Hi everyone!
Okay, so here’s a topic that comes up pretty often for people dealing with SIJD… and it’s also one that’s affected me personally.
Many of you have asked me about strange popping sensations and/or pain in the front of your pelvis. Sometimes over the hip socket, and sometimes right by the pubic symphysis, which is the major joint in the very front of your pelvis:
Sometimes this pain and snapping can mean that you have a somewhat serious issue that you need to attend to. But sometimes, it can just be muscular.
So for your own peace of mind I want to tell you, personally, about the crazy symptoms I’ve had when some of these muscles get tight.
Ok… which muscles are we talking about?
The hip flexors are mainly responsible for hip flexion… aka raising your leg straight out in front of you. They are the main actors when you move your leg forward to take a step.
There are actually two muscles which together make up the hip flexors, as you can see in this picture. It’s the psoas major and the iliacus:
This picture also shows us the hip adductor group of muscles.
You can see in the picture that we have the adductor brevis, adductor longus, adductor magnus, gracilis, and the pectineus.
These muscles all work together to perform hip adduction, which essentially means moving our leg inwards towards the center of our body.
Tight hip flexors and tight hip adductors can cause some pretty crazy sensations throughout the front of the pelvis.
For example, in the picture above, you can see how the hip adductors attach directly to the pubic bone. When these muscles get tight on me, I have actually gotten some pretty crazy snapping sensations that have made me freak out and think I have pubic symphysis dysfunction.
Now, that’s not to say that my pubic symphysis has never moved out of alignment.
But there were a few times throughout my saga when I’d show up at my chiropractor’s office on the verge of tears, thinking there was something seriously wrong with my pubic symphysis, and he’d check it and say no… it was actually okay.
(And yes, having someone check it is slightly awkward, but when you’re in that much pain you really don’t care).
Pubic symphysis dysfunction can be very painful and debilitating in its own right.
But I want to reassure you that you can also have snapping right around the area of the pubic symphysis and have it actually be tight muscles.
Hip flexors
Similarly, when the hip flexors– those muscles in the front of the hip– get tight, they can also cause painful snapping sensations and, sometimes, even produce a popping sound.
This, of course, would definitely make just about anyone freak out. My tight hip flexors have definitely made me panic thinking I had a labral tear of the hip, because it can be a very awkward sharp pain in the area directly over the front of the hip socket.
(Let’s go back to the iliacus and the psoas major once again):
However, rather than an issue in the actual hip socket, often people instead have what’s known as snapping hip syndrome.
In snapping hip syndrome, it’s actually the tendons that connect the hip flexors to the top of the thigh bone that end up producing that snapping sensation. That’s because then the muscle belly of the hip flexors gets tight, it puts way more tension on the tendons, causing them to snap over the thigh bone instead of gliding the way they normally do.
Radiating pain
I have also had crazy radiating pain shoot up from my hip adductors, specifically. It’s not just that they were tight in the area over the pubic symphysis. Instead it’s that the whole muscle would be spasming, and I’d massage the muscle halfway down my thigh and get radiating pains up the front of my pelvis.
In a way, though, it would actually a relief when this happened. Personally , I’d much rather have pain coming from a tight muscle or trigger point, than a problem with an actual joint.
So… this is not to say you shouldn’t get checked out, if you have concerns.
No… I don’t mean that at all. My info here is definitely not a substitute for medical advice.
But… you can read this article if it helps you not to freak out in the meantime. Know that there’s a good chance the pain you’re feeling will turn out to be muscle spasms (aka easily fixable!).
How to fix tight muscles:
Determine the cause
In my experience, usually these muscles would get tight when I started doing a new exercise or something that tired them out… and I started doing it a lot.
For example, when I first started doing the Muscle Energy Technique more than once a day, that’s the time it really set off my hip adductors. (It was the shotgun technique, aka squeezing my legs together, that did it. Technically, this technique can actually be used to realign the pubic symphysis, but like all good things, it’s possible to overdo it!).
That experience definitely made me realize why my PT made me promise to only start out only using MET once a day.
But basically, I backed off, and did a little extra stretching, and the problem mostly went away on its own. (When it’s a short-lived problem like this, it actually can go away on its own, which I know can be pretty shocking to anyone used to dealing with chronic SI joint dysfunction!).
Heat and/or Ice
However, you can also try using ice or heat on the area. (In particular, you might want to try a moist heating pad — I’ve found they can be way more effective than the regular ones!).
Stretching
Stretching can help to relieve, as well as prevent, future muscle spasms. In my personal experience, once your muscle is really knotted up, stretching alone isn’t enough to reverse the process. Usually you’ll need to actually release the muscle first– see the massage section next.
However, once you have released any muscle knots, stretching can actually provide a huge benefit in improving your range of motion, and preventing the spasms from coming back.
The tricky thing about stretching when you have SI joint dysfunction is that your routine needs to be tailored to stretch your muscles– not your joints! This is a common mistake a lot of people make– even physical therapists. (More info on this coming up in the future!).
Releasing the muscle knots
In my own experience, I often found that once my muscles were spasming to the point of causing pain and popping, this would mean they often needed a little extra help beyond what stretching alone could do.
When you truly have a trigger point or adhesion in the muscles and/or fascia sometimes the most important thing you can do is find a way to manually release it. Once you do this first, then all the other interventions such as stretching become a lot more effective again.
At times, I had my massage therapist work on my hip adductors where they run closer down to the knee, and even that can actually make a big difference. (Check out my post on how to get a massage when you have SI joint dysfunction!).
However, regular massage therapist won’t be able to directly target your hip adductors where they attach to your pubic bone. What you can do is can check out pelvic floor physical therapy for that, because they are able to directly work on the attachment points where the muscles connect to the pubic symphysis.
There’s also a lot you can do for yourself! You can learn to release the muscle knots and trigger points in muscles ilke your quads and adductors on your own. Some people swear by foam rolling, although I personally prefer to use this handy little Massage stick, which works wonders.
Conclusion
As always, I hope this was helpful! If you’re having any new or changing pain, it’s important to take it seriously … but also know that it could very well be muscular. 🙂
Long-term recovery
In the long-run, all of these issues — whether it’s pubic symphysis dysfunction, or snapping hip syndrome– will get better as you stabilize your pelvis overall. I was able to develop a comprehensive recovery plan that let me stabilize, and now I’m doing so much better!
2022 Update: I’m happy to say that, now that my SI joints are stable, I’m really not dealing with any muscle tightness at all. Check out my recent post Why I stopped needing regular massages for SI joint dysfunction for more!
What did you guys think of the post?
Have you experienced popping throughout your pelvis since developing SI joint dysfunction? What have you done that’s helped?
Let me know in the comments below!
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Useful resource: Snapping hip syndrome— WebMD
Photo Credits:
- Pubic Symphysis: OpenStax College
- Hip Flexors (Muscles): Beth O’Hara
My Sacroiliac Joint Saga 