A huge part of my recovery, in addition to learning which exercises to do and which specific interventions to use, was learning what not to do.
As I wrote in a previous post, the SI joint is like a puzzle. For me, the process of understanding my own joints had to be very intellectual. As much time as I spent exercising or going to the chiropractor, I probably spent three times as much time identifying the things that made me worse, and learning to restructure my life so I could avoid those movements.
Basically (as anyone who’s ended up at this blog knows) our bodies are not perfect machines. We can have a joint that is really stable in one position (usually the position it’s in the most often) but when you start to take that joint out of its neutral position and into positions that challenge its stability more, that’s when you run into problems.
For the SI joint, I’ve found that one of the quickest motions to challenge it would be when I turned or twisted at all.
Like, you know that polite thing you do when you’re walking down a crowded sidewalk, and someone is coming in the opposite direction, and you both do a polite little half-turn to make room for the other?
At my worst, that was guaranteed to make my SI joints lock up. Same with trying to make it through a crowded grocery store, navigating through aisles jammed with carts.
It sounds ridiculous really, and on the surface, it seems counterintuitive. After all, there were times when I felt fine– when my SI joints were aligned, and I was able to walk for a mile or two at my own pace around my neighborhood.
Now I’d been in the supermarket for less than five minutes, and already felt like I’d “twisted funny,” and couldn’t walk anymore?
The thing about this joint is that when you really get to know it a little bit more, this actually does make sense.
Our SI joints are the most stable when our pelvis is in a neutral position, and we aren’t twisting.
When we start to twist, we naturally begin to put more pressure in the SI joints and the ligaments that are meant to hold them in place. If those ligaments have been compromised, the joints are going to go right out of place.
Moving a little bit when we twist is in fact a normal motion for the SI joints– they are intended to provide us with a little bit of “give” across different motion patterns. But without the ligaments there to provide backup and prevent things from going too far, too much motion can occur. That’s when you run into problems.
There are other motions/actions which I’ve also found can over-stress the SI joints, and potentially re-strain the ligaments.
Think about it. If you have an SI joint injury, you have most likely strained/slightly stretched out the ligaments, and you are also probably lacking adequate muscle strength.
So you can take motions which might have been okay for another person, or for you before your injury, but they aren’t okay now.
Basically, all of these include subjecting the joints to more force than they are able to handle in the current state they are in (with sprained ligaments and a potential lack of muscular support).
- Turning/twisting the pelvis while walking
- Turning/twisting to sit down in a narrow space (like at a crowded restaurant when you have almost no room to squeeze into your chair)
- Bending over to reach something far away (like across a wide counter)
- Stomping really hard on the brakes in your car (this has actually been known to cause SI joint injury, especially if you’re trying to hold down the brakes while in an accident)
- Accidentally misjudging your steps and tripping (like walking over uneven ground and stumbling because you didn’t realize there was a dip)
These are all things that have aggravated my SI joints at times.
You probably have other positions/motions which you’ve find make things worse for you (and I’d be really curious to hear them, if you do!).
Overall, the reason you want to avoid straining your SI joints is not just about reducing pain, it’s actually about trying to reduce the frequency with which you re-irritate the SI joint ligaments.
When a ligament is sprained and inflamed, it’s going to be a little more stretched out. And, although a stretched out ligament may never completely tighten up all the way again, you want to give it as much of a chance as you can to heal.
If you’re constantly bombarding it and re-stretching it, that is simply going to prolong your healing time. (I won’t say that it makes healing impossible, because I definitely re-injured mine multiple times, and I still healed). But this is what you want to do to minimize healing time and maximize healing potential.
So, what you need to do is really make sure you have a calm and clear mind (I know, easier said than done) and try to pay attention, as you’re going through the day, to what makes things worse. It’s probably a good idea to keep a journal, because that will let you identify patterns over time.
Maybe you thought two completely separate events were making you worse, but when you stop and think about it, they actually both involved the same movement pattern.
It won’t be possible to make it so you never re-aggravate your SI joints again. But you’ll be taking a huge step forward simply by being aware.