Powerful female hormones, injuries & back pain

Hey everyone,

Something my female readers ask me pretty about often is whether our hormones can play a role in SI joint dysfunction.

The answer to this question is definitely yes — although it’s something you may not notice as much, once you become stronger.

Basically, one of the hormones a woman’s body releases in the days leading up to her period is a hormone called relaxin.

As the name suggests, relaxin acts as a chemical messenger that tells our muscles and ligaments to relax.  Its main effect during childbirth is to cause the joints of the pelvis to become looser, meaning there is more room for the baby to pass through.

However, relaxin is also released during our menstrual cycle, beginning around day 14, in preparation in the event we do become pregnant, meaning the concentration is higher in our bodies during the second half of our cycle.

I saw a female physiatrist once who explained it so clearly:

“I have extremely healthy women come into my office– women who are runners, women who are training for marathons– and sometimes it seems like, during their period, all they have to do is bend over and tie their shoe, and they can throw their back out.”

This is the effect of relaxin– it loosens our ligaments up, to the extent where we cannot always count on them to hold things in place those few days of the month, where normally they would.

***

I have definitely noticed this going on in my own body.  For me, during the worst of my saga, it would begin 3-4 days before I get my period, right when I ‘d get my other PMS symptoms.  All of a sudden, I would feel my SI ioints start to move around a lot.

Back when I was doing worse, and my joints were more prone to locking up, they would start locking up much more easily.

It got to the point where I sometimes had to swear to myself, in those days leading up to and during my period, that I wouldn’t be tempted to judge my overall progress by the way things were at that moment in time, and not to lose hope.  (I’m sure my plummeting mood didn’t help with my gloomy outlook, either).

I really had to talk myself through, and say, I know things really seem that bad right now, but your joints ARE doing better.  Just wait a few days and see.

And then, sure thing, once my period had passed, things would go back to normal (or at least, back to baseline anyway).

***

2017: Since my SI joints are doing better now, I don’t notice quite the same extreme fluctuations in my level of function.  I have more muscle strength to hold things in place, and my ligaments have had more of chance to heal after my original injury.

However, every month, I can still feel things become a little looser, and my SI joints seem to have a wider range of motion (and not in a good way).

Update, 2022 Version:

Since I wrote this original post in 2017, so much has changed. I no longer really notice the impact of my monthly cycle on my SI joints, because I have enough muscle strength to cover up whatever is going on with my ligaments.

So, although my body is still releasing relaxin each month, I can actually still do things like exercise and hiking– which I used to have to avoid– the same way I can at any other time in my cycle.

So to all the ladies out there, if you’re dealing with SI joint dysfunction (or any chronic musculoskeletal issue) this is definitely something to be aware of.

It might be worthwhile for you to track how your menstrual cycle impacts your pain. I honestly was totally unaware of the connection, until that doctor suggested I start paying attention.

Once I knew, it did make things a little easier.  I learned not to freak out if things felt worse during a certain time of month, and instead knew to wait, and that it would probably pass (which it did every time).

Becoming aware of this cycle is what taught me when to push myself, and when to rest– knowing that a strategic pause at the right time would actually still play a role in my recovery.

***

For more info, here are some links to check out:

This really informative article from the BBC News: Menstrual cycle injury risk link

Scientific iterature review: The effect of relaxin on the musculoskeletal system

The Clue app helps you keep track of your hormonal fluctuations each month. I checked it out and it seems pretty easy to use so far!

Published by Christy Collins

Hi, I'm Christy! I'm a health coach who helps people overcome SI joint dysfunction and chronic pain.

31 thoughts on “Powerful female hormones, injuries & back pain

  1. “I really had to talk myself through, and say, I know things really seem that bad right now, but your joints ARE doing better. Just wait a few days and see.”

    As someone who practices mindfulness, suffers from a newly diagnosed but slowly healing SI joint issue, and the lovely mood changes of PMS, this phrase (and your article) is just the validation/reassurance I was seeking when typing in my Google search bar “SIJ and menstruation.” 😉

    Thank you!

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  2. I only get my pain during certain times of the month. Sometimes it’s ovulation, but most of the time it’s during PMS. It’s 100% hormonal for me, and there are some months I am unscathed, for whatever reason. I know now there is no quick fix, and I just have to deal with those days the best I can. One of my resolutions for the new year is to get in front of this a little more and commit to more strengthening and stretching. Looking forward to diving into your website for more suggestions. Thank you so much for sharing! Feels good not to be alone.

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    1. Me too! At ovulation my SI joint can go into major spasm. Often starts with pirreformis muscle then can spread to pulling the entire joint out of alignment. Sometimes left side, other months it’s right side. And many months in a row I can be fine but then it comes back out of the blue. Colder months are worse for me.

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  3. It’s such a relief to find this blog and read what you’ve been through. I’ve had back pain for 18 months and only just getting an SI joint diagnosis. Some days I just feel
    Like it will never get better. It is definitely worsened by my hormones too. Thankyou for the time and effort you’ve put into this, it’s so helpful xx

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  4. My si joint pain sky rockets two days into my period. I can barely walk and end up laying down in pain for one to two days. I wasn’t sure at first if the pain was related to my period, but after the last two cycles it was very obvious. I feel like it has gotten worse. Thanks for sharing, best information I have found any where to help me.

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  5. How about menopause does it also effect this hormone for SI joint pain? Thank you for your information I finally get it ..

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    1. HI Vicki, I would think that no longer having those same monthly fluctuations would, over time, be stabilizing for the joint. In general, the SI joint can actually become more stable with age, in both men and women, because the joint can “fuse” and become less mobile as we get older. Not typically what people think of with joint problems, but for the SI joint, age can help.

      Glad my blog has been helpful!

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  6. Thank you so much for this. I am presently trying not to lose my mind, but your article allowed me to notice that the fluctuations are exactly as you explained. Do you have any suggestions for long term improvement?

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    1. Hi Erin, I found that as my SI joints stabilized over time, as a result of everything else I was doing, my hormonal cycle affected me less and less each month. Even though the same amount of relaxin was being released, and affecting my ligaments, once they had stronger muscles surrounding them, it just didn’t seem to have as much of an impact anymore. You can find everything I did here: https://sijointsaga.com/sacroiliac-healing/

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  7. Is anyone having groin pain with SI joint pain? I too notice it more during my period. What is the remedy to this? I have a young child and it’s hard to pick him up!

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      1. I went to naturopath and she suggested Nem by Webber’s natural.It is the membrane of an egg in the vitamin.It works for some people.Fortunately, it worked for me!I don’t take it every day anymore and sometimes take it at night when the si joint was stiff.A specialist told me I would be on pain meds the rest of my life.I haven’t taken any.

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          1. Thank you, I hope it works for others as well.I remember two years ago, I was barely able to walk and took extra strength Tylenol and Voltran.I think I took a muscle relaxer too.It was for weeks.Also, happened during ovulation as I have been doing the billing’s method for 4 years.

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            1. Last thing, I forgot to mention that I am able to sleep in a bed now and not in a sitting position.I also meant that I did not take any prescribed medication by a doctor or specialist and haven’t taken a tylenol in several years.

              Thank you for this website as it makes us not feel alone.Also, we are all made to help one another when we are able too.You are a blessing.

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  8. Thank you so much for sharing your experience! I have been suffering from SI joint dysfunction for only 6 months now and with physiotherapy there was tremendous improvement. But something in my yoga practice seems to have an adverse affect and I am yet to figure out what. However, one thing I have definitely figured out the pain suddenly flares up a week before my periods. I have always had a difficult PMS and a surprise in store every 6 months with new symptoms adding and fading away. With yoga and ayurvedic approach, I was able to get rid of many PMS symptoms but this one is just so annoying. Thank you so much for sharing your experience – I hope to incorporate some from your experience.

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  9. omg, I thought i was injuring my SI joint on my regular exercise, but i remember that this si joint pains happens every now and then, last time it happened this intense was more than 6 months ago, so now it happens again 😦 it triggers my anxiety so bad. I’m so glad I found your website, it really makes me think I’m not the only one

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  10. This has been my life for the better part of 6 months, I have pain everyday in the left side si joint area, butt and also hip, which I am told are weak, so the thing is to strengthen my core muscles, this isn’t happening quite as fast as I’d like though. Maybe some or you find the real challenge is sleeping, as in getting comfy, can’t sleep on the affected side, and often the other isn’t so comfortable either. So I lay there until the wee hours or morning, and I’m up during day exhausted, good thing I work from home a few days a week. The days when I do hate to venture out are difficult, bcs I live in NYC, you don’t always get a seat, and many platforms are outside. Yes I do notice changes during that time of month with this pain, for me it’s the last few days usually, I ache more. This month it was the beginning.

    Pls tell me this gets better, I am so exhausted
    rearranging my life around the pain, I am doing a chiro and I was doing physical therapy, they recommend custom orthotics stating these issues r related to my gait(walk), I’m just amazed how fast this came upon me, all during the pandemic, I wasn’t doing as much admittedly but to think it could become like this. Can someone share what works for alleviating the pain, I take ibuprofen, (try to avoid it) I do stretch as well, bcs were told that’s very key.

    I also started using magnesium oil for muscle aches and it seems to have helped, How long does it take to really get well. I hope anyone taking the time to read this is well on their way to healing or has healed from these issues

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    1. Hey Tia, please know that you are definitely not alone. I’ve actually been hearing from many people that lockdown, and being less physically active than usual, has definitely taken a toll on them.

      Things can definitely get better! I tried a lot of things as well, and eventually figured out a path forward.

      You might want check out this post, which explains how I was able to stabilize my SI joints: https://sijointsaga.com/2017/08/07/healed-sacroiliac-joints-without-surgery/

      Best wishes!

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  11. I was diagnosed with sacrilisits and prescribed celebrex.I did t believe it and never took the prescription.I thought it was ovulation as I have been tracking g it for 3 years and it was.This time same pain under right rib the will go away couple days.Good to research on your own!

    Like

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