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SI Joint Dysfunction: Regain Pain Free Squatting

Jaime Alnassim

Online Coaching | Strength & Conditioning

April 25, 2020

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The squat is hard enough without being sore, hurting, or thinking about how you don’t want to do the movement. If you have ever tried to squat while having SI Joint pain, it just does not happen. Sacroiliac (SI) joint dysfunction, when there is pain in the sacroiliac joint region that is caused by abnormal motion, either too much motion or too little motion in the joint. The SI joint is the joint between the sacrum and the ilium of the pelvis. This can cause low back, tailbone, and hip pain; and the pain only increases with physical activity. All you want to do is lay down and never move again, but don’t do that. The problem will only get worse from lying down, standing, and sitting for too long. However there is hope, you can be free of this pain that no one person should ever have to deal with.

Like every injury, it is hard to fix the problem if you do not understand how it came to be in the first place. There is a hand full of muscles that large and small muscles that can influence the SI joint. The piriformis, rectus femoris, gluteus maximus and minimus, erector spinae, latissimus dorsi, thoracolumbar fascia, and iliacus all have relationships with the ligaments of the sacroiliac joint. Anyone of these muscles could be the cause of the pain or even spasm and cause more pain. There are many nerves around the SI joint area and it is extremely sensitive. Sacroiliac joint dysfunction can also develop tightness and dysfunction (abnormality or impairment in the function of a specified bodily organ or system) in the hamstring, quadriceps, iliotibial tract, hip flexors and psoas muscle. This all leads to some uncomfortable days and nights. SI joint pain can be caused from hypermobility (too much) or hypomobility (too little). It should be easy to tell which one is your problem. Guessing you’re tight, bro.

There are many ways to attack this problem, looking at it through a hypomobility problem, let’s get mobility. First you have to look at your posterior chain. You might be able to squat a house, but are your glutes really as strong as they need to be? When you squat a huge amount of presser is put on the SI joint. Keeping this joint stable is a must and comes from a strong posterior chain (glutes and hamstrings). A tight psoas muscle is also can cause problems with the load on the SI joint during a squat. So there are two main points you can work on, weak posterior chain and tight surrounding muscles. If your pain is caused by hypermobility (super flexible), strengthening the posterior chain will help stabilize the SI joint and help relieve the pain. The SI joint takes a beating, even with extremely light weight. Looking at “Recent Advances in Lumbar Mechanics with Relevance to Clinicians”, Stuart M McGill, Ph.D. shows that during a squat with 27 kg (about 60 pounds) the SI joints peak load exceeded 6.5 kN. That would be 1,461 pounds of force! Think what happens when you start going 300, 400, 500 pounds or even more? The load on the SI joint will only go up.

Even if you think that your posterior chain is super strong, some basic strengthening movements will not hurt. The Glute Bridge may look dumb, but it is how you can work on the extension of the hips and learn how to activate the glutes. Even going back to the basics on every lift is worth trying. You would be surprised by how often you do not activate your glutes while training. It is all about making the small muscles around the hips stronger. Break down the movements you do and find out if you really are doing them “right”. Don’t just quarter squat and good morning the bar with one billion pounds. Start with the bar and see if you can even get low without having your hip flexors, shins / calves, and glutes become super tight, your back start to round, or a pelvic tilt.

Gaining mobility in the hips can be a take time. Once you start to feel the hips open up, you will only want to better yourself. The foam roller will become your best friend. The piriformis, rectus femoris, gluteus maximus and minimus, erector spinae, latissimus dorsi, thoracolumbar fascia, and iliacus all can be foam rolled. 30 seconds a muscle is a good start for rolling. Start with a soft foam roller if you have never used one before. Work your way to a harder one, if not a PVC pipe. Do not use a PVC pipe on your back, as you do not want to hurt the spine (Learn more: Five Ways To Increase Hip Mobility).While SI joint pain sucks and is no fun at all, you can get back to feeling normal and squatting heavy. This might sound crazy, but if needed take time off from the gym. If the injury is that bad then you need to rest up and just work on getting mobility and healthy.

Check Out This Video:

Video from Madden Physical Therapy

McGill, Stuart M. “Recent Advances in Lumbar Mechanics with Relevance to Clinicians.” The Journal of the CCA 33.2 (1998): 82-92. Web. 15 Jan. 2016. <link>.

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