Sacroiliac Pain: Movements, Postures, and Habits to Avoid

What Not to Do When You Have Sacroiliac Pain?

When experiencing sacroiliac (SI) joint pain, it is crucial to avoid movements and activities that exacerbate instability, increase shear forces across the joint, or lead to asymmetrical loading, as these can worsen symptoms and impede recovery.

Understanding Sacroiliac Joint Pain

The sacroiliac joints, located where the sacrum (triangular bone at the base of the spine) meets the iliac bones of the pelvis, play a critical role in transmitting forces between the upper body and the lower limbs. They are designed for stability rather than large movements, with only a few degrees of motion. When these joints become inflamed, irritated, or dysfunctional (either hypermobile or hypomobile), they can cause significant pain in the lower back, buttocks, groin, and even down the leg. Managing SI joint pain effectively requires understanding which actions to avoid to prevent further irritation and promote healing.

Movements and Postures to Avoid

Certain movements and prolonged postures can place undue stress on the SI joint, leading to increased pain and inflammation.

• High-Impact Activities:

  • Running, jumping, and plyometrics: These activities generate significant ground reaction forces that are transmitted up the kinetic chain, creating compressive and shear forces across the SI joints, which can aggravate an already sensitive joint.
  • Deep squatting or lunging with heavy loads: While strengthening is important, performing these movements with poor form (e.g., excessive lumbar flexion or pelvic tuck) or with heavy weights can overstress the SI joint, especially if there's an underlying instability or hypomobility.

• Asymmetrical Loading and Twisting Movements:

  • Single-leg standing for prolonged periods: Distributes weight unevenly, increasing stress on the weight-bearing SI joint.
  • Aggressive rotational movements: Actions like a forceful golf swing, throwing, or sudden twists of the trunk can create significant shear forces across the SI joint, particularly if the core is not adequately stabilized.
  • Unilateral leg exercises without control: Activities such as single-leg deadlifts, step-ups, or lunges performed with poor form or excessive weight can challenge SI joint stability. If your SI joint is painful, these should be approached with extreme caution or avoided until pain subsides and stability improves.

• Aggressive Stretching and End-Range Motions:

  • Deep, aggressive hip stretches: Especially those that target the piriformis or hip external rotators (e.g., figure-four stretch, pigeon pose) can sometimes put excessive torque or shear on the SI joint if performed without proper control or if the joint is already hypermobile.
  • Forced lumbar flexion or extension: Movements that push the lower back to its end range, such as touching your toes or extreme backbends, can indirectly strain the SI joint by altering pelvic mechanics.

• Prolonged Static Postures:

  • Long periods of sitting: Especially on soft, unsupportive surfaces or with a slouched posture, can lead to SI joint stiffness and discomfort by reducing natural movement and increasing static load.
  • Prolonged standing: Can also be problematic, particularly if uneven weight distribution is favored (e.g., always shifting weight to one leg).

Lifestyle Habits to Reconsider

Beyond specific movements, certain daily habits can unknowingly contribute to or worsen SI joint pain.

• Poor Postural Habits:

  • Slouching or slumping: While sitting or standing, this can alter the natural curves of the spine and pelvis, placing abnormal stress on the SI joints.
  • Crossing legs: This often leads to an asymmetrical pelvic tilt and can contribute to SI joint dysfunction over time.
  • Carrying heavy bags on one side: Creates an uneven load on the spine and pelvis, stressing the SI joints.

• Unsupportive Footwear:

  • High heels: Alter the body's center of gravity, increasing lumbar lordosis and potentially anterior pelvic tilt, which can place added stress on the SI joints.
  • Worn-out or unsupportive shoes: Can lead to poor biomechanics during walking and standing, affecting the entire lower kinetic chain up to the SI joint.

• Ignoring Pain Signals:

  • Pushing through pain: Continuing activities that cause or worsen SI joint pain will only prolong recovery and can lead to chronic issues. Listen to your body and modify or stop activities that trigger discomfort.

Exercise Practices to Modify or Avoid

While exercise is crucial for recovery, certain exercises may need modification or temporary cessation.

• Abdominal Exercises that Strain the Lower Back:
  • Traditional sit-ups or crunches: If performed with excessive lumbar flexion or without proper core engagement, these can place undue stress on the SI joint. Focus on core stability exercises that maintain a neutral spine.
• Heavy Lifting with Poor Form:
  • Deadlifts or squats with spinal flexion: Even moderate loads can be detrimental if form is compromised. Prioritize maintaining a neutral spine and controlled movement, or avoid these lifts until pain resolves and stability is restored.
• Aggressive Flexibility Training:
  • Overstretching tight muscles around the hip and pelvis: While flexibility is important, aggressive stretching, especially if it elicits pain or targets an already hypermobile SI joint, should be avoided. Focus on gentle, controlled movements and stability exercises.

The Importance of Professional Guidance

It is paramount to seek an accurate diagnosis from a qualified healthcare professional, such as a physical therapist, chiropractor, or physician specializing in musculoskeletal conditions. SI joint pain can be complex, and its management often requires a tailored approach. A professional can help identify the specific cause of your pain (e.g., hypomobility, hypermobility, inflammation) and guide you on appropriate movements, exercises, and activities to avoid or modify, ensuring a safe and effective recovery plan.