This SI Joint information was graciously supplied by Richard DonTigny, a well known leader in this field from Havre Montana. Many individuals constantly go to a chiropractor to have them adjust this area but it can be very effective to learn how to gently and accurately self correct with the advantage of bringing almost immediate pain relief. Richard DonTigny has a great website where you can get detailed well explained information and even purchase video materials on how to get these corrections working for you.
On the right are basic techniques to reset the SI area. The first one will look familiar to those of you familiar with post-isometric relaxation or muscle energy technique. This series of images, shows different positions in which to do the same basic exercise. They can even be done standing up in an airplane corridor!
The instructions are to bring your leg up to the chest, grasp the leg with both arms, and push outward with the leg against resistance. DonTigny recommends pushing outward hard for five to 10 seconds, then alternating legs, doing each side three to five times. Note that this can be done supine, sitting, standing using a chair, or in a doorway
The next offering is a self traction correction. I like this one as it can even be done lying in bed. When doing any of these exercises in the supine position be certain to hold your abdominal muscles tight when raising or lowering your leg to prevent anterior rotation of the pelvis. There is a first class video available for Richard Don Tigny with print out exercises which is available from the Dynamic Core Program CD for patients.
Richard DonTigny makes excellent additional seldom heard points regarding SI dysfunction.1)Periarticular injections are superior to intra-articular injections for diagnosis of SIJ dysfunction.(2) Murakami Fukushima (3) found that many times cervical strain will not release until the SIJ is corrected. (I have certainly found this to be accurate)
The last form of correction is in the color photo on the left hand side. You can self-correct any time during the day no matter what position he happens to be in at the time. Just by pulling the knee into the axilla or bringing the axilla down to the knee. Stretch firmly several times on each side, alternating sides each time. Remember to hold those abdominals tight as you raise and lower your leg for protection against an anterior pelvis rotation.
Stretching the psoas is usually counter productive as a dysfunction of the SIJ will cause the psoas to become tight while correction of the dysfunction will loosen it. If you stretch the psoas you will increase the dysfunction in anterior rotation of the psoas. Similarly the SIJ dysfunction will cause a vertical shear on the piriformis at the S3 segment. Correction of the dysfunction corrects and relieves the vertical shear. The piriformis, the G. max and the iliacus all have origins on both the sacrum and the ilia. The shear is the cause of the piriformis syndrome. Similarly the sacral origin of the G. Max will tend to separate from its ilial origin and the ilial origin of the iliacus will tend to separate from a small slip on the sacrum.
1.DonTigny, RL: A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology: the implications for lumbopelvic function and dysfunction. In Vleeming A, Mooney V, Stoeckart R: Movement, Stability& Lumbopelvic Pain: Integration of Research and Therapy. 2nd edition. Edinburgh, Churchill Livingstone, 2007, Chapter 18, pp 265-278
2. Murakami E, Tanaka Y, Aizawa T, Ishizuka M, Kokubun S: Effect of periarticular and intraarticular lidocaine injections for sacroiliac joint pain: Prospective comparative study.J of Ortho Science 12(3):274-280, May 2007
3. Fukushima M: Radiographic findings before and after manual therapy for acute neck pain. International Musculoskeletal Medicine, 30(1): 1-19, 2008