“HALP! My SI joint bugging the heck out of me!”
I hear this from clients all the time and as a former card-carrying member of the cranky SI joint club, I get how miserable SI joint pain can be.
It seems like half the people I meet have a literal pain in their butt (or rather their SI joint), which begs the question, why do so many of us have SI joint discomfort?
I’ll start by saying that this is a complicated topic that doesn’t have a cookie cutter answer.
First, if you’re not familiar with the SI joint, it’s the area between your sacrum (that triangle bone between your butt cheeks) and your ilium (those big pelvic bones).
And since you have one sacrum and two illum, you have two SI joints.
For the most part, even if it feels off, crooked, or out, your SI joint can’t really go “out of alignment,” short of extreme, acute trauma involving something being torn or a bone being broken. It’s actually a really strong, resilient area! In fact, SI joints are actually meant to have and tolerate some movement.
So if your SI joint isn’t actually “out of alignment” why does it feel so dang uncomfortable in certain positions?!?
The long (VERY oversimplified) short of this is that sensations in your body, including discomfort, tightness, and pain can be a result of tissue damage OR they can simply be somewhat random signals from your nervous system.
This seems pretty dumb, so why would your body do this?
Most of the signals from your nervous system exist to protect you.
You have tons of nerve endings in your muscles/joints/ligaments/tendons that constantly monitor things like muscle tension, range motion, speed of movement, and body position.
Your body is also brilliant at adapting for the sake of efficiency, which means that you can get really good at habitually moving through the same patterns on a regular basis, which brings me to tolerance and preparedness for load!
Generally speaking, every individual will be able to tolerate certain positions better than others, but a fun fact about your nervous system. It’s fickle. It doesn’t want you to move too much or too little through any one joint, so when you go into a position for what it randomly deems too long (aka sitting all day on those f*cking ZOOM calls), it might start sending those super fun signals to your brain that your SI joint hurts, because it would like you to change positions.
Conversely, this is why when you do split stance exercises like lunges after not working out for a while or you decide to take up running for the first time in 5 years, your SI joint might be unhappy with you.
You haven’t built the strength and tolerance to put those joints through that level of stress and your nervous system is sensing this. The signals that it is sending you are essentially a message NOT of “OMG TERRIBLE THINGS ARE GOING TO HAPPEN!” but of “Hey there, so you are moving pretty fast in an area that feels a little vulnerable. Maybe you could slow and pay attention to this?”
Annnnn-nnnnnd, to add to the fun, if you are a longtime runner/lifter/walker who suddenly developed SI joint pain, it could actually be a combo of all of the above, where you always shift one side of your pelvis up and the other side of your pelvis down, so your nervous system is sensing the habitual loading pattern of your SI joints and it’s not loving the repetitive movement and may or may not be also tuning in to you being well adapted + strong in some ways and not as strong in others.
So with this in mind, how do you address this – particularly if your nervous system is extra sensitive, so if feels like everything you do bothers that joint?
Again, it depends. (Don’t you just hate that answer? Me toooooooooo!)
For some people, periodically having your SI joint get weird, just means avoiding the movements that make it feel like crap for a couple days and letting it work itself out.
BUT for a lot of us, that’s not enough and movement can help.
- Exercises that improve your movement variability and body awareness. To put that into English, it means gradually loading your pelvis in the ways that it’s NOT as good at moving, so if the right side of your pelvis always rotates forward and up, and then left side always rotates back and down, then if you can teach your body to also practice the opposite movements, it may make your SI joint feel better.
- It could also be moving a little bit more throughout your day, so if sitting makes it feel worse, maybe try sitting in different positions on those ZOOM calls or even turning off your video and pacing around your living room for short breaks.
- Finally, general stability and strength work can be really helpful and NOT just around the pelvis, but in your entire body, because movement doesn’t exist in a vacuum. The position of your rib cage, feet, shoulders, spine, can all influence the position of your pelvis, and in turn, SI joint. Focus on being a well-rounded mover with control at all the major joints and you’re set up not just for less pain, but it’ll also make you a fitness badass.
Final notes on repetitive positions and SI joint discomfort:
One of the most powerful things you can do for yourself is identify what positions make it feel better or worse. For example:
- Does it feel better to do exercises where your weight is balanced equally over both legs or in a split stance (for most people with active SI stuff, split stance exercises may feel icky initially, BUT you can gradually work up to where they won’t!)
- Does it bug your SI to do work on your belly? Does legs turned out or turned in feel better or change that experience? For me, I can do work on my stomach when my SI joint is cranky, BUT legs turned out feels like garbage. Legs turned in is fine. However, for some of my clients it is the opposite! They prefer legs turned out AND for some people, it feels much better to skip that position during a flare up.
- Is there one activity that makes it feel worse or does it relate to your emotional state? Yep, physical and emotional stress can make joints feel extra sensitive. It’s really annoying.
Want some specific exercises and tools to address SI discomfort for yourself or your clients? I’m running a webinar with the absolutely brilliant Jenn Pilotti about how to use movement to address SI joint discomfort.
This webinar is all about practical application. We’ll teach you how to develop stability, strength, and resiliency from the ground up looking through the lens of SI joint discomfort.
It takes place on May 30th from 12-1:30 PDT and if you can’t make the live, there will be a replay!