Do you have one small, painful spot on your back? Right where the blue arrow is pointing?
Pain in this area is one of the main indicators of sacroiliac joint (SI joint, or SIJ) pain. This pain can occur when the joint between your sacrum (your tailbone) and your ilium (the big curved bone of your pelvis) gets pulled out of alignment, usually because of tight muscles around the hip.
Wait, I have a joint there?
You do! The pelvis isn’t one solid block of bone. It’s actually made up of five bones that fit together like puzzle pieces to form a more-or-less solid girdle. I say more or less because there can be some slight give in the joints between the bones. The three bones of the hip (the ilium, the ischium, and the pubis) are fused, and your SI joint is the connection between your sacrum and your ilium.
This joint functions a little like a zipper, with strong layers of ligaments holding the two pieces together while still allowing some small amount of movement. But it’s built for stability, and too much movement or pull in any one direction and you’ll know about it, often with a pain at the back of the hip, towards the top of the SI joint.
The Snowball Effect: The SIJ version
When we have pain or trauma (like slipping and falling, or jarring a joint) to joints, muscles, or other tissues, the body quickly tightens muscles around the area to help protect it from further damage or irritation. Great! Except that the protective tension can also lead to additional irritation via the misalignment discussed above.. And the ball rolls on until you put a stop to it.
Ok, so what should I do if my SI joint hurts?
Joint misalignment is often due to tight muscles, fascia, and other soft tissues; Your SI joint has a lot of muscles and fascia surrounding it. (If you want to dive deep into the muscles, ligaments, and bone related to the SIJ, go here. So loosen them up!
Trigger point self-therapy in the glute region, the adductor region (inner thigh), the outside of the hip, and even through the lower back can provide relief from SIJ pain. All you need is a tennis ball! Here’s how: sit or lay on the tennis ball, or lean into it by pinning it against a wall in the areas shown below.
Trigger Point for Glute (Bum) Muscles
Sit with the tennis ball pressing into the soft tissue to the side of the sacrum (tailbone). Roll it or move it up and down to find tight spots and hold it until the tension or soreness disappears. Use a moderate amount of pressure – it should feel like “good hurt”.
Trigger Point for Adductor (Inner Thigh) Muscles
Lay face down with one knee out to the side, hooked over the roller so the roller is pressing on the inner thigh, foot to the outside of the roller. Roll it or move it up and down to find tight spots and hold it until the tension or soreness disappears (it’s safe to apply pressure this way anywhere between just above the knee and the crease of the hip). Use a moderate amount of pressure – it should feel like “good hurt”.
Trigger Point for TFL and Glute Min (Outside Of Hip) Muscles
Lay on your side with a tennis ball in the fleshy part of the outside of your hip, or pin the ball against the wall in the same area. Hold pressure until the tension or soreness disappears, then move to find a new spot (move towards the front or back of the hip). Use a moderate amount of pressure – it should feel like “good hurt”.
Secondary causes can be tight muscles farther from the joint. Give them a stretch with one of the following stretches:
Kneeling Hip Flexor Stretch
Kneel on one knee and take a BIG step forward with the other side. Squeeze the glute on the back leg, and drop the hips forward to stretch the front of the hip on the back leg. Not feeling the kneeling? Here are other ways to stretch your hip flexors.
Pretzel Glute Stretch
Lay on your back and cross one ankle over the opposite knee. Draw the knee back towards your chest, bringing the ankle with it, and hold in place by wrapping your hands around your shin or the back of your thigh (between your thigh and calf).
Knee Hook Stretch for TFL and Glute Min
Lay on your back with both knees bent, then drop both knees to one side. Hook the ankle of the bottom leg over the knee of the top leg to pull the knee slightly towards the floor.
Important Safety Reminder!
The trigger points and stretches above are great for SI joint pain, but that doesn’t mean they are right for every single person. If you feel pain with any of these, please stop immediately and seek treatment with a remedial massage therapist, an osteopath, or a physiotherapist (or physical therapist). They’ll be able to give you a better idea of what’s going on, and to treat you appropriately.