What happens when the SI joint is out of alignment?

Hey everyone,

So here’s a common symptom of SI joint dysfunction that I hear people describe just about all the time.

It’s this feeling of a deep pain coming from the area around your SI joints. Like a stuck feeling.

A feeling that you ought to just be able to move a certain way, or stretch just the right amount, and things ought to pop back into place.

But the problem is that nothing you do actually resolves the problem. Maybe you tried a few exercise videos off of Youtube, and you thought you felt better for a moment, but ultimately, nothing really seems to take the pain away.

To me, this kind of pain sounds like your SI joints may be out of alignment.

What does that mean?

To understand the joint being out of alignment, we first have to back up and remember what, exactly, makes up the SI joint.

The SI joint, or sacroiliac joint, is where the hip bone (or ilium) meets with the sacrum (the base of the spine).

When the SI joint is out of alignment, this means that the hip bone has moved out of place, relative to the sacrum.

It’s important to remember that, when this happens, the hip bone is really only moving out of the correct position by a few millimeters. It isn’t even far enough to show up as abnormal in an x-ray.

The problem is that it’s still not the correct position for your body.

Even just those few millimeters can still have a big impact on your overall movement patterns.

The hip bone was designed to rest against the sacrum in a particular way. When it’s out of alignment, that puts a lot of stress on things like the cartilage and the ligaments– which they weren’t designed to handle for long periods of time.

So that’s what starts to cause the pain you feel, and the feeling that something is “stuck”– it’s because it is stuck.

Impact on movement patterns

If the SI joint is out of alignment, it can also cause difficulty walking. For me, sometimes it would make it feel like it was hard to move one of my legs.

This is because the SI joint is supposed to move a tiny bit when we walk. Even though most of our range of motion comes from the hip socket itself, our body is expecting to get a few degrees of movement out of the SI joint as well. If that SI joint locks up, our hip bone doesn’t rotate when we go to take a step. That means, ultimately, that our leg doesn’t swing out in front of us as far as our body was expecting, leading to that “stuck” feeling.

When the SI joint locks up, it can also cause pain in other places, such as the feet and knees.

This is because, when our leg isn’t able to hit the ground at the angle it was designed to, it ends up placing additional stress on places like the feet and knees.

I hear from many, many of you wondering if foot pain in particular can come along with SI joint dysfunction– the answer is yes.

For me, that pain would disappear almost immediately once my joints were put back in alignment. That’s because, technically, I didn’t have a foot problem. I had a problem in my pelvis, that was causing me to use my foot differently. Once I fixed the root of the problem, the secondary issue went away.

Correcting your alignment

This brings me to what is perhaps the most important part of knowing about the SI joint being out of alignment– knowing how to correct it.

Regardless of which type of adjustment you’re using, the goal of any realignment technique is to help get that hip bone get back into the proper position, relative to the sacrum.

Again, we’re only talking about a joint that can move by a few millimeters. However, in the same way the joint being out of alignment by just a tiny bit can cause all kinds of problems, you’ll likely experience significant relief once you’ve aligned things correctly again.

Which pattern of misalignment do you have?

Unfortunately, something which even many physical therapists may not be aware of is that there’s more than one way for the SI joints to be out of alignment.

“Out of alignment” is a pretty generalized term, which simply means the hip bone has moved out of place, relative to the sacrum. But that term alone doesn’t tell you which way the hip bone has moved.

Instead, there are specific terms that can be used to further clarify exactly where the hip bone has moved, compared to the sacrum. These terms refer to specific, known patterns which each must be corrected in precise ways.

I’ll describe these terms in more detail in future posts, but just to give you an overview, these terms include things like:

If someone is going to correct your alignment– or if they’re going to teach you self-corrections– it’s really crucial that they explain to you exactly which of these patterns you have, and what their rationale is for diagnosing these patterns. (More on this later!).

Different types of adjustments:

For more info:




Illustration credit: Mikael Haggstrom/Gray’s

Published by Christy Collins

Hi, I'm Christy! I'm a health coach who helps people overcome SI joint dysfunction and chronic pain.

7 thoughts on “What happens when the SI joint is out of alignment?

  1. Hi, Christy!
    Thank you for sharing your information and your experience.
    IIt took so long for me to realize my pain generator was SI joint . At the beginning I had low back pain, btttock, groin and thigh pain like many of patients with si joint issue.
    Unfortunately, I could not find rhe cause. for 5 years. Lots of treatments aggravated my symtom.
    The pelvic instabiluty is so severe that it affects my whole body. I have never heard the condition like me.
    Iive been bedridden.
    I am south korean. I cannot find any doctors to treat me.
    Now I am considering the fusion surgeryin US.
    IBut I am worried.because of Imy severe condition.

    Just wanted to tell someone who could understand me.
    Thank you for your time reading this.
    I am not that fluent in English. Sorry.

    Liked by 1 person

    1. I suffered for 7 years, I know what you are going through. I have been going to a chiropractor using the activator method. My pain level has gone from a 9 to a 2! Sleeping 7 hours in a row, not using my cane. Dr says will take a year to get muscles in order they were severely atrophied. Cut muscle relaxers from 4 a day to 2. You can change your whole life, God bless you.


  2. Hi Sungae,
    I know I already responded to your email, but I wanted to respond here so that others can see– there is ABSOLUTELY reason to believe things can get better!

    Unfortuately, I do hear from many people all over the world who’ve had trouble finding someone to help them in their area, and don’t believe they’ll ever find way out of their situation.

    However, I am here to tell you that that absolutely is NOT true! There is always a way. There may be an option near you that you haven’t discovered yet (this turns out to be the case for many people, regardless of geographic location).

    Or, there may be a option that is worth travelling for.

    I believe there is a solution for everyone– what that is may be different from person to person. That is why I’m working so hard to raise awareness with my site.

    The important thing is to never give up, and keep trying new things!


  3. Hi I just watched your video I’m a 37 yr old woman with AS,RA,OSTEOARTHRITIS, and many other issues t the most painful and the one reacking havoc in my life is my si joint I have si joint disjunction I have issues with my body becoming contorted due to movement in my si joint but recently I started feeling like my si joint drops away from my spine and shifts left or right it’s very painful I was interested in learning more on the last area of your video when u explain the si joint can shift.. thank you for your time and for explaining these differences and giving me hope it can be fixed


    1. Hi Mandy, really glad my site can help! I totally understand the feeling you’re describing… that can absolutely be what it feels like, when the SI joint is out of alignment.

      What more specifically would you like to know? I’ll keep it in mind for a new video!


  4. Hi Christy. I was 33 when I had a really bad lifting accident and was crippled. No one new what what going on exactly. I know that my right SI joint was stretched and my sacrum was forced downwards as I was twisting. Prolotherapy I think got me back walking again but I think it stayed out of alignment because I couldnt bend forward. I recently reinjured myself and feel like I forced it out of alignment more. Crippled once again. How in the world can I find a knowledgeable person to fix me? Im only 43 years old and I have 20 month old twins! 😦 I live in Phoenix, AZ. No one seems to know much about this from whom Ive seen. Do you know anyone in this area? Thanks


    1. Hey Matt, I get this question pretty frequently. A few years ago I got tired of telling people “no,” I couldn’t help if I didn’t know anyone in their area. So, I decided to put together a set of strategies to help you get the help you need. Knowledge is power- the more you understand about your condition, and the treatments available, the better you’ll able to find help.

      Check out this post I just wrote for more: https://sijointsaga.com/2023/04/05/help-for-sijd/


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