The SI joint, labral tears, and pelvic floor dysfunction (Body Harmony PT)

Hi everyone!

Here’s a really great article from Body Harmony, a physical therapy practice in NYC.   (I found it because someone shared it in one of the SI joint Facebook groups that I follow).

This article highlighted a few issues that often come up in my emails with people, so I wanted to be sure to bring it to your attention!

Many of us refer to the SI joint as our “hips” casually, in conversation.  However, in scientific terms, there is only one hip joint– the hip socket, where our leg bone inserts into the pelvis.


The hip joint, where the thigh bone fits into the pelvis

The scientific term for this joint is called the acetabulum, and inside of it sits a ring of cartilage that’s meant to cushion the surface where the top of the thigh bone sits.  This ring is called the labrum.

There are several different types of injuries and disease processes that can affect the hip joint.

A common condition in people with SI joint dysfunction is a labral tear, where somehow, due to wear and tear or in an activity that involves extreme force, that protective ring of cartilage inside the hip joint develops a tear.  (I’ve written more about labral tears in this post).

It can be somewhat common for labral tears and SI joint dysfunction to develop together, because the dysfunctional muscle patterns that can be caused by one can affect the other.

And, as the article points out, these same abnormal muscle patterns can also cause another big problem– pelvic floor dysfunction.  

The author explains that when we move abnormally,

“…we may inadvertently cause strain on the muscles of the pelvic floor. These muscles support the bowel, bladder and sexual organs. When these organs experience strain, a number of issues may result, including incontinence and pain with intercourse.”

Pelvic floor disorders can arise in their own right, and they can be a pretty big deal.  (I’ve collected a few resources for you in the Pelvic Floor and Women’s Health sections of this site).

All of the major skeletal muscles that support our vital organs (digestive, reproductive, excretory) can also cause them to stop functioning optimally, if these muscles become too tight or too weak.

Pelvic floor physical therapy can help by restoring these muscles to their proper functioning, by relaxing spasms in tight muscles, and strengthening muscles that have become weak.

And again, all of the structures in the pelvis are connected, so it’s important that a physical therapist always look at the whole picture when trying to fix any type of dysfunction in this area.

The only tricky thing I wanted to point out:

The article makes the point that a good pelvic floor PT should also be careful to look at the role of labral tears (and, I would argue, the SI joint and pubic symphysis).

However, based on all my experience, I have to be honest that it might be hard to find someone who can do all of this.

Generally speaking, the process to become a pelvic floor PT is so involved that for a lot of people, once they complete the training, they start focusing on the pelvic floor completely.  So, if you ask a pelvic floor PT to evaluate your SI joints, you may find they prefer to refer you out to orthopedic PT.  (At least, this seems to be how things are done in the US).

But in an ideal world, you’d be able to find someone who’s able to keep all of these factors in mind (or at least have a trusted colleague they can refer you to).

So… there you have it.  

I often wish I could give you all a simpler answer, or promise you’ll be able to find a PT who’ll be able to treat you successfully.

It can be hard– that’s why I hope that at least I’m helping by giving you an idea of what to be looking out for!

So, I hope this was helpful.

As always, any comments or questions, you can share your thoughts below or email me at


4 thoughts on “The SI joint, labral tears, and pelvic floor dysfunction (Body Harmony PT)

  1. kjd says:

    Thank you for sharing this information. Although I do not have pelvic floor dysfunction, I have had a labrum repair recently and also have been treated for 4 years now for Lumbar spine stenosis. When I asked the PT postop about the relationship between the labrum and the pelvic floor, I was pushed aside. Very interesting. I knew it was all connected for sure, especially since I noticed for 3 weeks postop that my urine stream and kegel efforts had changed and seemed very week.
    Am working on gluteal muscles, quads and the internal and starting back with external flexors of the hips in therapy and have seen great improvements.
    Thank you for sharing this much needed discussion.


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