Sacroiliac What?

You have a very tight sacroiliac joint on your left, my RMT said to me. Sorry, my what?

Your sacroiliac joints (or SI joints) are located on both sides of your pelvis between the ilium and sacrum bones in your pelvic. They are two of the three joints that make up your pelvis and have a very small range of motion. The function of the SI joints is to allow torsional or twisting movements when we move our legs. The SI joints and pubic sympthesis (at the front of the pelvis) allow for small movements while the legs act like long for movement. Each SI joint is stabilized by an intricate set of ligament connections and supported by a network of muscles. When standing up right, running, or walking, your SI joints support the entire weight of your upper body. SI joint injury and pain can bring even the most enthusiastic runner to a halt… which is what happened to me. I was forced to essentially take all summer and fall off running.

I started noticing pain and stiffness to my lower back, more so on my left side, which got worse after long runs, sitting for a while, or upon waking up in the morning. I tried chiropractic treatment but the problem only got worse. Finally I hobbled my way into an RMT’s office with then horrible lower back pain on my left side which extended into my glut muscles. My RMT has magic hands. She works her way into my tight glut muscles to the point where I want to scream, but after 2 months of treatment, I am finally running pain free again.

photo credit: http://briceferrestudio.com/

Sacroiliac joint pain is usually located either to the left or right of the lower back, although it can be experienced as band line pain across the whole lower back. Pain can range from an ache, to a sharp pain which can restrict movement. SI joint pain may radiate out into your buttocks, low back and even radiate to the front into the groin. Symptoms can include stiffness in the lower back when getting out of bed or up after sitting for a long time, aching in one side of the back, tenderness on palpitation to the area, and pain to the area after running.

As runners we love to get out there and do our thing, but we are the worst at stretching. Admit it, how often do you actual stretch after a run or use your foam roller? Heck, you probably don’t even know why you bought that weird blue foam cylinder in the first place. This could be causing PROBLEMS!! Running causes inflammation to muscles as we push our limits, tear our muscle fibres and build strong, leaner muscles. The build-up of lactic acid that is released by our tissues when we run increases inflammation to our muscles and when we don’t release it, it can start to cause injuries.

What can cause an SI joint injury? SI joint pain occurs when an injury or condition irritates the joint surfaces or supportive muscles and ligaments around the joint. It may be the result of a single traumatic event, such as a hard fall on the buttocks as you rip down a trail, or come on over a longer period of time as a result of altered biomechanics, such as over-pronation of the feet or muscular imbalance around the pelvis.

Is there hope? YES!
First: Get your (tight) butt to an RMT and have them work through your unhappy muscles.

Second: Grab that weird blue foam cylinder out of the back of your closet, put it on the ground and start rolling out your glutes.

—Position 1: Lie on your side and roll the foam roller along the outside of your hip.

—Position 2: Bend your leg and place the outside of your foot on bottom of your thigh muscle above your knee and lean into the side that is the most tight.

—Position 3: Bend both your knees to 90 degrees, lean into the glute that is tight and take the weight of the foot on the same side.

Third: grab a tennis (or preferably a lacrosse ball), and roll it under your glute muscle similar to how you were using the foam roller. The tennis ball is smaller and harder so it can get into the muscle deeper. You can also stand against a wall, and massage your upper glut/lower back into the ball against the wall until you want to cry. Trust me, it will hurt, but it is a good hurt.

Take time to focus on strength training. Pelvic stabilization and core strengthening exercises are essential to help correct muscle imbalances and support and strengthen your SI joints. Core strength is essential for good posture, pelvic muscle balance and normal range of motion of the surrounding joints. Planks, sit ups, oblique crunches, reverse crunches, regular crunches and balance work such as on bosu ball can help to strengthen your core muscles.

If the injury is significant enough, you may have to take a break from running. Although this is the worst thing a runner can hear, it is necessary to getting better. Even professional runners take breaks when they get hurt. You have to think long term. Do you want to run right now or do you want to be able to run for the rest of your life. If you have an injury STOP RUNNING, REST, AND HEAL! I rested for the better part of 6 months! I still ran, but I greatly reduced the amount and the distances I was running and it was the hardest thing, but now that I am feeling better, I am so happy I took the time to rest and heal.

Information source:
Fitness Theory Level 1: Muscles and Injuries
Anatomy and Physiology Level 1 and 2, University of the Fraser Valley
http://www.livestrong.com/article/539573-an-inflamed-si-joint-running/
http://www.sportsinjuryclinic.net/sport-injuries/low-back-pain/sacroiliac-joint-pain