Sacroiliac Joint Pain

The below diagram is a view of your pelvis from behind. Let’s get our landmarks! Put your hands on your hips with your fingers forward and your thumbs traveling down and behind your back. Do you feel those back dimples? That is the ‘posterior superior iliac spine’. In the diagram it’s coloured red. To be more specific – it’s the top portion of bone coloured red; the other regions have other names! Important for us clinicians in forming our diagnosis and treatment plans. But technically the Sacroiliac joint is formed between two bones; the one coloured red and the triangular one with many holes.

Injury/damage to this area is usually referred to by a number of classifications:

  • Sacroiliac joint syndrome

  • Sacroiliac joint strain

  • Sacroiliac joint sprain

  • Mechanical low back pain

Yasin is a clinician who prides himself in being the best diagnostician he can be. He often thinks of ‘syndrome’ as a way of a clinician saying ‘I’m not quite sure’ or ‘around there somewhere’!

Ideally one needs to be able to identify if it’s a:

  • Problem on the surface of the bone (periosteum)

  • Sprain (ligament injury) as can be seen from the below diagram. One of the ligaments is shown, coloured in pink. There are other ligaments that affect the joint too, but let’s not get into that!

  • Strain (tendon or muscle related to the joint), as seen in the below diagram, In this instance I’m showing the Gluteus medius muscle. Look how it comes near the Sacroiliac joint, In-fact it attaches to what is termed the lateral aspect of the PSIS! A great clinician will take time to figure out not only which joint is injured, but where in the joint that injury is. As in this case – if it’s the outer aspect – then one has to check the gluteus medius too. Because just treating the joint alone might not work in the long-term if the muscle keeps pulling on the joint.

A complete assessment and treatment approach can also incorporate movement analysis and reparative exercises. As illustrated with the below diagram, you might have a gluteal weakness leading to a sacroiliac joint sprain.

Not only do we have to investigate and treat the gluteal muscle, we also have to ask why the muscle is weak. We have an exercise studio where we can look at your movements, muscle strengths, flexibility, nerve flexibility, stability and patterns of muscle recruitment! That’s a lot!!!

As illustrated with the below diagram – this is just one of the many exercises we can teach you to rehabilitate (in this instance the gluteals) the specific muscle while also integrating your core balance and core muscles.

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