Sacroiliac Joint Dysfunction:
Anatomy, Risk Factors, and Prevention

Sacroiliac Joint Dysfunction (SI Joint Pain) is a condition that affects the lower back, pelvis, and hips. It occurs when there is a problem with the sacroiliac joint, which is the joint that connects the sacrum (the triangular bone at the bottom of the spine) and the ilium (part of the pelvis). SI joint dysfunction can cause significant discomfort, pain, and mobility issues, making it challenging to perform daily activities. In this article, we will discuss the anatomy, biomechanics, and function of the sacroiliac joint, what causes SI joint dysfunction, risk factors, and prevention measures to help you understand this condition better.

The sacroiliac joint connects the sacrum and the ilium. The sacrum is the triangular bone that sits between the two hip bones at the bottom of the spine. The ilium is the broad, fan-shaped bone that forms the upper part of the pelvis. The sacroiliac joint is a synovial joint that has a thin layer of cartilage. It has several ligaments that help keep it stable, including the anterior sacroiliac ligament, posterior sacroiliac ligament, sacrotuberous ligament, and sacrospinous ligament. The muscles of the lower back and pelvis, such as the gluteus maximus, piriformis, and erector spinae, also play a crucial role in supporting the sacroiliac joint.

The sacroiliac joint is designed to absorb shock and transfer forces from the upper body to the legs during movement. It allows for a small amount of movement, usually less than 3 to 4 degrees of rotation and 2 to 4 mm of translation. The SI joint is stabilized by several muscles and ligaments that attach to it, providing support and preventing excessive movement.

Risk Factors for SI Joint Dysfunction

Sacroiliac Joint Dysfunction can occur when the sacroiliac joint becomes inflamed, irritated, or moves too much or too little. This can lead to pain and discomfort in the lower back, buttocks, and thighs. Pain can be sharp or dull and may worsen when sitting, standing, or walking. SI joint dysfunction can also cause stiffness, numbness, or a tingling sensation in the legs. In severe cases, it can cause difficulty walking or even standing. Sacroiliac joint dysfunction (SI joint dysfunction) is a condition that causes pain in the lower back, buttocks, and thighs. Several factors can increase the risk of developing SI joint dysfunction. Here are the top 5 risk factors for SI Joint Dysfunction.

1. Repetitive Movements and Overuse

Engaging in repetitive activities or overusing the SI joint can contribute to dysfunction. Certain occupations or sports that involve repetitive twisting, bending, or lifting movements can place excessive stress on the SI joint, leading to irritation, inflammation, and dysfunction. Jobs that require prolonged sitting or standing in unnatural positions can also contribute to SI joint dysfunction. Ergonomic modifications, proper body mechanics, and regular breaks to change positions or stretch can help reduce the risk of SI joint dysfunction associated with repetitive activities.

2. Pregnancy

One of the primary risk factors for SI joint dysfunction is pregnancy and childbirth. During pregnancy, the body undergoes significant hormonal and biomechanical changes to accommodate the growing fetus. Hormones like relaxin cause ligaments in the pelvis to loosen, preparing the body for childbirth. This increased laxity in the ligaments can lead to instability and misalignment of the SI joint. Additionally, the increased weight and altered center of gravity during pregnancy can place additional stress on the SI joint, increasing the risk of dysfunction. Proper prenatal care, including exercises to strengthen the muscles around the SI joint and supportive devices such as maternity belts, can help minimize the risk of SI joint dysfunction during pregnancy.

3. Injuries

Trauma or injury to the pelvis can significantly increase the risk of SI joint dysfunction. Falls, accidents, or sports-related injuries that involve a direct impact to the pelvis can cause damage to the ligaments, muscles, or bony structures surrounding the SI joint. This can lead to instability, inflammation, and pain in the SI joint area. Proper evaluation and management of pelvic injuries, including physical therapy, can help restore stability and function to the SI joint and reduce the risk of long-term dysfunction.

4. Weak Muscles and Poor Posture

Postural imbalances and muscle weakness can contribute to SI joint dysfunction. Poor posture, such as excessive anterior pelvic tilt or uneven weight distribution, can place additional stress on the SI joint, leading to dysfunction. Weakness in the muscles surrounding the SI joint, particularly the core, glutes, and hip stabilizers, can result in inadequate support and stability for the SI joint. Strengthening exercises, postural awareness, and corrective exercises to address muscle imbalances can help reduce the risk of SI joint dysfunction associated with postural issues and muscle weakness.

5. Age and Degenerative Changes

As we age, the cartilage in the SI joint may start to wear down, leading to degenerative changes. The gradual loss of cartilage can result in joint dysfunction, inflammation, and pain. Age-related degeneration of the SI joint is a common risk factor for SI joint dysfunction. While the degenerative changes cannot be reversed, appropriate management strategies, including exercise, manual therapy, and pain management techniques, can help alleviate symptoms and improve function.

Prevention Measures to Reduce Risk
for Sacroiliac Joint Dysfunction

Preventing SI (sacroiliac) joint dysfunction is crucial for maintaining optimal function and reducing the risk of debilitating pain in the low back and pelvic region. By implementing preventive measures, individuals can minimize the risk of SI joint dysfunction and promote overall musculoskeletal health. Here are some of the top preventive measures for SI joint dysfunction:

Core Strength

Strengthening the core muscles, including the deep abdominal muscles, back extensors, and hip stabilizers, is essential for maintaining proper alignment and stability of the SI joint. Strong core muscles provide support to the pelvis and help distribute forces evenly, reducing the strain on the SI joint. Incorporate exercises such as planks, bridges, and bird dogs to target the core muscles and promote stability.

Hip and Glutes Strength

Strong hips and glutes play a crucial role in supporting the SI joint. Weakness in these muscles can contribute to instability and increased stress on the SI joint. Include exercises like squats, deadlifts, lateral leg raises, and clamshells to strengthen the hip abductors, external rotators, and gluteal muscles. Strong and well-balanced hip and glute muscles help maintain proper alignment and reduce the risk of SI joint dysfunction.

Flexibility and Stretching

Maintaining good flexibility in the muscles surrounding the SI joint can help prevent stiffness and reduce the risk of dysfunction. Focus on stretching exercises that target the hip flexors, hamstrings, quadriceps, and lower back. Stretching can help alleviate tension, promote better alignment, and reduce the risk of SI joint dysfunction.

Balance Exercises

Maintaining a balanced exercise routine is important for preventing SI joint dysfunction. Incorporate a variety of activities that promote strength, flexibility, and cardiovascular fitness. Avoid overdoing a particular exercise or repetitive movements that place excessive stress on the SI joint.

Body Mechanics and Lifting Technique

Practicing proper body mechanics during daily activities and exercises is essential for preventing excessive stress on the SI joint. When lifting objects, bend at the knees and hips, keeping the back straight, and avoid twisting or jerking motions. When sitting, use a supportive chair with good lumbar support and maintain proper posture. Be mindful of body alignment during activities and avoid excessive or repetitive movements that place strain on the SI joint.

Proper Footwear

Wearing appropriate footwear plays a significant role in maintaining proper alignment and reducing stress on the SI joint. Choose shoes that provide adequate support and cushioning for your specific activities.

Prevention Exercises against SI Joint Dysfunction

There are several prevention measures to avoid SI joint dysfunction. Maintaining good posture, strengthening the core muscles, avoiding repetitive motion, wearing proper footwear, maintaining a healthy weight, practicing good body mechanics, stretching regularly. It is estimated that about 15-25% of chronic lower back pain is related to SI Joint Dysfunction. However, regular exercise can help prevent the occurrence of this condition. Here are 4 exercises that can help prevent sacroiliac joint dysfunction.

1. Glutes Bridge

The bridge exercise is an excellent way to strengthen the gluteal muscles and stabilize the SI joint. Start by lying on your back with knees bent and feet flat on the floor. Press your feet into the ground, engage your glutes, and lift your hips off the floor. Hold this position for a few seconds, then slowly lower your hips back down. Aim for 10 to 15 repetitions, 2 to 3 times a week. Common errors to watch out for include arching the lower back or using the hamstrings instead of the glutes. Proper form is essential to target the intended muscles and prevent SI joint dysfunction.

2. Clamshells

The clamshell exercise targets the hip abductor muscles, which help stabilize the pelvis and SI joint. Start by lying on your side with knees bent and heels together. Keeping your feet together, lift the top knee while keeping the feet in contact with each other. Pause for a moment at the top, then lower the knee back down. Aim for 10 to 15 repetitions on each side, 2 to 3 times a week. Be cautious not to roll the hips backward or lift the feet apart. This exercise can help strengthen the hip abductors and improve SI joint stability.

3. Bird Dog

The bird dog exercise is a great way to strengthen the core and improve overall stability, including the SI joint. Begin on all fours with your hands directly under your shoulders and knees under your hips. Extend your right arm forward while simultaneously extending your left leg backward. Keep your back straight and avoid rotating the hips. Hold this position for a few seconds, then return to the starting position. Repeat on the opposite side. Aim for 10 to 15 repetitions on each side, 2 to 3 times a week. Common errors include sagging the lower back or lifting the leg too high. The bird dog exercise helps promote core strength and stability, reducing the risk of SI joint dysfunction.

4. Pelvic Tilt

The pelvic tilt exercise targets the muscles of the lower back and abdomen, promoting proper alignment and stability of the SI joint. Begin by lying on your back with knees bent and feet flat on the floor. Gently flatten your lower back against the floor by tilting your pelvis backward. Hold for a few seconds, then release and return to a neutral position. Aim for 10 to 15 repetitions, 2 to 3 times a week. Be mindful not to arch the back excessively or push too hard. The pelvic tilt exercise helps improve core control and alignment, supporting the SI joint.