Considering SI Joint Surgery? Think Again

There’s a commercial currently playing on the talk radio station I listen to in my home area of New Orleans, LA, selling a minimally invasive procedure to alleviate SI joint pain, sacroiliac joint.  I know many surgeries that used to require a night or two in the hospital are now outpatient, this is probably one of them.  Is surgery really the answer when an exercise prescription and work modification could give you the same result?

SI and iliofemoral joint areas

What and where is your SI joint?  The pelvis and the sacrum compose the sacroiliac joint.  In conjunction with the iliofemoral joint, these joints account for movement and muscle attachment points for the LPHC (lumbopelvic hip complex).  Muscles above and below this area come together so we can walk, jump, run, twist, support, and stabilize the transition between the upper and lower body. The sacrum is set between the left and right ilia like a keystone. This is where the axial skeleton attaches to the pelvic girdle and the appendicular skeleton of the lower extremity. There is little movement at this joint which is classified as a diarthrodial joint (Cheatham & Kolber, 2016).

SI joint pain is a form of low back pain. Mechanisms that may contribute to sacroiliac pain include but are not limited to LPHC muscle imbalances, neuromotor weakness, trauma, overuse, poor sitting posture, and pregnancy (Cheatham & Kolber, 2016).  Most people don’t treat their bodies well by sitting extended hours daily at home and work and eating poorly to put on excessive weight.  These daily habits create pain that is first annoying to intolerable.  When they go to a doctor who makes a living on surgeries, that’s the option they are given.  Because bloodwork doesn’t show muscle tightness and weakness from poor posture and overuse, a person thinks surgery is their only option to alleviate the pain.  Is this you?  Probably so.

Low back pain is the most common form of pain around the world.  Most of it is manageable to preventable through exercise and wellness.  Similar to weight gain, low back pain doesn’t happen and end in one day, it happens over time until you notice it and can’t stand the discomfort.   85% of male gymnasts, 80% of weightlifters, 69% of wrestlers, 58% of soccer players, 50% of tennis players, 30% of golfers, and 60 to 80% of the general population were reported to have LBP (Daniels, Pontius, El-Amin, & Gabriel, 2011). Individuals who have LBP are significantly more likely to have additional low back injuries, which can predispose the individual to future osteoarthritis and long-term disability.

“But my job chains me to a desk all day and I get paid really well.  Am I supposed to quit my job and be in a gym all day?”  Of course not, silly.  Working from home obviously has added more stress to your life overall because you’re not set up to work 10-hour days at your dining room table or small desk in the bedroom.  Reducing and possibly eliminating SI joint pain starts with stretching muscles around the hips, like the quadriceps and abdominals.  When you sit, your knees are bent, and you lean forward into the screen.  This contracts the quadriceps and abdominals for long periods of time, causing them to be in a constant tightened condition.  The corresponding hamstrings and low back muscles get weak and can’t function to their standard potential either. 

SI joint pain areas

Sacroiliac joint pain primarily occurs around the posterior buttocks or sacroiliac region and can refer into the groin or down the posterior, lateral leg to the knee in some individuals (Cheatham & Kolber, 2016; Kurosawa et al., 2017).  A simple way to reduce SI joint pain is by daily stretching of your quadriceps and abdominals to assist the body in maintaining proper length-tension relationships in those areas.  Review the pictures below for examples on stretches.  To strengthen the weak muscles of your hamstrings and low back, add a couple sets of glute bridges, prone cobra, and/or planks.  Over a couple weeks, you can ease the pain without leaving the house and needing any equipment.  These suggestions are not the be all end all for helping your low back pain.  Working with a specialist such as myself, can provide you with more detailed info and corrections to last longer. 

Abdominal stretch
Standing quadriceps stretch

The low back area is affected by tightness in your ankle areas and weakness in your cervical spine areas, it truly is a complex problem.  By addressing a 1-2 muscle groups directly above and below the SI joint, you can avoid surgery.  Remember, follow the money.  Doctors know surgeries and prescriptions, not much on postural distortions and nutrition.  Find a fitness and nutrition professional to help decipher your individual issues.  Ask your company for help with standing desks and ergonomic chairs.  Worker’s comp is expensive.  Any investment to keep you at work generating a paycheck for your family is worth it.

To learn more about preventing injuries, increasing mobility, reducing joint pain, and getting more out of life, please go to my website,  I offer group and personal instruction via Zoom weekly sessions to help your tennis, golf, workouts, and lifestyle hobbies.  Download my free report, 3 Tips to Reduce Back Pain Your Doctor Doesn’t Know.  Guaranteed to open your eyes and give you a new direction on staying healthy and active you didn’t know possible!

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