This month’s question is looking at sacro-iliac joint (SIJ) stability. The SIJ is made up of the bottom of the spine (the little triangly bit before your tailbone) and the inside edge of the pelvic bone (the large, ear-shaped bone in your hip). SIJ instability is in the top three causes for: hip pain, knee pain, lower back pain, over-worked adductors & groin strain and sometimes it can even affect the shoulder or the ankle.
I would say at least 60% of the people I see have SIJ instability causing some problems. The reasons vary (and I can go into the anatomy/details another time if you want – let me know in the comments) but starting to fix it is extremely simple.
So, for the test: How are you on one leg?
Stand with legs hip-width apart.
Lift one knee up so it’s level with your hip. (it’s important to lift your knee up in front of you, not your foot up behind you)
How much do you wobble? How is your balance? Are you a little shakey, or falling all over the place?
Which side is more stable?
Before we go any further, I should point out we are testing your STANDING leg. Not the leg that has the knee up. The leg that’s supporting you.
Now, you may be thinking well, my ankle’s not strong, but 9 times out of 10 once you get the muscles around your SIJ working properly, your ankle magically gets stronger. (hint: it’s not magic. It’s because your SIJ is more stable so your ankle has to compensate less).
How to Help It
There’s one very simple exercise we get people to do to start supporting their SIJ. It’s deceptively simple, but done correctly makes a big difference.
Stand facing a wall, about arm’s length away. Feel free to hold on to the wall for balance.
If you want to work your left SIJ, lift your right knee as high as you can.
Make sure your hip bones are even.
Try to keep your weight centred. A lot of people unconsciously shift to the side so their supporting foot is under the middle of their pelvis (to avoid using the weak muscles around the pelvis). Try to keep your foot-knee-hip alignment the same as when you were standing on two feet as much as possible.
If you can’t stay in good alignment when your knee is all the way up to your hip, only lift your knee as high as you can in good alignment.
Do this ten times, every day on each side.
Easy ways to fit it in
While standing in the kitchen, doing dishes or cooking.
While brushing your teeth
At the park while your kids play
When walking your dog
Just before your run or cycle
If you have trouble getting this one, feel free to ask us to review it with you at your next appointment.
Once you’ve tried it, let us know what you think – which side is more unstable for you? Do you also happen to have knee or lower back pain on that side?