Why sitting can be painful with SI joint dysfunction

Hello everyone!

I hear from a lot of people who say that sitting is one of their worst problems, wanting to know if this was a significant issue for me as well.

My answer here is two–fold.  First, I’ll answer you based on my own experience, and then address why it might be so painful for some of my readers.

For me personally:

Whether or not I experienced pain while sitting really depended on two things:

1) Whether my joints were in alignment, and
2) What type of surface I was sitting on.

If a surface was too hard or too soft, both could cause problems me.  Both would sort of push my SI joints into finding a new way to distribute my weight that, due to the fact that my ligaments were sprained, would cause too much motion in the joint.

I could sit down on a totally soft couch and find that as my body settled down into the cushion, it would cause my ilium to rotate posteriorly.

As you may know, there are different patterns of misalignment you can have in the SI joints. The posterior rotation was the one that kept coming back and causing the most issues for me. However, there are other patterns of misalignment which you may be experiencing (more on that in future posts!).

Regardless of which pattern of misalignment you may have, when the joint is out of place, it means the surfaces of the ilium and the sacrum aren’t lined up the way they are supposed to be.

The surfaces of each of these bones have interlocking “bumps and grooves” — where the ilium has a bump, the sacrum has a groove, and vice versa.  This is what helps the joint to stay in place and maintain stability.   However, when the joint is misaligned, you instead have the pain of “bump on bump,” which I think can be extra painful if you’re also sitting down and putting pressure on the area even further.

For more on this “bump on bump” pain, I really recommend this video on SI joint dysfunction from Coordinated Health.

So again, joint alignment as well as the surface of the seat itself have been the two main factors for me.

However, people can be so different from one another.

Everyone is unique, and some people may have pain even if their joints aren’t technically “misaligned.”  If someone’s joint is hypermobile (without getting stuck “bump on bump”) and they have sprained ligaments or inflammation in the area, this can increase pain as well, for a few reasons.

1) Again, sitting places extra pressure specifically on the SI joints, versus standing.

2) Moving around helps your body flush out toxins and byproducts of inflammation from your tissues.  When you hold still, those chemical substances tend to accumulate more, and this can cause pain.

It’s important to note that, despite a lot of the things you might hear, these toxins aren’t  “harmful” to your body.  They are the result of a vital, natural process and your body will flush them out eventually.  (You don’t need to be afraid of them or take crazy supplements to get rid of them).  It’s just that sitting still (or lying in bed overnight) causes them to accumulate a little bit more, so that might be why some people find they feel worse after sitting or when first waking up in the morning.

But remember, everyone is different.  

I’ve heard people say that sitting is the worst thing for them, and they find relief from walking around.  For me, walking was always extremely painful if my joints are out of alignment, and in those moments, I could actually relieve most of my pain by sitting or lying on the right surface.

It’s not just about chairs: modifying the various surfaces in your life.

I also found it was really important to find the right firmness level for my mattress, as a mattress that was too hard or too soft could also push my SI joints out of alignment.

The same for the surface I lie on to stretch– I bought this awesome stretching table because I had difficulty getting down onto the floor:

It was the perfect thing for me, but I did have to customize it with my own exercise mats to get just the right firmness:

So, as you can see, surface firmness is an important factor to keep in mind for many aspects of your life, not just sitting.

Okay, I think that’s just about it for this post.

Update: I wrote a related post for a reader concerned about sitting for ten hours on an upcoming flight, with some more tips and tricks for successfully sitting.  Check it out!

Hope this was helpful!