Sacroiliac joint pain

Sacroiliac joint pain is the single most common type of low back pain that I encounter at work.


Your sacro-iliac joint is the joint between the big triangular shaped bone at the bottom of your spine, the sacrum, and the two other bones of the pelvis, the ilia.

Big Joint Small Movement

It is the largest joint of the spine. It has a small but very significant amount of movement.


Pain in the sacro-iliac joints, is usually caused by the pelvic bones (ilia), being out of alignment with the spine (sacrum).


Realign the pevis and spine and the pain usually disappears. For most people it is that simple. The trick is then to keep it that way, and that can usually be acheived with doing the right stretches.


Typically, this pain is felt as sharp, anywhere from mild to debilitating. It is off to one side or the other, usually the left and sometimes both. It is well localised, the pain is specific, not vague or hard to locate. People will typically point to it with one finger. Sacro-iliac pain is often associated with leg pain. When it is bad it may give rise to sciatica, a line of pain down the back of the leg.

Far more often, it triggers pain down the side of the leg, along the ilio-tibial band (ITB). This pain may also continue down the outside of the lower leg. Sometimes there is no pain in the ITB until it gets touched or pressed, when it can be really sore. This is tenderness – it only hurts when you touch it.

The ITB arises from the outside top part of the ilium, a small muscle at the front of your hip, tensor facia latae, and the biggest most superficial muscle of your butt (and heaviest muscle in your body), gluteus maximus. It travels down the outside of the thigh on top of the outer muscle of the quads, vastus lateralis, and inserts into the tibia, the large bone of the lower leg.

While sacro-iliac pain may be bad, even debilitating, it is usually a far better pain to have than that of a prolapsed disc. Sacro-iliac pain is usually easy to treat with physical therapy and stretches, whereas a prolapse means there is damage, will take longer to get better and may even require surgery to fix.

If you think you have sacro-iliac pain, there are a few things you can do. The first is to address your stiff joints, misaligned pelvis and tight muscles, with stretching.

Your pelvic misalignment is most likey being caused by tight, unbalanced calf muscles. I see this over and over, every day I’m at work. It’s a part of the Typical Strain Pattern that most of the people that I treat have.

In this pattern, the calves are tight and tender. The right is worse. Everyone is suprised how much their calves hurt when I press them, because they don’t hurt to walk around on.

The tighter a muscle is the more tender it will be when you press it. There are 2 main muscles in your calf. Gastroc and soleus. Gastroc crosses the knee and the ankle joints. If it is chronically tight it will cause a chronic bend in your knee, that you won’t even notice. This chronic tension and bend will cause your pelvis to roll forward and down on the right.

But don’t take my word for it. Stand up and bend your right knee. What happens to your pelvis? That is exactly the pelvic imbalance I am talking about. The one may well be causing or contributing to your sacro-iliac pain.

The single best way to address this pelvic strain is to address the cause and stretch your calves. Frequently. Like every hour or 2 to start with. When you stretch, start and finish on the tighter side, most likely the right calf. There are many ways to strech your calves that I go into, in depth on my App. My favourite is the Calf Step Stretch.

The other single best way to address pelvic strain is from the top down by twisting your spine. You can do this lying, sitting or standing. Of course I cover all of these on the App. The easiest way to do this is the Knee Drop Twist.