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Low Back Pain and Hip Pain from Hooping: Sacroiliac Joint Pain (SI joint)
Posted by Jodi Jainchill PT, CFMT‘I am suffering from right lower back pain. I thought it was sciatica, but it seems that hooping is agitating my back and hip. Could it be my sacroiliac joint (SI joint)?’
Let me start by saying, the body is so complex, so it is always best to get a licensed practitioner to put their hands on you and evaluate you individually. But, it is important that you are educated so you can understand how to help heal your body and continue your daily life without pain and of course, hoop to your heart’s delight!
From my experience as a physical therapist, it is always important to check the SI join’s alignment. The pelvis is the foundation of your body. If your pelvis is out of alignment, then the rest of the spine has to stack itself accordingly.
What is the SI joint? Place your hands on the top of your hips on each side of your body and wrap your thumbs along your back. Where your palms rest is your ilium and about where your thumbs reach is where the ilium meets the triangular bone of the sacrum. This is loosely where the SI joint is.
The SI joint is held together by strong ligaments. There are no per say muscles that directly attach to the SI joint. BUT, there are muscles that influence the SI joint. It is important to stabilize the SI joint via its ligaments and the muscles that influence the joint. It is important to keep in mind that both males and females are affected. Although, it is noted that females do experience more SI joint dysfunction than males. This is due to the female pelvis having less contact at the actual joint than males. Also, since ligaments primarily stabilize this joint, during a female menstrual cycle, a female may experience more laxity in her ligaments. During this period for females, the SI joint may be more unstable. It may be a time to not perform activities that stress this joint. I will speak further on this later in this article
The three muscles that effects the SI join are the gluts, transverse abdominus and ‘lats’. It is important to stabilize your SIJ using these muscles. One excellent exercise that achieves this goal is bridging with a ‘lat’ pull down. Lie a foot away from a safely closed door and a theraband safely placed on the door handle. While lifting your hips in neutral spine and pelvis during the bridge, pull down on the theraband with arms and wrist straight. Pull down your arms towards your thighs with enough tension in theraband to stimulate your ‘lat’ muscles. Make sure your shoulder blades glide down your rib cage for correct alignment.
At the beginning, it is important to do exercises and activities that do not stress the SI joint. Therefore, do exercises and activities that require both arms and/or legs simultaneously. These exercises are referred to as ‘bilateral symmetrical’ movements. As you progress your exercise program, it may be safe to perform exercises that are one-sided. These exercises are referred to as ‘unilateral asymmetrical’ movements.
Another example of a ‘bilateral symmetrical’ exercise would be and ‘isometric adduction’. This exercise can be done several times throughout the day. Lie down on your back with your knees bent and feet flat on the floor. Place a plastic ball or folded pillow between your knees and gently squeeze your knees towards each other for 5-10 seconds. Be sure to breathe. You can perform this exercise 6x each time 4-5x a day.
An example of a ‘unilateral assymetrical’ exercise would be bridging with one leg. Notice, I have given exercises with the spine supported in the lying down, ‘supine’ position. As you progress with exercises, you may perform exercises in the unsupported position of sitting and standing.
Nutrition can also play a role in the health of your SI joint. You may want to ask your health care practitioner about taking manganese for a short period of time. Manganese, not magnesium, can help ‘tighten’ your ligaments. Also, sugar, caffeine and alcohol can increase your perception of pain.
If you are really unstable, it is beyond the scope of being managed without the assistance of a professional. You may need to be fitted with an SI belt or referred to prolotherapy. This article is to help educate you and help direct you whether you need further assistance.
Jodi Jainchill PT, CFMT