Sacroiliac joint (SIJ) dysfunction is a common source of lower back pain, often misdiagnosed as lumbar spine or hip issues. The sacroiliac joint connects the sacrum (base of the spine) to the ilium (pelvic bone), playing a crucial role in stability, load transfer, and movement coordination. When this joint becomes inflamed, restricted, or hypermobile, it can lead to persistent pain, altered movement mechanics, and compensatory dysfunction.
At Adaptive Physiotherapy & Massage in Booragoon, we specialize in evidence-based treatment approaches, incorporating manual therapy and targeted exercise rehabilitation to restore proper SIJ function and long-term stability.
What is Sacroiliac Joint Dysfunction?
The sacroiliac joint is a strong, weight-bearing joint that transmits forces between the spine and lower extremities. It has limited movement, acting as a stabilizing structure rather than a highly mobile joint.
SIJ dysfunction occurs when the joint becomes too stiff (hypomobile) or too loose (hypermobile), leading to pain and movement restriction.
Levels of Sacroiliac Joint Dysfunction
Sacroiliac joint dysfunction is classified based on joint mobility and stability deficits:
- Hypomobility (Restricted Movement)
- Decreased movement at the SI joint, leading to stiffness, discomfort, and limited hip mobility.
- Pain is often one-sided and can radiate to the lower back, buttocks, or thighs.
- Common in individuals with prolonged sitting, repetitive strain, or postural imbalances.
- Hypermobility (Excessive Movement)
- Instability at the SI joint, leading to pain, clicking, or excessive motion.
- Symptoms worsen with standing, walking, or prolonged weight-bearing activities.
- Common in pregnant women, individuals with ligament laxity disorders, or those with a history of trauma or surgery.
At Adaptive Physiotherapy & Massage in Booragoon, we perform a comprehensive assessment to determine whether SIJ dysfunction is due to stiffness, instability, or associated muscular imbalances.
Evidence-Based Treatment for Sacroiliac Joint Dysfunction
The management of sacroiliac joint dysfunction is tailored to the specific cause—whether restricted movement, instability, or a combination of both.
1. Initial Pain Management and Activity Modification
In the early stages, the focus is on reducing pain and inflammation while improving movement control.
- Activity Modification:
- Avoid excessive twisting, prolonged standing, or single-leg weight-bearing activities that may exacerbate symptoms.
- Reduce high-impact activities like sprinting, heavy squatting, or jumping temporarily.
- Pain Reduction Strategies:
- Ice therapy (for acute inflammation) or heat therapy (for chronic stiffness) applied to the lower back and sacral area.
- Supportive braces or SI belts may provide temporary external stability for hypermobile joints.
- Gentle mobility drills to maintain movement without excessive stress on the SIJ.
2. Manual Therapy for Sacroiliac Joint Dysfunction
Manual therapy plays a key role in restoring normal joint mobility, reducing muscular tension, and improving overall movement efficiency.
Joint Mobilization & Manipulation
- For Hypomobility (Stiffness):
- Gentle SI joint mobilization techniques to restore movement and alleviate discomfort.
- Soft tissue techniques to reduce muscular guarding around the glutes, hip flexors, and lower back.
- For Hypermobility (Instability):
- Stabilization-focused manual therapy to enhance neuromuscular control and prevent excessive joint movement.
- Proprioceptive retraining to improve awareness and coordination of pelvic stability muscles.
Soft Tissue Release & Myofascial Therapy
- Addresses tightness in compensatory muscles, including the gluteus medius, quadratus lumborum, and hip rotators.
- Reduces muscle spasms and improves blood flow to the affected area.
3. Exercise Rehabilitation for Sacroiliac Joint Dysfunction
A structured rehabilitation program is critical for restoring SIJ stability, improving movement mechanics, and preventing recurrence.
Strengthening Exercises
For Hypomobility (Restricted SIJ Movement):
- Hip Mobility Drills (hip circles, knee-to-chest, and cat-cow movements).
- Glute Activation Exercises (glute bridges, donkey kicks, clamshells).
- Dynamic Core Activation (bird-dogs, dead bugs, and side planks).
For Hypermobility (Excessive SIJ Movement):
- Stability-Focused Strength Training (isometric holds, core bracing, and resistance band drills).
- Single-Leg Stability Exercises (step-ups, split squats, and lunges).
- Pelvic Control Drills (abdominal hollowing, posterior pelvic tilts).
Neuromuscular Control & Proprioception Training
- Balance training on unstable surfaces (e.g., Bosu ball or foam pad).
- Pelvic clock exercises to improve hip and core coordination.
- Resistance band exercises for dynamic joint stability.
4. Return-to-Activity & Injury Prevention
Once pain is controlled and mobility is restored, the focus shifts to reinforcing movement efficiency and returning to full activity.
Functional Training & Movement Integration
- Progressive Load Training (controlled deadlifts, single-leg Romanian deadlifts).
- Lateral & Rotational Movements to reinforce dynamic pelvic stability.
- Controlled Plyometric Drills (hops, skips, and landings to assess stability under load).
Long-Term Injury Prevention Strategies
- Maintaining pelvic and core strength to reduce SI joint stress.
- Regular mobility work (hip openers, lumbar mobility drills).
- Monitoring workload and training volume to avoid repetitive strain injuries.
At Adaptive Physiotherapy & Massage in Booragoon, we focus on long-term solutions, helping patients restore function and prevent re-injury through movement retraining and stability enhancement.
Conclusion
Sacroiliac joint dysfunction can significantly impact daily life and athletic performance, but a structured rehabilitation plan can restore pain-free movement and long-term joint health. At Adaptive Physiotherapy & Massage in Booragoon, we provide an evidence-based approach, integrating manual therapy, targeted strengthening, and movement retraining to restore joint stability and function.
If you are experiencing SIJ pain, lower back stiffness, or instability, contact Adaptive Physiotherapy & Massage in Booragoon to begin your individualized rehabilitation program today.
References
- Cohen, S. P., et al. (2013). “Sacroiliac Joint Pain: A Comprehensive Review of Anatomy, Diagnosis, and Treatment.” Anesthesiology, 119(3), 657-682.
- Vleeming, A., et al. (2012). “Movement, stability, and low back pain: The essential role of the pelvis.” Clinical Biomechanics, 27(5), 455-466.
- Laslett, M. (2008). “Evidence-based diagnosis and treatment of the painful sacroiliac joint.” Journal of Manual & Manipulative Therapy, 16(3), 210-218.
- Hungerford, B., et al. (2003). “Evidence for altered lumbopelvic muscle recruitment in people with chronic sacroiliac joint pain.” Spine, 28(14), 1593-1600.
- Fryer, G. (2010). “The role of manual therapy in managing SIJ dysfunction.” Journal of Bodywork & Movement Therapies, 14(1), 18-23.
