises in relative comfort. Heat packs are an option, but avoid them if inflammation is present. If you are experiencing significant inflammation, your doctor may prescribe anti-inflammatory medication. Some physical therapists use ice packs to treat inflammation. Pregnant women with hypermobile SI joints may need to wear a special SI joint belt.
Some Pilates-evolved exercises may alleviate the symptoms of SI joint dysfunction, says Jennifer Adolfs, author of "Pilates Relief for Joint and Back Pain." Begin by lying supine and drawing one knee toward your chest. Hold for two counts, then release. Perform 10 repetitions on each leg. Then, lower both feet to the floor with bent knees, and let your arms rest comfortably by your sides. Keeping your heels and both hips flat on the floor, gently sway your knees from side to side. You will feel a stretch across your lower back.
Some Pilates-evolved exercises also help stabilize the sacroiliac joint. Lie supine with your legs extended . Bend one knee, and bring it toward your chest. Keep both hips firmly pressed into the floor as you circle the bent knee. Perform four clockwise and four counter clockwise circles on each leg. When you complete both sides, roll over on to your stomach. Bend one knee to create a 90-degree angle. Lift the lower leg from the floor and perform six clockwise and six counter clockwise circles. Keep both pelvic bones pressed into the floor. Repeat on the other leg.
Physical therapists at the Ohio State University Medical Center use pillows, small exercise balls and resistance bands to strengthen the muscles that support the SI joint. Sit, leaning on your elbows with your knees bent. Place a pillow or a small exercise ball between your legs. Contract your inner thighs as you squeeze the ball or pillow. Perform 10 repetitions, then wrap a resistance band around your outer thighs. Lie supine and press your thighs out against the band's resistance. Perform 10 repetitions.
Physical therapist Richard DonTigny designed a series of exercises to realign the SI joint and engage the core muscles, which are essential for sacroiliac joint stability. Some are extremely subtle, and may involve a considerable amount of concentration before you can feel them working. Sit upright with your knees bent and your feet flat on the floor. Without moving your feet or upper body, contract your abdominal muscles and push one knee forward while pulling the other knee back. Repeat, alternating direction. DonTigny suggests performing this exercise several times a day.