I’ve noticed that a certain theme has been coming up a lot lately among some of my readers lately.
And that topic is how the brain can affect the SI joint– by how it regulates things like our muscles, posture, and breathing..
This is a subject I never really thought about before, but all of a sudden I’m hearing from people who’ve had success with a few different approaches, all of which ultimately focus on the brain and nervous system.
Now, I find this 100% believable. I have recently been using a neuroplasticity-based program called the Dynamic Neural Retraining System in order to heal from a condition called mast cell activation syndrome. I’ve learned how many different aspects of our physiology can be positively or negatively affected by the state the brain is in… and let me tell you, it is absolutely nuts.
DNRS doesn’t specifically target musculoskeletal concerns, but now that I’ve had firsthand experience with the power of a brain-centered approach, I totally believe these similar approaches people mention are worth looking into for the SI joint.
One approach I’ve seen people mention quite often is called Somatics. There have been a few interesting discussions in our Facebook group lately, where people talk about some of the various approaches within somatics. I’ve been inspired to learn a little more about it, so I found this article by Lawrence Gold, which explains how the field of somatics views the SI joint.
He explains that he believes Si joint injury is not only due to a sprain of the ligaments, but actually, a neuromuscular response to trauma that causes the body to put uneven stress on the SI joint ligaments.
“When (the Trauma Reflex) lasts for decades, it’s that the injury has left such an impression on the brain that it displaces the healthy, familiar body image so that it’s as if the injury is always “happening right now” — along with the reflexive pulling away (muscular tightening). This change constitutes a change of muscle/movement memory.
Asymmetrical muscle pulls (and asymmmetrical posture) place more stress on one S-I joint than the other.”
I thought this was pretty interesting. My own approach has always focused on the relationship between strengthening the surrounding muscles to take the pressure off of the SI joint ligaments. However, I wouldn’t disagree with the idea that a “trauma reflex” within the body can be perpetuating the problem.
Another technique I’ve heard people mention often is Postural Reintegration (PRI). I’ve heard a few people mention it over the years, as they’d happened to find a physical therapist certified in PRI who had really helped them. I didn’t know too much about it, or that it was also related to the brain, until some fascinating comments from reader Amy on my blog recently. (Thank you so much for sharing your story, Amy!).
In her comments, Amy explains how she’d struggled for a long time, and had seen various medical professionals, for an SI joint that would simply not stay in place. However, after just a few visits with a PRI-certified professional (spaced out over a longer period of time) she has seen a great deal of improvement, and is now able to do all sorts of things she never used to be able to do.
“Unlike any P.T. exercises I had to do previously, these were not designed to isolate some muscles that ‘hold the S.I. joint in place.’ These exercises were designed to turn on certain muscles that my brain had forgotten how to use, and to turn off other muscles that my body used all the time (over-used) as I unknowingly developed bad compensatory habits over the years.”
Today, I do believe this is about much more than just physical “(ligament) laxity”, in spite of it feeling like that is all it could possibly be, and that we are able to teach our brains to call on different muscles at specific times.
So… both PRI and Somatics focus on the idea that there may be more at play in an SI joint injury than just an injury to the ligaments.
What to make of this?
Frankly, if I hadn’t heard so many first accounts from people who’d found these approaches helpful– and if I hadn’t been doing DNRS myself– I’d probably be a bit more skeptical.
But there is quite a bit of scientific evidence that demonstrates that, when we have an injury to the lower back, or even just back pain, it can inhibit the communication between our nervous system and our muscles.
That is, an experience of back pain can actually “turn down” the nervous system’s messages to some of our important postural muscles, meaning they don’t fire quite as much or do their job quite as properly in order to maintain good posture.
It’s one of those weird, paradoxical things about the body. In the initial moments of an injury, it might be good for our body to inhibit those muscles, so we don’t injure ourselves further.
However, if they then don’t get “turned back on” again, it’s really going to be counterproductive, as we need those muscles to be doing their job to keep us out of pain.
So there actually does seem to be a scientific basis for some of these approaches that build on the idea that, through changing our neuromuscular patterns, we can improve SI joint dysfunction.
In conclusion… the brain is a crazy, crazy thing.
I keep wanting to write something like, “the brain is really important to the body.” But of course, we all know that.
What I am really trying to say is that I’ve learned through my own personal experience how trauma — whether it’s emotional or physical– can change the brain. And how it seems like now, we are just starting to explore all the amazing things that can happen when we start to change it back.
If you are interested in checking out any of these approaches, I definitely recommend doing so!
For more on how communication between nervous system and muscles is disrupted in instances of back pain:
Russo M, Deckers K, Eldabe S, et al. Muscle Control and Non-specific Chronic Low Back Pain. Neuromodulation. 2018;21(1):1–9. doi:10.1111/ner.12738
Happy Monday and Happy Researching!
Thank you to ChristinaMina on Flickr for the lovely brain painting!
6 thoughts on “The SI joint and…the brain?!”
This is so interesting. I got diagnosed with Mass Cell Activation along with my SI joint injury as well. I’ll definitely be looking into this too. Thank you for sharing.
Hi Angela, you’re welcome! It was hard for me to believe at first, but it turns out there’s a huge relationship between the brain, trauma, and mast cell. I see Dr. Castells at Brigham and Women’s Hospital here in Boston and this is something I’ve learned from her. I strongly urge you to look into DNRS!
Here are two people who used it to recover from mast cell (it’s not at the top of their list of conditions because they had so much going on, but mast cell was part of it for both of them):
I’ll be talking about my own journey a lot more in the future, so stay tuned!
Hi Christy! This is very interesting. I believe I have SI Joint Dysfunction and I’m currently awaiting an MRI of my sacrum and spine to see if there are any red flags. I have chronic pelvic pain and have been doing pelvic floor physiotherapy twice a week for over a year and have been noticing pain and cracking in my sacroliac joints become a once in a while thing to constantly. Especially with my stiff tight muscles. Anyway, great post! Thank you for telling your story and educating others. 💙
Hi Michelle, I’m so glad my post was helpful! I hope you’re able to figure out what’s going on soon! As you may know, a normal MRI won’t rule out SI joint dysfunction… though it will, as you say, rule out any huge red flags. I think your best bet is to find a physiotherapist with experience in treating the SI joint. This can be easier said than done, but once you find the right person, it’s worth it! And this could potentially help with pelvic floor issues as well.
Best of luck as you move forward!
Postural reSTORATION – PRI. It’s a deep, deep rabbit hole. It all mainly relates back to the natural asymmetries of the body due to things like organ placement (big liver on right, not on left, hemispheric dominance of one side for motor control, asymmetric diaphragm influences (size, leverage, power) etc) that are present in all human bodies. Some are just better at managing their influence and maintaining some degree of being “neutral” or balanced. The whole “stretching a tight muscle” paradigm needs to die. You cannot make any appreciable change in tissue length over any reasonable period of time stretching tissue. It just doesn’t work like that and the research is quite clear. What can affect resting muscle tone is the relative positioning of the bones it is attached to and other neurally mediated factors. PRI works to restore positioning through breathing, activation of certain musculature in certain positions and other more complicated and deeper means such as vision, dental, etc. This stuff is all DEEP. I like this blog and think it has immense value, but I strongly feel the idea of “stretching” muscles that are tight is ineffective, shallow thinking and a means to work on symptom management, not addressing root cause.
Hi Christy, I injured my back 8 months ago. I tried holding back an 85 lb dog from jumping on a friend with a recent surgery. I had a back ache and my buttocks would get sore when I went for a walk. I then noticed I was having trouble bringing my leg up to climb steps. It seemed to get better for a while. Then it started bothering me more again. I started to wear an si belt. One day my right hip felt like it opened up. Then i was sitting in a chair the next day flexed my hips and got a cracking noise out of my low right sacrum. I thought I was all better. Not. I have also cracked really loud in my upper left sacrum. It is very tender and i have pain when i drop my knee out when laying down. Pain in my buttock left side. Everything on the internet makes me feel hopeless. I am going to try physio. Did your si ever crack out loud?