Sacroiliac Joint Dysfunction: How Physical Therapy Restores Stability

Sacroiliac (SI) joint dysfunction is a common source of low-back and pelvic pain, yet it often goes undiagnosed. The SI joints - located where the spine meets the pelvis - play a crucial role in load transfer, stability, and efficient movement. When these joints become irritated, stiff, or overly mobile, they can cause pain that affects everything from walking to lifting to simply getting out of a chair.

Understanding SI joint dysfunction and how physical therapy helps restore stability is key to finding long-term relief.

What Is the Sacroiliac Joint?

The sacroiliac joint connects the sacrum (the triangular bone at the base of the spine) to the iliac bones of the pelvis. These joints are supported by strong ligaments and surrounded by muscles that help transfer forces between the upper and lower body.

While the SI joint has limited movement, even small disruptions in alignment, mobility, or stability can create significant pain.

What Causes Sacroiliac Joint Dysfunction?

SI joint dysfunction can occur when the joint becomes either too mobile (hypermobility) or too stiff (hypomobility). Common causes include:

1. Pregnancy and Postpartum Changes

Relaxed ligaments and pelvic shifts during pregnancy can create instability in the SI joint.

2. Repetitive Stress

Running, stair climbing, heavy lifting, or uneven movement patterns can overload the joint.

3. Trauma or Falls

A fall onto the buttocks, car accidents, or sudden impact can disrupt joint mechanics.

4. Weakness in Core or Hip Muscles

When surrounding stabilizers underperform, the SI joint absorbs excess load.

5. Leg-Length Differences

Even subtle asymmetries can increase stress on one SI joint.

6. Degenerative Changes

Arthritis or age-related changes can reduce joint mobility and lead to pain.

Symptoms of SI Joint Dysfunction

SI joint pain can be difficult to pinpoint because it often mimics other conditions like lumbar disc issues or hip problems. Common signs include:

• Pain on one side of the low back or buttock
• Discomfort that radiates into the groin or down the thigh
• Pain when standing up from sitting
• Increased pain with prolonged standing or walking
• Difficulty with stairs or uneven surfaces
• A feeling of instability in the pelvis or hips

If your pain is aggravated by transitional movements - especially going from sitting to standing - the SI joint may be involved.

How SI Joint Dysfunction Is Diagnosed

A physical therapist performs a detailed evaluation to identify whether the SI joint is the source of pain. Assessment includes:

• Palpation of the SI joint and surrounding musculature
• Postural and gait analysis
• Mobility and stability testing
• Special tests that stress the SI joint
• Evaluation of hip, lumbar spine, and pelvic mechanics

Because SI joint pain often overlaps with other diagnoses, professional assessment is essential for accurate treatment.

How Physical Therapy Restores SI Joint Stability

Physical therapy is one of the most effective non-surgical treatments for SI joint dysfunction. At Core Performance Physical Therapy, our approach focuses on restoring balance, improving mechanics, and strengthening the structures that support the SI joint.

1. Manual Therapy to Improve Alignment and Mobility

Joint mobilizations, soft-tissue work, and myofascial release help reduce muscle guarding, restore movement, and improve pelvic alignment.

2. Core Stabilization Training

Strengthening deep stabilizers like the transverse abdominis and multifidus helps protect the SI joint from excess motion and load.

3. Hip and Glute Strengthening

Weak gluteus medius and maximus muscles are major contributors to SI joint instability. Targeted strengthening reduces asymmetry and improves pelvic control.

4. Pelvic and Lumbar Mobility Exercises

Improving flexibility in the hips, thoracic spine, and lumbar region prevents compensations that aggravate the SI joint.

5. Neuromuscular Re-Education

This retrains proper movement patterns during walking, lifting, squatting, and daily tasks to ensure long-term stability.

6. Posture and Activity Modification

PTs provide guidance on safe movement strategies, ergonomic adjustments, and exercises to avoid during flare-ups.

7. Supportive Tools (Clinic-Specific)

Depending on the severity, treatment may include:

• SI belts to provide temporary external stability
• LightForce laser therapy for inflammation
• VALD ForceDecks assessments to identify asymmetries
• Corrective strategies to optimize load distribution

When to See a Physical Therapist

You should consider PT if you experience:

• Persistent low-back, pelvic, or buttock pain
• Pain that worsens with standing, walking, or transitional movements
• Symptoms that return after rest or stretching
• A sensation of pelvic instability or “shifting”
• Pain during pregnancy or postpartum

Early intervention helps prevent chronic instability and reduces stress on the lumbar spine and hips.

Regain Pelvic Stability at Core Performance Physical Therapy

Sacroiliac joint dysfunction can affect daily life, movement confidence, and athletic performance - but it is highly treatable. With targeted strengthening, hands-on care, and personalized movement strategies, physical therapy restores stability and helps you return to pain-free activity.

If you’re experiencing SI joint pain, our team at Core Performance Physical Therapy is here to guide your recovery.

Schedule an evaluation today and start moving with confidence again.