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Anatomically speaking, the SI (sacroiliac) joint lies at the junction of the hip bone (the
ilium) and lower spine (the sacrum). Therefore, most people describe SI joint pain as low
back pain or pain in the back of my hip. This joint does not move much but it is critical in
transferring the upper body weight to the lower body. SI joint problems vary considerably,
and usually involve either hypermobility (excessive motion) or, not as frequently,
hypomobility (decreased motion). If the problem is hypermobility, there is usually a
degree of associated weakness in the surrounding musculature which can be strengthened
by a program designed by a physical therapist for specific abdominal, hip, pelvis and
lumbar exercises and resolve the problem. Many times, the problem returns when the
patient returns to weight-bearing exercise which may indicate movement dysfunction. In
these cases, despite the increase in muscle strength, there is need for extra stability via
an SI belt (available through physical therapists) which may be worn for more intense
activities until further muscle strength and endurance is achieved. When the dysfunction
is due to hypomobility, symptoms may resolve through mobilization of the joint, and
maintained through a specific stretching/range of motion exercise program. Your home
exercise program should involve advice on continued progression of strengthening/
stretching of the involved muscle groups with a focus on returning to all activities. Consult
a Physical Therapist for further advice and education regarding sacroiliac dysfunction. |