This article is about sacroiliac joint dysfunction, also called, sacroileitis, sacral torsion, turned sacrum, sprained S-I joint, sacroiliac joint syndrome, and sacroiliac (S-I) joint pain.
It explains what you need to correct it and it contrasts the correction-approach presented, here, with other forms of treatment in a way that I expect will make sense of them, to you.
It also lists symptoms and contains a link to an article with a more complete list of symptoms and explanations of their causes (that trace back to a turned sacrum).
You can read a more technically complete article, here.
It may see odd, to you, that many of the symptoms you have — pain in places seemingly unrelated to your sacroiliac joints — come from a turned sacrum.
At the same time, many of these pains are medically un-diagnosable — meaning, no medical explanation can be given for many of them — or the explanations given were educated guesses and the therapy didn’t work. If you’ve had extended therapy for those pains, and therapy for those mysterious pains didn’t help, or didn’t help enough, or didn’t produce lasting relief (common), they weren’t understood or approached, correctly, by the methods used.
WHO IS THIS ARTICLE FOR?
This article is for you if . . .
- you have found the information provided on sacroiliac joint pain, both by medical practitioners and “alternative” medical practitioners, to be “thin soup” that doesn’t make you feel particularly optimistic about your recovery from sacroiliac joint dysfunction and doesn’t increase your understanding, much, but only leaves you feeling faintly hopeful — hope perhaps tinged with desperation or despair.
- you have found pain medications inadequate to deal with the pain.
- you have tried therapies and/or surgery and are still in pain.
- you won’t settle for less than lasting relief and are willing to do the work to get it.
WHAT’S IN THIS ARTICLE?
- symptoms of sacroiliac joint dysfunction
- explanation of what healthy sacroiliac joints do
- what happens to your sacrum that causes sacroiliac joint dysfunction
- a comparison of not-so-successful and highly-successful ways of clearing up sacroiliac joint dysfunction
- a detailed explanation of how clinical somatic education clears up sacroiliac joint dysfunction
- a way to get started correcting the condition and ending the pain (CLICK, HERE)
The Simple Explanation of Sacroiliac Joint Syndrome (Dysfunction)
Sacroiliac joint dysfunction (SIJD) comes from displacement (misalignment) of the bones of the pelvis and strain at the ligaments that bind the joints together.
Of the symptoms of SIJD, pain at a sacroiliac joint (at waistline level, in back, two to three inches to one side) combined with groin pain is the most common. I list other frequent symptoms, below.
SYMPTOMS OF S-I JOINT PAIN SYNDROME
Sacroiliac Joint Dysfunction
Following are the most common symptoms of sacroiliac joint dysfunction. Many more exist that vary from individual to individual.
- pain at the groin and waistline, in back, same side – in combination
- pain around the top rim of the pelvis
- deep buttock pain, one side
- reduced ability either to bend forward or to stand up straight
On another page, I list more symptoms grouped by:
- SENSATIONS
- SKELETAL ALIGNMENT CHANGES
- MUSCLE/MOVEMENT MEMORY CHANGES
- EMOTIONAL EFFECTS
There are a lot more symptoms listed on the VIEW OTHER SYMPTOMS page
If you have two or more of the symptoms listed on this page, you likely have sacroiliac joint dysfunction.
But don’t assume that, from the symptoms. Other conditions can cause many of the same symptoms. Symptoms only suggest where to look for the cause. The way to tell if you have SIJD is by manual examination of your sacroiliac joints — something you can do, by yourself, as instructed in the video, below, SELF-ASSESSMENT OF SACRAL POSITION. If you find one side deeper, that’s it: a twisted sacrum and S-I joint strain.
Follow the instructions. Self-examination involves a simple movement with your hands to feel the region of your S-I joints. Pay close attention to the spoken instructions so you know what you’re feeling for. Don’t guess. Either you can feel it, or you can’t.
By feeling the region of your back described in the video, you can feel ridges on both sides with your fingertips. These are not the S-I joints, but the edges of the neighboring hip bones. Toward the midline (the spinal line), next to those ridges, you feel, and others may see, dimples. Your S-I joints are there. The dimples are easier to find in some
people than in others, but the S-I joints are there, deep to the dimples.
If you can’t tell, you may visit a chiropractor or osteopath to get a diagnosis and to get trained how to examine yourself. If you’re going to use the program of exercises to correct your own SIJD, you’ll need to be able to examine yourself before each exercise practice session to know which side to do.
If you’ve found one side sacroiliac joint deeper(“jammed”), you know what’s going on with you. Good for you. Now, you know what you need: a way to straighten out your sacrum so it stays straightened out. That’s on this page, at bottom.
If neither side S-I joint seems deeper, your symptoms may come from other
injuries — which is good news for you because other injuries are much
easier to clear up than SIJD. Visit the Consultation page to get a free Functional Assessment form. Complete it and return it to me by email for a recommendation.
Causes of a Turned Sacrum
THE SACRO-ILIAC (S-I) JOINT LIGAMENTS ARE NOT THE CAUSE OF S-I JOINT DYSFUNCTION, BUT THE VICTIM OF IT — and the side that hurts is the non-jammed side (contrary to what one might expect).
This Mayo Clinic entry describes recognized causes of a twisted sacrum.
Sacroileitis — Comprehensive overview covers symptoms, causes, diagnosis, treatment of inflammation of the sacroiliac joints.
Causes for sacroiliac joint dysfunction include:
- Traumatic injury. A sudden impact, such as a motor vehicle accident or a fall, can damage your sacroiliac joints.
- Arthritis.
Wear-and-tear arthritis (osteoarthritis) can occur in sacroiliac
joints, as can ankylosing spondylitis — a type of inflammatory arthritis
that affects the spine.
- Pregnancy. The
sacroiliac joints must loosen and stretch to accommodate childbirth. The
added weight and altered gait during pregnancy can cause additional
stress on these joints and can lead to abnormal wear.
- Infection. In rare cases, the sacroiliac joint can become infected.
In my clients’ experience, nearly all cases come from an injury, with far fewer from pregnancy or other causes. Injuries include falls (bicycle, horse, rooftop, skating, ladder, etc.) and motor vehicle accidents with one foot on the brake at the moment of impact jamming the leg into the hip on one side.
Unsuccessful and Successful Ways to Extinguish S-I Joint Pain
Not-So-Successful Approaches
You may be familiar with these approaches.
Two surgical measures used to stop S-I joint pain are radio frequency nerve ablation (“RFA” – cooking the nerve ending) and Sacro-Iliac Joint Fusion.
- Nerve ablation costs about $2,100 and lasts 9-12 months before the nerve regenerates — making repetition necessary.
- Sacro-Iliac Joint Fusion surgery costs about $22,000 and has the side effects detailed in the article just below. Neither corrects the problem, but only minimizes symptoms.
Click the image, below, to read the article by Dr. Centeno.
Skeletal manipulation is another approach. However, because of the muscle spasms triggered by a twisted sacrum, adjustments to the sacrum don’t “take”. Distorted muscular pulls distort the weight-bearing forces that go through the pelvis and distort its shape. Symptoms return or never go away.
Two other approaches have to do with the ligaments that bind the S-I joints — and they’re opposites.
- Loosen the ligaments by direct massaging or manipulation.
- Tighten the ligaments by prolotherapy.
If it strikes you as odd that practitioners use two opposite approaches (and not together), it suggests to me that their approaches are “shot in the dark” efforts in terms of something they know about. Certainly, if they were consistently effective, SIJD would not be considered so difficult to clear up.
But the ligaments are not the cause, but the victims of the twisted sacrum, and I’ve quoted the Mayo Clinic article as to causes. Any successful approach should somehow address the condition in terms of its cause, don’t you think?
Another approach, the approach I took and advocate, has no negative side effects, consistently provides lasting relief, and restores full function. I explain it, next.
Clinical Somatic Education
Because the field of clinical somatic education is relatively new and not well-known, I’ll briefly explain it, to you. You may see this page, for more explanation.
Clinical somatic education is a health discipline used to extinguish pain and improve movement. Muscles relax, nerve pain ends, and joints come loose. Instead of stretching, we use a completely different technique that causes a long-lasting relaxation of tight muscles by changing muscular control at the brain-level. It’s called, pandiculation.
Pandiculation: “The Whole-Body Yawn”
Pandiculation is an action pattern related to yawning that has far-reaching effects on muscular control and physical comfort. It’s ideally suited for retraining
muscle/movement memory. Pandiculation is a completely different technique from stretching or manipulation.
Everyone has experienced pandiculation. The “morning yawn and
stretch” is a pandiculation (but the athletic, warm-up stretch is not, by the way).
Pandiculation is what cats, dogs, and every animal with a backbone does, upon arising
from rest. People call it, “stretching”, but it isn’t stretching; it’s tightening muscles and then slowly relaxing and moving or even shaking (you’ve seen a dog do this movement). Pandiculation can be done in more ways than just yawning or the morning “waking up” stretch.
Pandiculation is essential to reprogram muscles and movement. You need to unlock
something before you can adjust it. Pandiculation unlocks muscle/movement memory, so it can be changed.
My earlier description of the causes of SIJD cites muscular involvement and distortion of pelvic shape. The two go together, as I have explained — but, to put it more succinctly, “Bones go where muscles pull them.” Clinical somatic education addresses the muscular involvement and skeletal alignment.
The system of somatic education exercises I developed to correct my own SIJD uses patterned movements to retrain muscle/movement memory. Changes of muscular pulls cause the pelvis to reshape. These changes can clearly be felt. Again, “bones go where muscles pull them.”
Click on the image, below, to see the entire comment.
TO SUMMARIZE:
Compression and twisting forces that converge at the S-I joints cause compression of the S-I joints, strain the S-I ligaments, trigger reflexive muscular contractions throughout the trunk and legs that cause muscle and cause radiating nerve pain (that may be mistaken for spasm) — symptoms that never let up, day or night.
S-I Joint Dysfunction or Sacroiliac Pain Syndrome (the word, “syndrome ” meaning a recognizable cluster of symptoms) comprise a complex collection of symptoms that doesn’t respond to therapy, when addressed directly. The key to stopping the pain is to get the position of the sacrum to straighten.
ACTIONABLE UNDERSTANDING
By now, we can see how the forces of an injury initially distorted the pelvis and how muscular contractions, maintained by muscle/movement memory, have kept the problem in place
That means that we can’t correct the problem in any lasting way by addressing the ligaments. (To tighten the ligaments, as in prolotherapy, misses the point and to stretch or loosen the ligaments may reduce their strain, but doesn’t correct pelvic shape or habituated muscular tension patterns).
It also means that we can’t massage away the problem (have you noticed?). It means that we have to free the person from the grip of cringe response and develop balanced, well-coordinated movement that supports the sacrum properly and induces the pelvis to become symmetrical (“mirror-image the same shape”, right-and-left).
Clinical Somatic Education to Correct Sacroiliac Joint Dysfunction:
The Role of Movement (“muscle”) Memory
The medical model, which uses drugs, surgery, and electrical or mechanical devices, generally targets a specific symptom or location of pain, but does not, typically, address muscle/movement memory — even if it does address skeletal alignment, as in chiropractic or osteopathy. Moreover, the medical specialty, “pain management”, is a branch of anaesthesiology; it’s primary approach is to mask or hide pain, not to eliminate its cause.
Unlike the medical model and standard therapeutics, clinical somatic education uses action (movement) patterns not to stretch, but to free — and then re-pattern — the muscular tensions that cause the pain of S-I joint dysfunction and keep the condition in place.
The key term, here, is, “patterns”. Thomas Hanna, in his book, Somatics | ReAwakening the Mind’s Control of Movement, Flexibility and Health (available at many public libraries and via amazon.com), talks about how those tension patterns form with an injury and the process of ending them and their symptoms.
These changes of muscular tension pattern influence pelvic shape over the long term. It’s an entirely new, brain-muscle-based approach that works without need for stretching, strengthening, or soft-tissue manipulation. Instead, it corrects muscle/movement memory, and thereby gets all of the effects of strengthening, stretching, and soft-tissue manipulation — but in a lasting way.
Somatic education causes no undesirable side-effects, other than occasional, short-term soreness immediately after a practice session and lasting 1-2 hours, or 24-36 hours after a practice session, lasting about as long.
ComfortingYour S-I Joints.
With clinical somatic education, we correct S-I Joint Dysfunction in three stages.
- Unlock the Situation. We reduce the tension levels of the involved muscles, sufficiently to unjam the jammed S-I joint to permit repatterning of the forces that keep the pelvis distorted.
- Reshape muscular tension and movement patterns through practice of movement patterns consistent with a sound, symmetrical pelvis and healthy S-I joint function.
- Reinforce healthy, free, balanced patterns of movement — not by strengthening, but by developing better integrated movement habits. These movement habits become second nature and do not require special attention in daily life.
Click on the image, above, to see entire comment.
See the section, below, to get started with Comforting Your S-I Joints, for free. It’s free because I expect you to find it effective and to purchase the rest of the program.
Comforting Your S-I Joints | A RECIPE for RELIEF
This self-renewal program been well-tested — starting with myself as the first “guinea pig”. (Remember, I am a trained practitioner of a health discipline to eliminate pain and rehabilitate movement.) I had most of the symptoms listed. Once I found the exercises worked in me, I published them as preliminary instructional videos and then started teaching them to clients.
I understand why someone might be very cautious about taking an alternate approach to clearing up the problem — and I suspect that you may already have “been the route” with both medical and “complementary medicine” practitioners, to little avail. What I can say is that no one has gotten worse, from this approach, and an overwhelming percentage have gotten better. Everyone I have worked with, personally (I’m a clinical somatic educator practicing since 1990), has been satisfied with the result.
The program consists of a series of somatic education exercises that retrain movement (muscle) memory, done in a specific order.
As in a cake recipe, no one ingredient constitutes the entire recipe, and there are steps of preparation; a somatic education exercise may be viewed as an ingredient and the whole program is the recipe.
Who is This Program For?
The “Gentle Spine Waves exercise” in Unit 1 of the program is such an ingredient and a step of preparation. It’s not expected to relieve your S-I symptoms, by itself (although it works for simple back pain); it’s a necessary step to unlock the situation. What it does is relax the back muscles; this step is one of preparation, not of “cure”.
HOW TO UNLOCK THE SITUATION:
Unit 1 of Comforting Your S-I Joints is the foundation of the program. Called, “Unlocking the Situation”, it decompresses a jammed S-I joint so that the sacrum can be caused to move by the exercises in Unit 2. You do Unit 1 before every practice session of Unit 2 exercises. Scroll to the bottom to send for instructions to get started for free.
By getting started with Unit 1, you can develop the confidence that you actually can succeed at this program and, as improbable as it may seem, do for yourself what medical professionals and therapists have been unable to do, for you. Structured exercises that retrain muscle/movement memory can do for you what manipulation, drugs, TENS (“transcutaneous electrical nerve stimulation” — nerve stimulation through the skin), or surgery, cannot.
After the unlocking, exercises that use pandiculation accelerate changes of muscular (postural) habits. The pelvis starts to reshape and the sacrum, to migrate to a new, comfortable position. With practice, improvements accumulate.
Once the changes have occurred, pandiculation exercises reinforce the new pattern. Job done.
If you’re used to exercises or therapies that produce such small changes that you can hardly tell if anything is different, this isn’t that. With somatic education exercises, you can feel changes rather quickly (obvious after two practice sessions). As, your movement and posture change, the symptoms of SIJD fade out.
TO GET STARTED, at no charge
To get started with Comforting Your S-I Joints click, here.
A quick-response email message will come to your email address requesting permission to mail to you. Once you give permission, “Getting Started for Free” emails will come to you with bite-size steps for Unit 1 of Comforting Your S-I Joints.Comforting Your S-I Joints is a system of movement-based action patterns that reprograms muscle/movement memory in a lasting way. You’ll feel changes for the better with each practice session; changes accumulate over time. The entire system extinguishes the pain and restores mobility.
Final words: These exercises are refreshing, not tiring. If you’re feeling too tired to practice the exercises, practice them and get refreshed.
BY ENTERING YOUR INFORMATION, ABOVE.
Click the image, above, to find out about
availability of personal mentoring through the program
with me, Lawrence Gold.
~~ Since 1996, I have offered a Lifetime Money-Back Guarantee ~~
with accurate attribution of its authorship
and contact information.
http://lawrencegoldsomatics.blogspot.com/2011/04/understanding-sacro-iliac-joints.html
Your article is a god send for me. Why? For the last 25 years I've suffered badly from an undiagnosed syndrome of pain but not one physical therapasit has understood. Exercise has always been the order of the day. All the stretching, massage, manipulation, exercise, steriod injections etc hasn't worked one other than put me back in bed for complete rest. I do have SI joint dysfunction bi laterally, a weak psoas, back pain, torso pain, neck pain and painful spasms of the quads amongst other mysterious body aches and pains. Your article explains to a T what I've lived with all those years. In additon, the Labrum in my hip had frayed extensively away from the bone and cartilage had gone. It all adds up. Thank you so very much for posting… like I said it's been a godsend for me.
I have a fused right SI joint from a MVA in 1999. My left SI, muscles and tendons have been very bothersome in the past 5 years. I have been telling my doctors for years that I feel twisted and after reading your article, now I know why! Because of that fusion I'm not sure if I can get any relief.
Hello!
Where can i enter my email to receive the regimen described?
Scroll to the end.
in your service,
Lawrence Gold
The psoas would not affect urination. As this entry states, a twisted sacrum may affect urination.
I have a hypermobile sacrum- and it causes pelvic pain, especially bladder pain. I can't seem to get it to stabilize. I will try these exercises. What are your thoughts on prylotherapy?
to "anonymous"
Prolotherapy assumes that the problem is slack ligaments. The therapy is supposed to tighten them.
The diagnosis of "hypermobility" misses the point. The jammed side is the problem, and that's a product of unbalanced and distorted weight-bearing stresses causing the sacrum to ride out of its centered and balanced position.
Prolotherapy doesn't correct such imbalances.
I've been doing your free exercises for right SI pain for 2 weeks and am about halfway through them. I have pain, but it's different than it was and I can't sleep on my sides comfortably. I take ballet 4 times a week, but it has stopped aggravating the pain since I've been doing your program. I know I needed to retrain the muscles on my right side around hips as they weren't firing correctly. I stopped doing one of the exercises (on belly, leg forward far to the side, lift head…) because it hurt on the right when I put my head back down. If I continue thru the free program, do you think the pain will go away? how to proceed? buy the full program and try it, or would you recommend a brief consultation. Thank you, I think this is the right answer for me.
Nice post…
to mumnmgr
When an exercise makes you cringe from pain, skip it and move on; you'll come back to it, later, when you're more fit for it.
This question is answered in the introductory track of the program, Comforting Your S-I Joints | http://somatics.com/page7-S-I.htm.
Buy the full program; it's guaranteed (no time limit).
Hi there! I'm so glad I found your page. I tried to sign up above for your free Comforting Your S-I Joints program as a starter, but got an error message. Is it still possible to sign up for it? Thank you kindly! I have been in pain since January and practitioners are finally landing on SI joint dysfunction.
Kim
Go to https://lawrencegoldsomatics.blogspot.com/2014/06/getting-started-for-free-regimen-for.html