SI Joint

Many patients at Body Gears seek physical therapy because of low back and/or sacroiliac joint (SI joint) pain. The finely tuned motion motion at the SI joint plays a crucial role in efficient walking patterns and movement at the hips during functional activities. This motion has been shown in the research literature to increase when degenerative lumbar spine disorders, such as degenerative disc disease, are present (Nagamoto, et al 2015), which is why low back and SI joint pain are often.

Though the motion at the SI joint is important, the stability of the joint is equally important. Research has shown that the less stable the SI joint, meaning more movement at the SI joint, the slower the gluteal muscles begin firing during hip extension, which is an important motion needed for efficient gait/walking mechanics (Takasaki, et al 2009). Because of this delay in gluteal firing the hamstrings compensate and have to work extra hard to pick up the slack, leading to weak gluteal muscles and tight, short hamstrings (Arab 2011) and this can further contribute to pain and dysfunction at the lumbar spine and SI joint.

What all this means is that stability at the SI joint and retraining the glutes to engage to take the stress off the hamstrings should be a target of physical therapy interventions with patients experiencing low back and SI joint symptoms. Two exercises we use here at Body Gears to achieve these goals are the “prone ballerina” and “glute at wall”.  The prone ballerina targets and strengthens the multifidi muscles to bring greater stability to the SI joint and the “glute at wall” exercise is designed to strengthen and retrain the gluteal muscles to engage during functional hip extension. Using these exercises along with other techniques helps to return balance to the SI joint and the surrounding muscles, reducing pain and symptoms associated with SI joint and lumbar spine conditions.

Ian Flannery, SPT