Sacroiliac joint (SIJ):   Your sacrum is the big bone at the bottom of your spine.  It looks like an upside-down arrowhead.  The spine attaches to the hips at this point, and it takes a lot of stress.  When you run one leg moves in front as the other moves backward.  This places a lot of torque on the SI joint.

History:  SIJ dysfunction can be traumatic from a fall and landing on your butt bone.  It can happen when you reach and twist to get the last bag of groceries from the car or the jumping athlete who always pushes off with the same leg.  It is most common in pregnant females and teenage girls.  Their body adapts as their hips widen and all the ligaments in that area can become stretched.  BUT it can happen in anybody. 

Self-Exam:  Here are some things you can look for in yourself. 

1)      Stand in front of a mirror and look at your hip bones.  One may look higher than the other.  Your belly button may look off-center and those little pointy bones in the front of your hip may be at different heights. 

2)      You try to touch your toes you bend off to one side or the other.  There is a good chance bending forward will hurt really low in your back.

3)      When you return from bending over you may have pain really low in your back.

Treatment:

1)      Manage the pain:

a.      NSAIDS will help. 

b.      Kinesiology taping with strong tension across the joint will add stability.  LIN

c.       Ice or heat can relieve your pain.

                                                              i.      Ice right after you get done running

                                                            ii.      Heat on non-running days

d.      Continue your normal running routine.

2)      Restore full motion:

a.      This is a tricky situation.  You need to stretch the tight muscles without twisting your SI joint out of place again.

b.      “Move into the light.”  Only do stretches which do not increase your back pain.

                                                              i.      You will notice you can go a lot further to one side than the other.  Until your SI joint calms down, this will be expected.

                                                            ii.      Stretching does not have to be part of your warm-up or cool-down.  But it HAS to be part of your training program. LIN

3)      Begin non-weight bearing exercises to restore strength.

a.      For now, all of your exercises should be symmetrical; what you do on one side you should do on the other side at the same time.

b.      Exercises to strengthen your core.

                                                              i.      Crunches, bridges,  plank, super persons (Politically correct), the selection is endless. VID

c.       DO NOT do exercises like side plank, bicycle, or Russian twists until your SI joint is back in place.

d.      Once your SIJ calms down, progress to asymmetrical exercises such as side planks, plank punches, single- leg bridges, bicycles, etc. to your routine

e.      You will not be at this level for a long time

4)      Begin weightbearing exercises and asymmetrical exercises with emphasis on control versus strength and power.

a.      Apply the kinesiology tape to stabilize your SI joint before you start your weight-bearing exercises.

b.      You can begin adding symmetrical exercises such as wall slides and sit-to-stand.

c.       If these are pain-free you can progress to asymmetrical weightbearing exercises such as static lunges, lateral step-ups, etc.

d.      Do not forget to keep core exercises in your workout.  LIN

5)      Correct running mechanics.

a.      Gradually return to your previous running.  Start on relatively flat ground or even on a treadmill.  The best part of returning to running with a treadmill is that you can actually hear your footsteps.  Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move.  If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running.  Listen and ‘feel’ how you run.  Is one leg hitting the ground harder than the other?  Does one arm swing differently than the other?  Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.

b.      As soon as you can run without pain and without a limp you can return to your normal running routine.

6)      Return to running speedwork and hills.  After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.

7)      My favorite step, get back to full running!  Have fun.  Eventually you will bust something else and be back to the website to fix that. 

8)      If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do.  We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.