I realized yesterday that everything I’ve written about my own road to healing really comes down to two factors:
- Letting sprained ligaments heal
- Building muscle strength
These two factors make up two equally important sides of the same coin. You need both for healing. The key is to balance one against the other.
Why? Let’s look in more detail.
1) Letting sprained ligaments heal
Basically, SI joint injuries occur when some sort of trauma or overuse sprains the ligaments that are meant to hold them in place.
When a ligament has been sprained, it means there has been “a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints” (check out this article from the Mayo Clinic).
The unfortunate reality is that when a ligament has been sprained/stretched out, it may never completely heal and shorten back up to its original length.
However, it can still heal and tighten back up to an extent, so that at least the acute injury phase/inflammation is over, and it becomes a little more stable.
So part of recovering from an SI joint injury requires allowing the ligaments to heal, and not continuing to perform motions or activities that continue to re-injure them, or possibly cause them to become even more stretched out.
For me, this corresponds to the parts of my story where I talked about learning to adjust my movement patterns and habits, so as not to put more strain on the joint.
It also meant eventually coming to the conclusion that receiving chiropractic adjustments to the area were more trouble than they were worth, because of how they stressed the ligaments.
Essentially, you need to cut way back on anything that stresses the joint, so that your ligaments have a chance to calm things down. If you keep stressing them and continually pushing them outside of their normal range of motion, you’ll prolong your healing process (or possibly never heal).
(Side note: This is why people use prolotherapy: its purpose is to try to help ligaments tighten back up).
2) Building muscle strength
The other equally important thing you need to do is build your muscle strength back up to where it was before the injury– and then some.
Because the truth is, you’ll probably never be able to count on your ligaments to the way you were able to before your injury (not that it’s something you ever had to think about consciously! They were just quietly doing their job).
However, when your muscles are strong enough, they can “take over” for ligaments that have been stretched out.
You have all sorts of major muscle groups that contribute to the stability of the SI joint, and when they are strong enough, they can support the joint to the extent that you may no longer notice your ligaments being sprained.
This is essentially what happened for me. I know my ligaments will never quite tighten back up to the way they used to be. But once I stopped constantly re-spraining them with chiropractic adjustments and got physically stronger, my joints stopped moving out of place. I stopped having to think about my movement patterns as much, because my muscles were holding my joints stable.
- See my corresponding post When muscle strength takes over for weak ligaments
3) Uniting the two factors
Unfortunately, when your ligaments are already sprained, building muscle strength is not always the most straightforward.
Your muscles and joints were designed to move with your ligaments holding things in place. Without them doing their job, things get a little bit tricky. Normal movements that wouldn’t have hurt before can end up putting way too much stress on your joint.
That’s why it’s so important to have a strengthening program that takes your ligaments into account. So many people get stuck in a cycle where they’re working with PT’s and medical professionals who just don’t get it, and give them cookie-cutter strengthening programs. Generic back-strengthening programs don’t work for this, because they continue to place pressure on the ligaments instead of allowing them to rest.
That’s why, to truly move past this injury, you need to be able to strengthen while allowing your ligaments to heal.
The right exercise program will allow you to start building strength, while putting minimal stress on your ligaments– and shouldn’t cause any pain!
Update, May 2022: As many of my readers know, I used to think aquatic exercise was the only way to strengthen while rehabbing your SI joints. I wrote that because it was the best advice I knew how to give at the time.
However, I’ve learned sooo much more now. Although I still think aquatic therapy is great, I also know that there are tons of options to help you start strengthening, even if you can’t get to a pool. There are super gentle core training exercises you can do, and even certain techiques to improve how your nervous system communicates with your muscles. As long as you’re doing all of these things with an awareness of what’s happening with the ligaments– that’s the part that’s truly key.
For more info, check out my Strengthening posts:
- Three major muscle groups to strengthen for SI joint dysfunction
- The goal of strenghtening is to maximize your body’s own support system
- The core and transverse abdominis
And you can also check out my posts on Aquatic Therapy, which can be a great way to strengthen while being gentle on your ligaments:
- The importance of pool exercise to my recovery
- One of the best things you can do for yourself in a pool: traction
Gosh. Okay, that was a lot of information!
The SI joint is a super complex subject– which is what can make it kind of fun to write about. But it’s also why I personally struggled with it for over five years before finding the answers I needed. That’s why I’m so determined to share what I’ve learned.
What did you think of the post?
Have you been able to strike a balance between strengthening and letting your ligaments heal? Let me know in the comments below!
And just a note–
There are many people who decide to proceed with SI joint stabilization surgery, or require other forms of treatment such as prolotherapy. The purpose of this post is not to make a value judgement on anyone else’s path to healing, or imply that you should be able to heal without surgery.
I am simply sharing what worked for me, and I’m grateful that the extent of my injury wasn’t worse, so that I could recover in the way I did. What worked for me may not work for everyone, which is why I make an effort to address other potential avenues for healing on my blog.
28 thoughts on “How I healed my SI joints without surgery”
Have been fighting this myself for some time now. Thanks for all your insight.
You’re welcome! Glad my writing is helpful.
So grateful to have found you! Beginning this healing journey now.
Hi Jada, I’m glad you found me too! Hopefully my story can help you along your journey ❤
Have you heard of or tried an SI belt?
I feel like I’m reading about myself! Thank you so much for writing about your recovery! I’m am excited and hopeful for the first time in a very long time! Thank-you, thank-you, thank-you!!!
Hi Angie, you’re so, so welcome! I love hearing my blog is helping people!
Excellent write ups!! I have though same theory about the chiros. All make sense. First I’d heard of prolotherapy, very intriguing. I was wondering if you have any suggestions on yoga videos for strengthening and still protecting from stretching ligaments and tendons too much?
Can you tell me if you wore a SI belt at all during your recovery?
I personally didn’t use an SI belt. I tried one on once and didn’t like the way it seemed to be restricting my movement, so I took it off. However, the shape of individual people’s SI joints can be really different, as can be the nature of our injuries. What works for one person won’t necessarily work for another. A lot of people actually do find the belts helpful, so I do think they are worth a try.
Hi, just like to say I totally agree with the pool for strengthening the SI joint, i have had chronic SIJD for over a year and could barely walk across the room but after one 10 minute sesssion I felt the difference. I would also like to mention I do wear an Sij belt and it worked really well for me, I’m still recovering because I have a failed l4/5 fusion which I think is the reason for my SIJD and not sure if I will ever fully recover until I have revision surgery on my spine, does anyone else have this issue?
Hi Cat, sorry to hear about what you’re going through. That’s really great that the pool has been helpful for you, however. Hopefully someone else will chime in if they’ve had a similar issue– I will say that I think it makes a lot of sense to think your failed fusion could be the cause of your SIJD. If you have restricted or abnormal motion at the lumbar spine, this can definitely affect way forces travel through your SI joints, and your body will have to compensate. It’s hard to say if you could recover without revision surgery– I think it would depend on the degree to which your overall spinal motion is currently being affected. But certainly, doing whatever you can to build up your strength in the meantime is key! Wishing you the best of luck in your recovery.
Thank you so much for all the time and energy you have put into this fabulous blog. I have my SI joint pain 3 and a half years and can’t believe I haven’t come across it sooner. After little or no relief from the usual treatments, I have been comfortable and pain free for almost 2 years by drinking celery juice, which I’d only started taking to heal some stomach problems. The anti inflammatory effect on my SI joint was a pleasant surprise, but it only works if I stay away from all exercise except walking. No-go activities like weight training or even gardening can still send me back to square one. I need a plan so I can get life back to normal and look forward to doing some gardening without a relapse. I’m so grateful for all the information you’ve shared here. I’m going to use it as my blueprint.
Hi Cat …. wandering how you are doing now. I too had L4-5 in 2018. Stayed bed ridden for 20 months. Traveled to see Dr Jerry Heash. My pelvis was locked on both side and in an bilateral upslip position. Fortunately Dr Heash out of 9 different physical therapists was the only one that helped me. Although I am no longer bed ridden. I am
Still in tremendous pain on my SI joints. Thinking my weak muscles in back like QL , Piriformis, and glutes have a lot to do with it as well. So I am also using pool therapy to try to strengthen myself. Plus seeing a therapist twice a week. Christie has a lot of great information as well. But you seem to be in my shoes with the fusion. My hardware was removed and I think it made me worse. May I ask how you’re doing now? And if you’re doing good what did you do to get there. Of course I’m losing patience after all this time. After my second surgery June 2019. I did spend 18 to 20 hours a day in the bed. So I know it’s going to take me some time. But yesterday my sacrum felt like a four-story building was on top of it. After my second surgery June 2019. I did spend 18 to 20 hours a day in the bed. So I know it’s going to take me some time. But yesterday my sacrum felt like a four-story building was on top of it Welp !
Very challenging. Thankfully for Christie, and for me revisiting this blog I just found a Met therapist in my area. Although I do love mine I don’t think she’s helping me as much as I need. Thankfully for Christie, and for me revisiting this blog I just found a Met therapist in my area. Although I do love mine I don’t think she’s helping me as much as I need.
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Thank you for writing this down. I got more information here than any other site.
I am 58 and went to Zumba for the first time. Guess I did something I shouldnt as the next day I was really hurting. After Dr visits and no help but pain pillz I went to
a chiropractor who said I had tilted my pelvis, I had been walking lopsided for a few weeks and he said he wasn’t surprised I hurt …Well 4 visits later I was hurting more and one morning I woke writhing in pain my husband having to call 911 as I couldn’t walk.
I have never had back pain so this is all new to me. So again Thankyou !!
Hi Tina, I’m so glad my site has been helpful! Wishing you the best of luck in your recovery!
I would like to thank you for your blog. It was an answered prayer. After almost four years of chronic pain I finally feel like there is a light at the end of the tunnel. Learning how to adjust myself was the turning point. I feel like I can now start to strengthen without being in excruciating pain. I’ve tried chiropractors, orthopedics, had X-ray , and mri. Tried physical therapy but it put me in so much pain I had to stop. Thank you for all of the helpful information you put out there.
Hi Trish, you are totally welcome! I’m so glad you found my blog!
Loved the positive details in your journey. It is inspiring. I have experience two episodes of Pain. First time was July 2017 which lasted for a month and this time it is August 2018 and it has been a month. Last time it was me sitting for 8 hours for 5 days while the screen was towards my left. This time it happened with wrong posture while picking up a 20 pounds weight. I don’t have complete diagnosis nut based on my reading I feel I am having SI joint issues.
Can you tell how to know how severe is the issue?
I agree with all the above – your blog is immensely helpful and at the end of the day, I’m the one who has to figure this all out for myself (in a perfect world I’d go to PT daily to get realigned but insurance would never pay for that). I’m right at the two year mark and had I of known al thatl I know now, I would not be in this painful mess. Hopefully all this info helps someone out early in their journey and helps them avoid surgery, etc.
Hi Kayla, I’m so glad you found my blog helpful. I really hope this information helps you and is able to save you some time on your journey as well 🙂
What type of pain would you workout with during recovery? Would you take NSAID’s and go to the gym?
Hi Benjamin, Actually I would definitely not recommend using nsaids in order to work out, if you were in too much pain otherwise. That’s because, with the SI joint, you really don’t know exactly what’s causing the pain, and what you DO want is for those ligaments, which have likely been sprained, to heal. Pain can be a sign that the joint is out of place— meaning the ligaments are also stressed and out of place— and that really isn’t something you want to push through. A good PT can teach you to realign the joint yourself, in a gentle way called the Muscle Energy Technique.
And to start out with exercise, I recommend aquatic exercise where you’re putting so much less weight on your joints, or also starting out with some really gentle core exercises like these, which you can do lying down: https://sijointsaga.com/2017/06/19/core-training/
I injured my SIJs when a nurse did not move me properly from a recovery bed to a wheelchair. I fell limply onto the floor. The damage from this fall was massive. Both hip labrums tore; bilateral hip bursitis emerged, which is still with me; both SIJs were badly sprained; two lumbar discs both tore and bulged; there was extensive facet joint damage; the pubic joint was badly damaged, resulting in chronic inflammation and instability; and there was a coccyx fracture. A bunch of soft tissue injuries resulted as well, for the reason I was in the hospital in the first place was because of an abdominal injury. The fall made that injury quite a lot worse.
I tried PT for a year and a half, and I put my heart and soul into it because I wanted to get better. But it made my injuries notably more severe, so I gave up on PT and had screws drilled into my back two months ago. (That’s on top of three other surgeries that were done to fix my hips & some soft tissue stuff.) Before the back surgery was done, I had an X-ray done for which I stood first on one leg, then the other. When I stood on my right leg – the side onto which I had fallen in the hospital – my entire pelvis shifted upwards by a couple of inches and my pubic bone per se separated pretty widely. The pelvis stayed stable when I stood on my left leg. So in addition to having screws drilled into my lower spine & right SIJ, they drilled screws into the pubic bone to stabilize it, too. Before the fall in the hospital, I had zero back issues, zero chronic pain, zero disability. I walked three miles every day and was just very active in general; I could never sit still. I haven’t been outside other than for medical stuff in two years. I have trouble remembering what it is like to live without pain. But I know that is how I used to live.
My husband and I were unable to find a lawyer to fight for financial compensation because the nurse did not report the fall. There appears to be zero recourse for a patient if the medical personnel do not report the adverse event. I don’t know what can be done to fight this – put cameras in hospitals? Have no-fault victim’s compensation like Sweden and New Zealand do? This has devastated me physically and mentally; I am a broken person. I am still young – quite young, in fact – but I feel ancient and defeated by life. My husband feels defeated, too. The medical establishment owes me better treatment than this, but it failed utterly and then doubled down on this failure.
You may not read this, but I needed to share. I was naive before this happened in that I thought people would actually care if someone’s life were destroyed by medical negligence. The truth is that nobody cares – not the nurse who did this to me, not the hospital for which she worked, not the many, many doctors I’ve since seen for injections, surgeries, exams, etc., etc., not the dozens of lawyers I’ve called to try to seek a legal remedy. They say my medical records definitely indicate that I was injured but that, because the nurse didn’t report the fall, it would be very hard to prove to a jury that she is at fault. That nurse is still out there working with patients and I feel genuine fear that she has hurt someone else or will do so soon. Yet my husband and I seem to be the only ones who care. The doctors et al. around here don’t seem to care. Patient safety is a sham and your life can be ruined and no one will care. There is no recourse. There is no financial help.
To say I feel hopeless about the future is an understatement. I don’t know if I’ll ever get back to doing normal activities. I am awake and unable to sleep because my period has caused so much agony in my back that I fell about weeping not too long ago, unable to bear the pain. I never had period pain like this before I was injured. This is bad enough I am going to get a hysterectomy once I find the right doctor. I cannot take this period pain anymore.
Thank you for your blog.
Hi there, I just saw your comment, and I am so, so sorry this happened to you. I don’t have any easy answers, except to say that what can seem very obvious to us as everyday people, in terms of right and wrong, doesn’t always translate into a fully-functioning legal system. I’m not sure if you’ve tried this, but I would suggest contacting your elected officials and at least drawing some attention to this issue.
I offer coaching calls for readers of my blog where I can help you problem-solve and try to come up with solutions no one else as thought of. I’d be happy to do one for you free of charge. You can find more info here: https://sijointsaga.com/2020/02/25/i-am-now-offering-coaching-calls/
Accidentally came across ur blog . I have been suffering from lower back pain for a year now and only recently I was diagnosed with chronic sacroiliac inflammation . I would like to write to u with regards to this. Thank you .
Hey Anita, glad you found my site! I actually offer coaching sessions for people who want 1 on 1 feedback– go here for more info! https://sijointsaga.com/2020/02/25/i-am-now-offering-coaching-calls/
I got a 10 percent damaged SI joint while pregnant and doing lots of repetitive bending movements and lifting while working while pregnant until my son was the size of 3/4 through pregnancy. Unfortunately, was still broken when I returned to work, so tore my hamstring while picking up a heavy item. Then I saw a physiotherapist, who diagnosed me with SI joint dsyfunction as could not bend sideways easily. I did twice daily exercises of from the physiotherpist and wore a serola SI Belt and 3 belts around the hips for 4 years and was in considerable pain much of the time. Then had an mri, the SI joint had healed completely but had water in my sacrum bone (source of pain) and hamstring tendonitis in the MRI scan. I had to then stop my TSL muscle at the side working as a primary muscle and do some hamstring and TCL muscle stretches to get my almost paralysed buttocks muscles to work again.. I haven’t worn an SI belt or had pain for a month, and doing bending movements without pain again. It can heal -yay