The anatomy of the sacroiliac joint.
Many causes of lower back and or leg pain are often due to dysfunction of the sacroiliac joint, otherwise referred to as the pelvis.
This joint supports the spine. It is a strong weight bearing joint that interlocks two other joints. It absorbs shock to the skeleton and stabilises the skeleton when walking.
Inflammation to these joints can cause lower back, buttock and thigh pain. This is due to abnormal function of the joint.
Signs and symptoms include:
- Dull lower back pain
- Aching at the hips
- Pain which may become sharp when standing up after sitting down or when lifting the knee when climbing stairs. It usually occurs on one side (uni-lateral) but can be felt on both sides (bi-lateral)
- With severe dysfunction, pain may be felt in the hip, groin and/or down the leg
Dysfunction can be tested as follows amongst other, more clinical methods. It’s recommended you book a session with a (your) Pilates instructor for an assessment. Once identified your training programme can be adapted to help strengthen these areas and ensure no further damage:
- Prone knee flexion test
- Sit and reach
- Standing hip flexion
During pregnancy a hormone called relaxin is produced by the body to allow the pelvis to stretch in preparation for birthing. Therefore, pelvic problems may become more prevalent during pregnancy when micro tears and appear in the joint. Extra caution should be taken not to over stretch and stress the integrity of the joint.
Muscular anatomy of the sacroiliac joint.
There are a number of muscles that relate to and support the movement around the sacroiliac joint and include gluteal and hamstrings.
Why is it important to exercise these muscles?
Care must be taken to exercise all of these muscles equally so as to hold the structure of the body in neutral alignment. Once these muscles become weak or imbalanced in strength, the body comes out of correct posture and the “knock on effect” will start to affect all of the joints of the body leading to incorrect posture, pain and disability, which is exacerbated with loss of bone density and degeneration of the skeleton as we grow older.
Daily functional activities and key exercises that you can do from home or work!
Work: Seated in your work chair, or standing
- Squeeze your buttocks tightly which will tilt the pubic bone forwards
- Pull your abdominals in tightly
- Press your lower back into the chair back
- Lift your rib cage
- Pull your shoulders back and down
- When seated and pausing, wrap your arms around the chair back and clasp your hands together
- Lift the chin slightly into neutral position
- When driving or typing; squeeze your shoulder blades together taking care not to arch the back (you may need to adjust your driving position)
- When using your cell phone lift it to eye level, try not to lean over it
- When urinating try to stop the flow of urine 3 times during mid flow
- All of the above can be applied, but obviously with the privacy of your own home you can repeat the above but whilst lying on the floor with knees bent and soles of the feet on the floor
- From this position nod your head placing your chin to your chest. Look at the pubic bone, arms straight by your side an inch off the floor and hold this position for 15 seconds. Repeat 3 times.
- From the same position but with head down, ENSURING that your back is flat and glued to the floor, imagine your legs to be as light as a feather and raise your heels off the floor, balancing on the toes, one side at a time and once you have mastered that, both together.
- Once you have mastered the above, lift ONE leg at a time into a box position (2 sides of a box, 90 degrees at the hip and knee joints). Then lowering the leg with a bent knee and placing it back to the floor, LIGHT as a feather.
Soon your deep core muscles will have strengthened enough to move on to more intense and complex methods, but ideally to progress you should join a Pilates class to ensure that your execution of the exercises is safe and correct.