What happens when an SI joint gets stuck?

If you have SIJ dysfunction, this is a really important concept for you to understand.

There are different types of issues that can affect the SI joint, but this was the main problem for me, during the entire five years I struggled with this problem.

***

The sacroiliac joint is made up by the meeting of the sacrum and the two hip bones, or ilia, on either side.  (I describe the anatomy of the joint in more detail in my section What is the SI Joint?).

250px-sacroiliac_joint-svg

When one of your SI joints get stuck, what happens is that one of your hip bones has rotated backwards and become wedged against the sacrum.  (The scientific way to say is that the ilium has rotated posteriorly).  Basically, it gets stuck in such a way that it can’t get back out on its own (not without some help, anyway).

In the image below, I’m using my model pelvis to show you where the hip bone gets “jammed” against the sacrum.  My pencil is sticking right into the space between the two (this is looking at the pelvis from the back):

IMG_3717 (1).JPG

The reason this problem is so confusing, and under-recognized by medical professionals, is that the hip bone doesn’t actually rotate very far at all.  We are only talking about a couple of millimeters.

If you were to put someone with a “stuck” SI joint in an x-ray or an MRI machine, they wouldn’t look abnormal.  That is why SI joint dysfunction is so hard to diagnose: the joint becomes jammed within what would appear, to most observers, to be its normal range of motion.

But that joint is supposed to be able to move.  And, like anything in the body, when you don’t let something do what it is meant to do, that causes problems.

Having healthy, functional SI joints allows us to:

A) Move our legs through their full range of motion as we walk

B) Absorb some of the force that comes from each leg hitting the ground as we take steps.

Once you deprive the SI joint of its full range of motion, you impede these functions.

Even though the SI joint is not intended to have a lot of motion, those few millimeters of motions serve a lot of important functions in terms of our ability to move overall.

When one of my SI joints would become stuck, I wouldn’t really be able to lift the leg in that side.  It was really an odd, confusing sensation.  I’d have this dull ache in my lower back, and then I’d notice I wouldn’t be able to lift one of my legs.  At first, it didn’t even seem like the two things were even connected.

But again, due to the way our pelvis functions as a whole, you need motion at the SI joint in order to move your leg normally.

So, once one of my SI joints wasn’t moving optimally, it also meant one of my hip bones wasn’t moving the way it was supposed to.  This, in turn, restricted my ability to move the leg on that side.

And once one of my SI joints was stuck, there was nothing I could do on my own, as an untrained person, to fix it.  It was clearly jammed in one position, and all of my attempts to fix it– or even move normally and go about my day– only seemed to make things worse.

Luckily, there are ways to “unstick” a stuck SI joint.

The first way I discovered was through chiropractic adjustments.  In fact, my chiropractor, Dr. K. was the first person to even explain to me what sacroiliac joint dysfunction was.  He was the one who was able to unstick my SI joint when it got stuck.

However, I would later discover that chiropractic adjustments were too rough on my sprained SI joint ligaments.  Even though they were technically putting my joints into place, they were making it harder for my ligaments to heal.

I actually got much better once I started realigning my own joints using the Muscle Energy Technique, which was taught to me by my physical therapist Paula.

It’s possible to get better.

I’m probably going to jinx myself as I write this, but as of right now, it has been eight months since the last time my SI joints rotated out of place and I needed to adjust them.

Because of what I’ve been through, I feel very passionately about educating others with this condition, so they don’t waste years dealing with something that does have answers, like I did.

I’m going to keep writing and creating resources based on my experiences, and I hope you will stay tuned!

Some related posts:

My first attempt to explain this concept by video

Why do some people’s SI joints get stuck, when others’ don’t?

My Key Points series outlines the different steps of my recovery (of particular relevance to this post is Key Point #6: When someone finally told me only one SI joint could lock up at a time).

And for more anatomy-related posts, be sure to check out my What is the SI Joint? page.

Hope this was helpful!

If you have any questions, you can always leave a comment below or email me at sunlightinwinter12@gmail.com.

 

22 thoughts on “What happens when an SI joint gets stuck?

  1. Mike says:

    Just had this problem. Was causing my lower back muscles to spasm, shifting my whole pelvis out of whack. I was in agony for weeks and couldn’t get a diagnosis. I switched chiropractor s and my new, more experienced chiropractor easily unblocked my sacroiliac joint in one treatment. What a relief! I look forward to strengthing this area.

    Like

  2. Dave says:

    Trying to figure out what’s causing my si to get out. Of whack to begin with. Unilateral exercise like one arm dumbbell press, seems to do it. But so do Hindu squats. I’m at a loss.

    Like

    • sunlight in winter says:

      Hi Dave– it’s good that you’re able to identify some of the things that make you worse. I’d definitely pay attention to your body and avoid these activities.

      I’m not surprised that unilateral exercises make things worse. One of the functions of the SI joints is to transfer forces from your upper to lower body, and vice versa. Sending force through the joint in an asymmetric manner is likely to cause some rotation throughout your pelvis and stress the SI joints.

      Generally speaking, I’d recommend trying to avoid anything that causes rotation through the pelvis. It’s certainly possible that Hindu squats, or regular squats in general, are going to place more force on your SI joints than your ligaments can handle. I’d found that a lot of exercises to strengthen the glutes (and other muscles) that are technically correct can be too much for the SI joints, if the ligaments there have been sprained. Here’s a few posts you might want to check out, if you haven’t seen them yet:

      Why do perfectly good exercises sometimes make things worse? http://bit.ly/2Bjo4Vu

      A post about how to protect the SI joints while stretching (specifically talks about the hamstrings, but gives some general principles that are good to keep in mind for all stretches/exercises). http://bit.ly/2nFMTJh

      And last, a post about some of the things I’ve found that make my own SI joints worse: http://bit.ly/2AmfYPX

      Hope this helps!

      Like

  3. Laura Tracy says:

    First, wow, thanks for this website!!

    Background: I believe my injury happened from jumping on a rebounder in an uneven fashion :/ a few days later I started to be in pain and it worked it’s way up to about a level 3-4 (out of 10). I went to chiropractor (only) once who said my SI was ‘jammed up’, but didn’t adjust the area in any way, he just loosened the glute, my pain went down in 2 days. I’ve since gone to a message therapist who specializes in balancing hips (in a crazy soft way/loosening surrounding muscles…) and my hips are actually in line and remain in line (not sure my SI joint can be out if hips in line?).

    SOO, I’m trying to understand my problem. I have pain at a level 3 in the area if I walk on the treadmill, for example, after about 30 minutes, then it calms down after 2-3 hours but otherwise I either have no pain (in the mornings and even during morning pilates) or a level one pain (as in I feel something but not pain per se).

    Are the injuries you talk about the same in terms of pain ? Thanks so much!

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    • sunlight in winter says:

      Hi Laura, so glad my blog is helpful!

      I hope I can answer your question– I’ll definitely try the best I can! As you know from this post and others, I find the most helpful way to describe SI joint dysfunction is to get very specific about how the ilium and sacrum are positioned, in relation to each other. Sometimes chiropractors and PT’s will try to simplify their explanations, because they’re assuming you won’t be interested or they don’t have time to go into detail. Make them! You have a right to know!

      I think it’s possible that sometimes when people say “the hips” they might be talking about the positioning of the pelvis as a whole, in relation to the lumbar spine. For example, there’s a condition called “anterior pelvic tilt” where both sides of the pelvis are tilted too forward, but that’s a symmetrical problem. (When you have SI joint dysfunction, it’s assymetrical– if one hip bone rotates forward, the other one rotates backward). Anterior pelvic tilt can indeed be caused by muscle tightness, and also weakness. https://www.medicalnewstoday.com/articles/317379.php

      I personally have never heard of anyone being able to release the kind of “stuck” SI joint I’m talking about (when the ilium is jammed backwards against the sacrum) by working on the muscles. However, it’s also possible that when they say your SI joint isn’t moving properly, they mean the muscles around it are in spasm and restricting its motion. If this is the cause, then it makes sense that getting the muscles to relax would help. So if you’re able to get relief this way, that’s great! But I don’t think your joint is getting “locked” in the sense that I talk about in this post, if muscle work releases it.

      I’d suggest asking the massage therapist to explain what she’s doing in more anatomical terms, and if the position of the sacrum and the ilium are part of what she’s looking at when she works on you.

      I hope this helps! Let me know if you have any more questions!

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  4. Natalie Keadle says:

    It is such a relief to read about someone that has had the same experiences I’ve had with my si joint dysfunction. It has become more and more painful to the point that now it consumes my every thought! Mine started off with my si joint getting stuck. I would do exercises that were suggested by a PT that would sometimes “unstick” it or I would have to go to the chiropractor for adjustments for relief! But the relief was only temporary. It gradually began happening more frequently. Then one day all of a sudden my back shot out in a pain that I didn’t even experience when I had natural child birth with my daughter. I dropped to my knees and couldn’t move up or down. It hurt sooo bad it was unbearable! I had someone take me to the chiropractor and was told that my si joint was flipped/rotated backwards. I’ve actually had that happen 2 times. So the time span for relief after the chiropractor adjustment has gotten shorter and shorter until it doesn’t even last 1 or 2 days maybe. I can hardly walk, getting up and down sitting to standing is excruciating. Within the past 3 or 4 Wk’s the pain changed somewhat more drastic. The chiropractor said that my si joint is not only fixating but is also rotating my ilium down and forward! I’ve come to the point that I didn’t know what else to do so I made an appointment with an orthopedic doctor assuming the only solution would be surgery of some sort! Well I was told that my pain is only from arthritis and inflammation around the joint. I was so disappointed with the results of my visit. I do not doubt that there is probably significant arthritis there now and causing a lot of pain, BUT I also KNOW that my sacrum and ilium are not in alignment and will not stay in alignment long enough for me to do the exercises recommended to build up core stability to prevent it. The only thing the dr suggested was for pain management! I don’t want pain MANAGEMENT! I want them to fix the REASON I’m having pain! I couldn’t believe it when the doctor said my x-ray looked normal other that arthritis! I just knew it was going to reveal the worst hip problem ever. To read your comment about x-rays and MRI not showing a problem now explains to me why the doctor didn’t “get it” that I hurt beyond an arthritis pain! So what to do now??? If I treat the arthritis and inflammation, will my si joint stay in alignment for me to do the exercises to build up core? HELP!

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    • sifter says:

      Two things helped me. To get out of pain Dontigny alignment, and bridging WITH THE HEAD RAISE will lessen tour pain. Once pain is down 75%, I strongly recommend Foundation Training for maintenence. I know your pain, I was on the pavement at a BP gas station in Chicago for 10 minutes. Google Dontigny, it’s free, and Erich Goodman Foundation Training.

      Liked by 1 person

    • sunlight in winter says:

      Hi Natalie, I’m so sorry to hear about all this– hopefully I can provide some help!

      Unfortunately, I am not surprised that the orthopedist wasn’t able to help you. More and more doctors are becoming aware of how complicated sacroiliac joint dysfunction can be, but we still have a long way to go. You are right that pain management alone might not be enough. I would keep trying to find another doctor, and also look for a physical therapist with experience in treating the SI joint.

      In terms of medical specialties, I would suggest you try to find a type of doctor called a physiatrist (their specialty is “Physical Medicine and Rehabilitation,” although sometimes they might actually work in pain management centers). Not every physiatrist will be familiar with SI joint dysfunction, but I think your chances of finding someone who’s able to help you might be higher if you look within this specialty.

      Here’s a post about physiatrists: https://sijointsaga.com/2017/09/29/sacroiliac-joint-doctor/

      And here’s a great video that shows what it’s like when a doctor really is comfortable treating the SI joint– this explains all your treatment options. I truly wish everyone could find a doctor like Dr. Goldberg in this video. https://sijointsaga.com/2017/07/24/physiatrist-si-dysfunction/

      I’d also suggest you try to find a physical therapist with experience in treating the SI joint as well. While doctors can be helpful, in the case of SI joint dysfunction, a lot of what they will probably do is refer you to physical therapy and monitor your progress. It really takes a PT to help you to develop the right exercise program.

      A good PT will be able to help you reduce the symptoms of arthritis, and also build up strength in the muscles in the area so that your joints will be able to stay in place for longer. (If you don’t have enough muscle strength to support your joints, your chiropractic adjustments won’t stick).

      As you may have seen from reading my blog, I really think aquatic therapy is the most promising form of PT for SI joint dysfunction, because it can be so much gentler on your body than land-based PT.

      So, you are right to take your pain seriously and keep looking for answers! I hope this was helpful– let me know if you have any more questions!

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  5. Rosie Blackburn says:

    Hi Christy,

    Finding your blog has cheered up my morning. I found you after waking up for the thousandth time (probably literally) with the feeling that one side of my sacrum was digging into the mattress – and it stays for hours on end after I’ve got up…I asked my partner to have a look, and yes, it’s sticking out, again. So I googled ‘one side of sacroiliac sticking out’ and up you popped! I’m so glad to have found someone who knows my pain and gives me some hope. The ‘sticking out’ pain is the least of my worries – some days I limp around, simple, necessary things like cooking and work is hell (I work in a shop, standing 10+ hours a day, 3/4 times a week, constantly moving, bending and lifting – it’s been appalling when my hip has got stuck…but hey, you gotta make a living!?!).

    Our NHS (I’m in the uk), much as I love them, have been rather useless…well, their specialist muscoskeletal physio’s have given me exercises (endless bridges and clams), which have improved the muscle strength in my glutes, which have helped to a point, but they really, really don’t get SJD. From day one, when they asked where the pain was, I would point directly at my right SJ, but they didn’t seem to listen or understand – they just say I have tight, weak glutes (less so now I’ve been doing them for months). But the exercises aren’t specific to my issue, they’re their default answer to most things I suspect (I have friends with very different issues to mine doing the exact same exercises) and, as I say luckily they’ve helped, a bit, but the major underlying issue is still very much there and, as I say makes itself known pretty much every day.

    One NHS physio did say I have an anterior tilt, though the soft tissue masseur / Pilates teacher I see says it’s in posterior tilt! At least then I started to know what the pain was -whether it’s anterior or posterior, it’s definitely my sacroiliac. Before that I thought it was the labral tear that the MRI I had showed I had…it’s been a long, painful, frustrating journey to get to a point of knowing what the actual pain is (as I say to people unfortunately it’s not like a broken ankle or something you can see and point to and know, straightaway what the problem is – at the start ‘it’ just hurts, a lot) caused by, but I’m glad I do now – it does make a big difference knowing what’s going on in there, even if you can’t subsequently, immediately get rid off it (wouldn’t that be nice!).

    There’s no one thing I can say started this all of – I am hyper mobile on my right side and my right foot sticks out like a pigeon but there was no major trauma, but I’ve been in pain, hobbling on and off (admittedly some days I’m mostly fine), for 18 months plus.

    Your point about chiros making things worse / letting things heal, makes me wonder if ‘messing about’ with the joint is a good idea. I don’t see a chiro but I’ve done yoga once or twice a week for years (intense, ‘strong’ iyengar yoga), recently started Pilates and my Pilates teacher also does soft tissue massage which has helped my poor old sacrum relax. But I’ve just had a few weeks off doing yoga, and for some of that time I was the best I’ve been since this started. Is the really quite strong stretching we do not a good idea I ask myself…..so linking from that, one thing I ask you please, what’s the difference between stretching the ligament (apart from being bad) and stretching the muscle (good)…. How do I do one without the other?

    I think I am going to start swimming (front crawl with a float to stop my arms doing all the work) and / or, if I can afford it, hydrotherapy, so my next stop is to read your page on that.

    Sorry, I’m going on too long. Basically, thank you for this blog, it’s great to know other people have experienced what I’m going through (sorry, that sounds cruel – but you know what I mean!), and are getting better – but if you could clarify my question re not stretching ligaments, that’d be very appreciated.

    Thanks again Christy.

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    • sunlight in winter says:

      Hi Rosie,
      So sorry to hear about all this! Let me see what I can do to answer your questions.

      Yes, I totally know what you mean about how people can give out generic exercises that technically strengthen the correct muscles around the SI joint… but actually aren’t good for the SI joint itself. I actually have a post up about that: https://sijointsaga.com/2017/11/28/sacroiliac-physical-therapy/

      Something else to keep in mind is that sometimes people use the same terminology when they are talking about different things. For example, in terms of the SI joints, you can say that the ilium (hip bone) is rotated anteriorly or posteriorly. However, this is only talking about the ilium in relation to the sacrum– it is specifically the SI joint, on one side.

      When people talk about an anterior or posterior pelvic tilt, they are actually talking about the pelvis as a whole– is it tilting forward or backwards? This is a symmetrical problem– it’s not just the SI joints, it’s the entire pelvis. I actually have a post up about that too, that explains more https://sijointsaga.com/2017/12/14/hip-balance/

      In terms of stretching muscles, not ligaments– unfortunately, this is a pretty tricky concept, and it’s not something I’d expect a patient to be able to figure out themselves! But basically, as you know, ligaments are the connective bands that hold a joint together. When you stretch a muscle, you need to move one or more of the joints that it crosses, in order to put that muscle in a different position. If a ligament is sprained, when you change the position of the joint, you can potentially re-irritate or re-sprain the ligament. So the key is, as much as possible, to find ways to stretch your muscles in positions that are gentle on your ligaments

      This is probably a concept I need to write about more, but I worked most of my stretches out with the help of my PT. I wouldn’t have been able to come up with the whole system on my own, although I certainly had to go through a process of trial and error to find out which stretches worked for me.

      Have you seen my post on stretches for the hamstrings? It only talks about stretching one muscle group, but it gives some general principles that illustrate what I’m talking about. As you can see, the stretches that worked best for me allowed the SI joints to remain in a relatively neutral position, and had my weight balanced symmetrically. The one leg standing up stretch towards the end didn’t work for me because my weight was asymmetrical, and my joints weren’t supported. https://sijointsaga.com/2017/11/10/hamstrings-stretches/

      I also found there were a lot of stretches I couldn’t do, initially, because I had to get down onto the floor to do them, and simply the act of sitting down and standing up from the floor could throw my SI joints off. That’s why I purchased this stretching table, which allowed me to do all of my stretches and exercises without having to worry about that part. https://sijointsaga.com/2017/08/26/sierra-comfort-stretching-table/

      So I think you can listen to your body and go by trial and error. If you feel worse, not better after a stretch, it is probably not a good idea for you to do!

      My PT Paula really was a gem because she was able to think flexibly. I hope that, if you keep looking, you might be able to find someone to do the same for you. It was definitely not easy for me to find her– I also wrote a whole series of posts on what it took for me to find someone to finally help me. https://sijointsaga.com/2018/01/09/physical-therapist/ So please, don’t give up hope!

      Hope this helps! Let me know if you have any more questions!

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  6. Felicita says:

    Sunlight, I keep getting stuck and having incredible pain!

    My husband can straighten me out but the SI jt often reverts. I am more and more immobile due to pain.

    Going to PT (again). Hope I can retrain this old body.

    I truly appreciate your post!

    Liked by 1 person

  7. Jules says:

    I’ve been having specific SI joint pain for a few years . Usually when they act up it feels like something is wedged or stuck in there.. Usually one side at a time & at times an ache all over area.. A few times I suddenly couldn’t walk , step, turn, sit , lay down, or bend over at all for an hour or so , with days following of lingering pain & lack of range of motion. Had ex-ray and no herniated or bulging disks.
    There is only one stretch where I feel any release (temporary) . It’s where I stand with one leg with foot on floor & toes forward , and the other leg is externally rotated and foot is elevated on a low countertop or surface ( do both sides) . – I assume I am stretching or releasing the periformis muscle or etc in that area between the SI joint & femor.

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    • Sunlight in Winter says:

      Hi Jules, so sorry for the belated response! Hmm. It’s hard to say exactly what that stretch is doing. It would be more of a stretch for the piriformis if you weren’t externally rotated.. or, in fact, were internally rotating that leg. Because the piriformis is an external rotator. But you may just be stretching it, or some of other glute muscles, in a way that works for you.

      Alternately, you’re right… it good be a position for the SI joint itself, depending exactly what position it was in to cause pain.

      You can also have pain if you have a lot of inflammation in the area that’s irritating a nerve, so I wonder if that stretch is taking pressure off of one of the nerves, as well.

      In a way, it’s a good sign that some of your worst bouts of pain have gone away on their own. For me, that would occur when my joint was “stuck” and that kind of pain would never go away on its own, without an adjustment to unstick the joint.

      So it’s likely that your joints are hypermobile, meaning they don’t stay in the proper alignment, but aren’t necessarily getting “stuck.” I did see what you said about feeling as though something is wedged– I think that actually could be nerve pain, or perhaps the sacrum and ilium are sort of jammed against each other, but luckily, it’s in a way that you don’t seem to need an adjustment to get out of.

      I think your best bet is to find a physical therapist who really understands the SI joint. (I know I say this to everyone, but I say it because it’s true!). I think PT’s who know how to use Muscle Energy Technique can even be better than chiropractors (once you really know what you are doing). Be sure to check out this page if you haven’t already: https://sijointsaga.com/physical-therapy/

      Hope this helps!

      Like

  8. Keri Ann Brown says:

    Wow! I just landed on this page after another of many searches about SI joint dysfunction, and it looks like exactly what I’ve been looking for!! I’ve been suffering with this issue for several months, and although chiropractic adjustments help, and I continue having them weekly, I’m so frustrated that I don’t understand more about this problem. My chiropractor doesn’t seem excited about answering my many questions, so I’ve been trying to educate myself online. I’m so excited to find this blog, and I can’t wait to read more! (On a side note, I can relate to your passion about educating others after what you experienced. After I overcame a lifetime of anxiety, I became passionate about teaching others what I had learned as well. It’s wonderful when we can use our own pain and growth to help others!)

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