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The Sacroiliac (SI) Joints are the critical link between your spine and your legs. They are the two dimples at the base of your spine. Their job is to transfer the massive loads from your upper body down into your legs when you walk, run, or jump.
When the SI Joint becomes dysfunctional, the pain is specific and intense. It is usually felt on one side of the lower back, often radiating into the buttock or the back of the thigh. It can make turning over in bed agony. It can make standing on one leg to put on a shoe impossible. It creates a feeling that your back is “out” or unstable.
Patients are often told their SI Joint is “out of place” or “dislocated.” At Breakthrough Pain & Performance, we know this is rarely true anatomically. The SI Joint is held together by some of the strongest ligaments in the body. It moves only a few millimetres. The problem is not that the joint is out of place. The problem is that the neurological locking mechanism has failed, or has become stuck in the “on” position.
To understand SI Joint pain, you must understand how the joint stays stable. It uses two mechanisms.
1. Form Closure: The bones fit together like puzzle pieces. The ridges on the Sacrum lock into the ridges on the Ilium.
2. Force Closure: The muscles (Glutes, Lats, and Core) squeeze the joint together to clamp it tight during movement.
dysfunction usually occurs when Force Closure fails. If your Glute Max (buttock) or your opposite Lat (back muscle) are inhibited, they cannot clamp the joint tight enough when you walk.
The brain detects this micro-instability. It senses that the joint is wobbling. To protect the spine, the brain triggers a massive reflex spasm in the deep ligaments and the Piriformis muscle. This spasm is what causes the pain. It is a desperate attempt by the body to create stability where the muscles have failed.
We treat the failure of Force Closure. We do not just crack the joint. We reactivate the Glutes and the posterior oblique sling. Once the muscles are doing their job of clamping the joint, the brain relaxes the painful protective spasm.
Sometimes the problem is the opposite. The joint gets stuck. This happens when the brain perceives a threat and locks the joint down permanently. The large ligaments (sacrotuberous and sacrospinous) become rigid and painful to the touch.
This often happens after a fall, a misstep off a curb, or a difficult childbirth. The brain remembers the trauma and keeps the joint splinted.
This locking prevents the natural shock absorption of the pelvis. The force of walking goes straight up the spine, causing headaches or neck pain. We use P-DTR to signal to the brain that the trauma is over. We reset the mechanoreceptors in the ligaments. Once the threat signal is removed, the ligaments soften, and the joint begins to move naturally again.
Pain in the SI Joint causes the Glute muscles to switch off. This is a known neurological reflex called Arthrogenic Muscle Inhibition.
This creates a vicious cycle. The SI Joint hurts, so the glute switches off. The glute switches off, so the SI Joint becomes unstable. The instability causes more pain.
You cannot break this cycle just by doing glute bridges. The brain is actively blocking the signal to the glute. We have to break the reflex arc first. We use sensory stimulation to dampen the pain signal from the joint. This opens the neural pathway to the muscle. We then immediately train the glute to fire. Patients are often amazed at how their strength returns instantly once the joint pain is silenced.
Many patients with SI Joint pain are told they have one leg shorter than the other. While true anatomical leg length differences exist (bone length), most discrepancies are Functional.
The pelvis is twisted due to muscle imbalance. The QL muscle in the lower back hikes one hip up, making that leg appear short. Or the psoas rotates the pelvis forward, making the leg appear long.
We do not treat this with heel lifts (which can make it worse). We treat the muscle imbalance. We release the tight QL and Psoas. We stabilise the pelvis. In almost all cases, the legs become even again once the neurology of the pelvis is balanced.
SI Joint pain makes sitting in a car uncomfortable. Our clinic in Shiremoor is easily accessible. We are just a 10 to 15 minute drive from most locations in North Tyneside.
We offer free parking directly outside the door. You can arrive, park with ease, and walk straight into a professional environment. We understand that walking is painful, so our clinic is on the ground floor with no stairs.
We follow a structured protocol for pelvic pain.
1. The Diagnosis: We perform specific orthopaedic tests (Laslett Cluster) to confirm the pain is coming from the SI Joint and not the disc.
2. The Release: We release the protective spasms in the Piriformis and QL muscles.
3. The Activation: We wake up the Glute Max and the deep core to restore Force Closure.
4. The Belt: In acute cases, we may use an SI Joint belt temporarily to provide artificial stability while the muscles strengthen.
This clinic is for you if:
We provide stability for your spine.
