The ligaments of the SI joint

The SI joint is mainly held together by bands of connective tissue known as ligaments.  

These ligaments hold the sacrum (base of the spine) and the ilia (hip bones) together to make up the two sacroiliac joints.

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The bones of the SI joint

Here are some diagrams which give you a general view of what the ligaments look like:

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View of the SI joint and ligaments from the front

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View of the SI joint ligaments from the back

An injury to the SI joint will generally involve an injury to one or more of these ligaments.

Like all ligaments in the body, when one of the SI joint ligaments is injured, it can stretch out and become looser than normal.   It can also be inflamed, which can cause additional pain.

Unfortunately, our bodies are not great at repairing ligaments.  Once a ligament becomes stretched out, it does not always regain its shape.

This is why SI joint injuries are so persistent and difficult to heal.  Our bodies were counting on those ligaments to hold our SI joints in place, and now they are no longer doing their job.

Even if your ligaments are stretched out, however, there are still a few things you can do to heal:

I had to strengthen my muscles, so my body didn’t rely on my ligaments as much.

I learned to stop doing things that aggravated my ligaments, which allowed them to heal faster.

Finally, I ended up realizing that chiropractic adjustments were putting too much force on my SI joint ligaments.  Even though the adjustments were technically putting my joints “into place,” at a microscopic level, they were also re-spraining the ligaments each time, making it harder for the adjustment to actually stay in place.

I got a lot better once I switched over to using the Muscle Energy Technique to realign my own joints.

There are other things that work for some people, as well.

  • Prolotherapy is a form of therapeutic injection that has been shown to speed ligament healing.  It is not a magic bullet, but it does seem to help some people.
  • Surgery: a surgeon uses screws to attach the bones of the SI joint together.  (The screws end up doing the job the ligaments once did).  Surgery is a very big undertaking that has risks, and some patients do not feel better afterwards, so it is something that requires a lot of research and forethought.

I will be talking about all of these options in more detail in the future.  Please stay tuned!

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