Hi folks I’m Bob Schrupp, physical therapist, Brad Heineck, physical therapist, together we are the most famous physical therapists on the Internet, in our opinion of course Adjust your posture Brad. Today we’re going to talk about sacroiliac pain everything you need to know to cure it We’re gonna basically talk about the anatomy, the causes, and then we’re gonna show you the exercises Yeah, this is a whole cornucopia Bob. This is gonna bring it all up I’m just gonna bring it all into one picture and you’re gonna have a good educational experience and have some success If you are new to our channel, please take a second to subscribe to us Please don’t make us beg, we provide videos on how to stay healthy, fit, pain free, and we upload everyday also But we will beg if you want Please go over to Facebook and “like” us so we don’t have to beg I distinctly remember as a child my mother would use the term sacroiliac And I don’t know if she really knew what it meant. I certainly did. I just thought it’s kind of a neat term Yeah, a lot of people use it They think I got sacroiliac pain cuz I have back pain, cuz a lot of times that’s right where it is, so let’s talk about where it is exactly here we’ve got Leopold our skeleton, but that’s not where it is We’re talking about down here in the sacrum, and then so that’s the sacral part, sacroiliac This is known as the ilium, this part of the pelvis, this big paddle shaped bone so it’s a joint right between the sacrum and the ilium sacroiliac. The sacrum is a triangle-shaped bone, and there’s a joint that it forms right with you So you’ve got two SI joints one on the right one on the left. Now if you can you zoom in on this close Don’t get Bob’s face in there because we don’t want to lose viewers. I’m out Okay, so if you look right here now this joint is not like an elbow joint or hip joint. It’s really quite solid. There’s actually some debate, does it actually move or not and that goes to the PhD level. But we’re gonna assume that there is some slight motion This is probably more than it would be. It’s got heavy ligaments that cover it up So it’s minimal, but it doesn’t take much to produce pain, so what we want to do is if this gets shifted Like this, or it can shift back, and we have to shift it forward. There you go, either way. It’s gonna rotate One way or another typically and there’s lots of PhDs discussing that, so if we show it from this side sometimes it gets rotated forward that way and sometimes it gets rotated back that way right so All right, so that pretty much covers the anatomy Bob, should we go on any further? No, let’s keep going. What are some of the causes, Brad? A common cause, like if you’re Walking across and use a curb or a sudden step down and you get that force going through your hip and that can jolt that SI joint and get it out of place. That’s one where you’re jumping off maybe the back of a pickup truck, anytime you get that sudden jerk Especially if it’s one foot, versus two feet, the landing at the same time. Trauma I’ve had people that are in a car accident, where they go forward and your knee goes into the dashboard And it puts a good jolt on that SI joint. A common one is women who are pregnant Because of the joint, the ligaments get laxed because of the hormones That’s a little bit different But you know this still could be used with that. Another one Brad is just sitting uneven. A lot of people sit on one side more than the other Or they cross their leg all the way the same time and that just puts a little bit of uneven pressure. If you do that year after year It can certainly cause things to be a little bit out of kilter That’s why we always talk about try to balance, posture, be upright, and yeah If you do something one way for a long time it’s good to correct it and maybe go the other way for a while So okay, common symptoms How do you know if this is back pain versus SI joint, it can be hard to tell. But some common things that we found over time is Typically SI joint pain will be in the back of a hip area, one side, usually one side and The pain typically it will refer down But not past the knee. If you’ve got pain all the way down to the foot, probably not SI Probably from the back here, which is interesting, but that’s a typical thing. I’ve seen pain in the groin from SI I see pain in the groin from a hip too But I think the pain with weight bearing is a common one, because when you’re walking you’re putting weight And if you remember what we talked about how that SI joint moves every time you walk, it can irritate that and get it to Shift a little bit up and down steps Walking or sometimes just standing and weight shifting. The problem is though you can get pain with weight bearing with a hip problem too, so that’s why it’s it almost takes a therapist to diagnose it But we’re going to show a couple tests you could try right Do that now okay Keep the video flowing. I know a couple comments that we babble on too much in our videos. Hard to believe it Okay, so if you lay down flat, supine, and not in a bed, better on a carpeted floor or a firm surface like this and We do the figure four so your ankle goes above the kneecap right on your thigh And then you let this knee drop down, and then we could put a little over pressure Yeah, and like as a therapist I actually put my hand on his pelvis and here and I do it that way to give a little cranking on there But you could do it yourself to see if it brings it on. Support here and here, and it doesn’t take much pressure. So even Bob as a therapist, he’s gently pushing here It’s just a little bit, you gotta get the leverage. He formed The number four right Yeah, we better get on with it. Okay, so we do this now what you’re looking for is the pain that you are experiencing, that’s bothering you. Now this could create a pain in the hip from a different source But we’re looking at the pain that doesn’t recreate your pain, the pain that you’ve been worried about if you go Oh god that feels just like the pain that is bothering me, then you know you’re right on You can do it on both sides now Just real quickly yeah, and then what’s the next one Brad? Compare one side to the other Yeah, I like to do this, this one you could do on a bed where you’re gonna Let this leg come off, make sure you don’t fall off, keep the shoulders way on. So I’m here. I’m being safe, and I’m gonna pull this and that’s gonna put a little torsion rotation on those SI joints and if I do this and I feel that same pain that we’re trying to get rid of And I pull this I say oh this is the same pain and you do that Then you know there’s a very good possibility that it is that SI pain You’ll want to do it on both sides. You don’t need to show it Brad, but you’ll want to test both sides All right And then the last one Brad is just a real simple test here Where you’re gonna need somebody else to help you out here And they’re gonna put their hand right about where the belt is cuz that’s usually where the ilium is and they’re gonna push on this and If that recreates your pain in the back here, this thing really shouldn’t hurt back pain. This would be something that would be pretty specific for a sacroiliac problem sure. And Bob’s not pushing real hard It’s just a gentle firm pressure. Now if you have a positive test on all three of these it may be a stronger indication that it is SI, not a 100% But stronger, the more that are positive, the more indication it is. Now the big thing is go right to the treatments and the treatment when you do it We got three of them, my favorite ones And I think Bob likes these as well. When you do these it should reduce the pain while you’re doing it And then when you’re done, it should feel better as well for the next hour. Double bonus. This is one I call I learned this one in PT school I’ve been doing it ever since, been supported by some continuing ed courses But see I’m gonna bring my right knee up I’m gonna grab my knee here around and support it, when my arm’s real strong. I’m gonna do an isometric push this direction It’s called a muscle energy technique in the therapy world He’s pushing, if his arm wasn’t there, the leg would actually go that way Yeah, so I’m gonna restrict that motion, lock that knee in, and I’m gonna push It doesn’t have to be a push as hard as you can But you’re gonna put pressure on there and while you’re doing that like oh that feels kind of good and when you get done It’s like oh that feels good, and then you’re gonna repeat that three to five times And if you get positive results that feels good, you’re gonna do that every hour And it won’t be too long and your pains are gonna be gone And now it’s possible like if the pain is on this side and that doesn’t feel better You might try it on the other side, this side might actually make this side feel better Yep, so you want to try it on both sides because it’s depending on which way your sacrum or ilium needs to be returned Okay, all right next one Brad You want a pillow yeah, I want a pillow You don’t need a pillow if you got carpeted floor, It’s not necessary, but this is a hard linoleum floor and It’s the tile I mean I want to protect my knee now. I’m going to stretch it I’m gonna be up tall like this not over like this And then I’m gonna bring this hip forward And that’s gonna Rotate that pelvis in this direction as you see my hand going, you can put your hand back here and push and again Just like I mentioned. It should feel good while you’re doing it Bob. Yeah, it’s like Oh boy, that feels like the right direction. It. Just feels like a good stretch. This one doesn’t work for me Cuz I know I’ve got some SI issues The next one is my favorite that works great for me if I throw it out when I go for a walk Or a run, and again you could do it on both sides, both legs again I’m not gonna do it because of the time issue Stool? I like a stool at home. I actually do it on my stairs outside cuz it’s the right height but I need something about this height and I’ll put my foot up on there and if you’re gonna do this you have to be stable, either something to hold on to or feel very stable you Should feel relaxed while you’re doing this. If you feel like your balance is off don’t even try it. You should be very stable, I’m gonna use this for some balance here, and I’m just gonna drop down and Even right now this feels great for me. I do this stretch Just because it feels good, but when I do have some back pain I’ll do this. It feels better while I’m doing it and I can walk around and it feels better. I’ve never seen that one before Brad I learned something today – it looks like a good one I was just going through it, yeah it’s turning it And quite often that is the way it needs to be turned Sometimes it needs to go the other way, but then again you might be again Sometimes if the pain’s over on this side it actually might help to do it on this side on the opposite side because it’s which way it needs to be turned so there you go That’s it I said, this is the cornucopia, this is it in a nutshell This is what we have to present, so good luck with your SI pain, and I think it’s gonna work well Thanks for watching You

90 thoughts on “Sacroiliac Joint Pain: Everything You Need to Know To Cure.”

  1. Hey guys… I have pain in my low right back… squats and deadlifts seem to trigger it… at certain angles it seems to trigger it, and starts to spasm.
    Same spot every time.

    Does that sound like a muscle issue or joint/disc?

  2. your videos are excellent i have learned to do many exercises by watching you and your partner brad and it has helped me with chronic neck and back pain thank you and I want to see more of your videos ?

  3. You guys are the best! I had some major SI issues not long ago, but I am steadily recovering and not backsliding despite increasing my activity (yay!). Some ppl might find it useful to know that their sleeping situation might cause/worsen SI joint pain. My pain went from being a small bother here and there (with some moderate flare-ups) to being a major issue after I changed mattresses. I used to sleep on a very firm mattress on the floor, and then I changed to a squishy mattress on a regular bed frame. Also, the mattress was older and seemed a bit sunken in the middle (so I was essentially crooked all night). I began sleeping on the floor (on a camping pad over hardwood flooring) this past summer, and I have felt better and better. No more mattresses for me!

  4. I have this problem after having 9 kids. I am very fit which helps but when this hurts it is awful. I think strengthening your hips with exercises helps tighten things up.

  5. I can't believe the timing of this video! Right now I have pain in the sacroiliac area for which I have seen a physiotherapist. Ligament strain which resulted in pain on the left side, which radiated down the back of my leg. Happened through bad posture maintained for a period of time while drumming (African djembe). Thank you so much!

  6. I was using the first technique and I felt relief, but when I would lower my leg I felt and heard a popping sound in my hip and then my butt muscles will begin to twitch. They only happen to my left leg which also is the leg that hurts. I was wondering what that could be and if I should be concerned. Thank you guys for your many videos! I have problems with sciatica and a big one that helps me is standing offset from a wall and then meeting my hip to the wall! Thank you guys!

  7. I started with S I pain after my first born 30 odd years ago. It comes back periodically and I see my Physiotherapist but I will try these exercises they look great. Thank you, your videos are excellent. Keep them coming

  8. Please don't let the trolls dictate how you do your videos. If they don't like your examples and anecdotes they should go elsewhere. I appreciate the opportunity to learn as much as possible.

  9. guys i really really need to know how to help my lower legs after i stand and walk all day.when i go home and sit down my lower legs throb and ache with pain.please help.thank you love u guys! ??‍♀️

  10. Perfect timing for this video. My SI has been acting up for a few days now. Just completed 1 set of these stretches and I already feel relief. Thank you both.

  11. Thank you for this video! It was exactly what I needed! You two are great, along with all the others who help create your videos. Many blessings to you all!

  12. Thank you so much for your great videos. I have a question. I have Chronic Lymphedemia in my torso and legs, I've trapped a nerve in my back which causes my left foot to go semi numb on the sole when I lie down. Are there any exercises I can do to help?

  13. How about running over a curve or or other items on the road. I get this pain when I run on the street vice the trail. It’s awful.

  14. Hi Guys, great videos … thank you! I have an issue that is not the result of trauma. It started after playing drums for the first time in a while about two months ago. The groin pain started immediately, bit has spread over time. My pain is located in the groin, inner thigh, hip and butt cheek of my right leg. The stretches in this video have not alleviated the problem. I visited my chiropractor twice earlier this week but the pain has increased in intensity, after heat packs, electrical stimulation and adjustment of the hip area. I haven't found any of your videos dealing with this type of pain. Medications are not resolving it. Did I miss a video you have previously done that addresses this type of injury? Please help!

  15. Awesome videos. I’ve had numerous experiences with professionals diagnosing my lower back pain as a rectus femoris or psoas issue. Been doing these exercises for some time now with great success and reductions in pain. You definitely have my subscription.

  16. Ya'll are so helpful. I did some of your hip arthritis stretches and finally got some relief after 5 years. Any advice for a psoriatic arthritis patient? Mine is in my SI, lower back, right knee and right ankle with both Achilles tendons inflamed at times.

  17. Just want to say “ you two rock…You are the best at explaining with a sense of humour exactly what to do for pain and the cause of it..I have been in pain for two and half years..and it is not plaisant .. keep the videos coming with info,, we love them.. thank you for your compassion and great advise..❤️

  18. Have you considered Facebook live so we can ask questions. Great videos. Thanks. And like that they are short but get a mic.

  19. What are your feelings on use of gravity chairs would that help or hinder back strengthening or helping fix si issues?

  20. I have lower back/one side hip pain after standing for a short period of time say 10 mins and its only relieved either by sitting or lifting the affected knee up. It feels like I need the SI joint cracking just to relieve the pressure! Sometimes a sciatica type pain happens when I'm in bed or sitting. What do I have?!

  21. Guys! I thought you were chiropractors! Now I see you are PTs, phew! I am dying to get rid of my SI joint pain which is incapacitating. Went to PT twice for 2 months, it got better, and now it's back to boot camp. They didn't teach me what you show. Keep up the great work! Thank you!

  22. In your test where where you are lying on a bench or bed, with the one leg over the side of the bed, and pointing towards the floor, the bed, is the sacroiliac joint, of the leg pointing towards the floor, being moved forward or backward?

  23. I have RA and Fibromyalgia. My SI joints throb constantly. Right side more than left. Also have bursitis in the right hip. I have had SI joint injections, facet injections, hip injections you name it. I am worried about the steroids having long term effects on me but they do give me great relief. I have been trying more healthy ways to reduce pain and improve my near zero flexibility. Thank you so much for your videos!!!! They help us so much. Between this, meditation, deep breathing, and my regular doctor visits including massage therapy, hopefully me and others like myself can manage the pain!

  24. Hi, Bob and Brad thanks for sharing the video. I get pain specifically in the two si joints when sitting or bending, but not for the rest of my back. Going into a posterior pelvic tilt helps with the pain as well. When I did those tests it did not cause me pain and I was wondering if you think that these stretches could still help with my type of si joint pain.

  25. If you don’t have a reaction from these tests, but it hurts to step down suddenly on a step, say, and to pull yourself up out of the seat of a car, and at random times with even slight twisting and bending, and there isn’t really any radiating pain – then what is the likely cause? I feel like I have developed a chronic weak, twinge-prone back that I’m masking as much as I can by keeping my abs tight… but this is twinginess that doesn’t completely go to that awful place where you’re walking crookedly from a pinched nerve (used to get those), and on the other hand doesn’t ever resolve anymore. It’s very frustrating! Thanks for any advice you can offer. My PT was stumped because I don’t have dramatic pain bending forward or backwards… I guess whatever I have was beyond his diagnostic abilities.

  26. This is the pain i am having! I had an incident where I jumped on an uneven trampoline at a party and it caused a back pain. I did see a clinic and they couldnt figureout the problem. They proscribed muscle relaxants. It helped to recover. But about 6months later (current day 7/21/18) it came back after sleeping wrong. There is a pain from my lower back but mainly the pain feels like Sciatic Nerve pinch. Whenever I motion my right leg the pain is where it stiffens the nerve or shoots pain down through the nerve. My foot becomes numb and cold. I can barely get up out of bed or stand for long periods of time. Sitting is even worst.

  27. I’m 22 years old and I have some lower back pain and I figured I got it while at the gym. I performed one of these exercises and it immediately helped so I will be trying the rest! Thank you guys! Thumbs up for sure ??

  28. Okay, so I had to come back to offer my sincere appreciation for this gem of a video presentation. I have been suffering from SI pain since 2015 I assume from my sedentary lifestyle. I used to shift my weight to one side causing the pain to manifest on my right side. Recent x-rays show inflammation in that area and now I finally know what my pain actually is. Seeking for relief I stumbled upon this video and tried the exercises and wow, I am just completely elated. I started feeling better immediately. Thank you, thank you, thank you. These three exercises are going to be the mainstay of my stretching routine for years to come.

  29. Thank you gentleman?Truly educational. I thought I had muscle issues, but it's SO joint for sure. I pulled my muscle connected to my ischium, on the left in 2001 and I've been compensating by sitting on my right leg for years. Incredible it took this long for it to finally give out. Although, I have done various forms of stretches over the years and self massage. (I'm a massage therapist). Thanks so much gentlemen, I will add your suggested stretches to my arsenal. Blessings #HumanRace

  30. Dang it. Thought this might be it however my pain goes from the hip through the hamstring past the knees into the calves and it is on both sides.
    Keep on hunting i guess.
    Still will try these exercises

  31. The exercise at 9:58 I tried that today at work, after being in pain for nearly 3 years. I heard a loud crack or pop, stood up and the pain was gone. Right now, though, it's kind of returned, but j think if I keep doing that exercise there's a good chance it might go forever. Thank you!

  32. I'm desperate and seen so many doctors…I can't afford this crap in so many ways. I've done chiropractic, neurologist…nerve ablation( no real help) and I sit so much because I hurt to much to stand and I try the pt…but i never seem to get improvement. No nerve pain. I've done the tests y'all show…gotten positive results for sacroiliac pain, but treatment doesn't help…of course i it's so expensive it's hard to do what I need to get better. Here's something I've been asking doctors without answer. I used to be able to do a back been no problem, now i stand and start to go back and can barely go back 30° it hurts SO MUCH WORSE and it feels like I'm hitting a door stopper…it just hits A BLOCK and there's no way i can go further back.

  33. I have problem when i sit . It not too much like abnormal thing .it is when i sit just direct below the hip
    Wat is this And solutions plz

  34. You guys are a life saver for real. Not only my own but others around me are safer because I was becoming s time home ready to explode from the years of constant pain and people around me not getting it and thinking I was over exaggerating it because I am young and look younger people think I shouldn’t be in that type of pain. Thank you from the bottom of my heart and and soul that you have helped me regain. I was becoming a heartless person who cared for no one.

  35. I enjoy the videos and they are very helpful in understanding and diagnosing the cause of some of my pain and alignment issues.
    My left SI has rotated forward causing my left leg to be extended and my left hip to move up and to the left causing my upper body to be tilted to the right.
    With the pain I believe it is an SI Joint issue, so could you tell me which exercises would help me ROTATE MY left Hip BACK in-place to correct my posture, get my left leg back in place and my upper body up straight again.
    thank you again for all the info…..

  36. Thank you so much!!!! I am a Hairdresser – my back pain is the WORST!!!! This explains everything to me … I will try the stretches, lets hope they work i am at my wits end with it … thank you 🙂

  37. I think i may have sj pain but i dont have any pain that goes down my leg at all. its just in the one specific spot could it still be sj pain?

  38. I've had SI pain for about a week now and it has been preventing me from doing my work as even sitting for more than 10 minutes produces pain. I just watched the video while massaging cbd balm on my back and then did two of the 3 exercises when finished and the pain when back at my desk has reduced by at least 40%. Thanks

  39. Question….is it a hip flexibility issue when one knee is more naturally lower than the other when performing that figure 4? One hip feels looser than the other…

  40. I went to urgent care for this pain it’s really really bad. I can’t get out of bed in the morning and am literally bedridden. At urgent care they gave me a torodol shot and prescribed me some torodol pills. They do help once they kick in and I can move around a tiny bit better but not nearly enough. I still cant walk without crutches is there anything else I can do for this pain? Should I call my primary doctor?

  41. My wife says I babble too much as well. But you guys are funny so I like the babbling, it gives your channel a good overall character. I enjoy the delivery of the info lol it's great

  42. What is the NAME of the stretch you did when you put your leg up on the stool? It was towards the end of the video.

  43. Your videos are great! People that don’t want the education along with the exercises can look up so other video. Knowing the why to the what is just as important, if not, more.

  44. @physicaltherapyvideo (Bob & Brad), is there a potential issue with doing an SI stretch on the wrong side? Or is it okay to be symmetrical about it by alternating and doing both sides equally? Would sense of pain vs relief indicate how that would be decided? Thanks for the great video!

  45. Wow, thanks!! Now I know what to call the horrible pain I've been having. And now I have something I can do about it!!!

  46. So much valuable information in all of your videos and yes I did subscribe haha , thanks guys I appreciate you making these videos and I love how you break it down for someone who isn't a medical professional to understand!!

  47. My pain seems to feel like it is right on the sacrum or just to one or the other side of it. Nothing radiates anywhere else.

  48. When I take a walk , It starts off fine , 1/4 of the way down the block I'll get pain on both hips or upper legs , Not high up on hips but lower down, Kind of gets worse as I go. I stop for a moment and it does not stop. I found out that when I climbed the stairs to post office, The pain stopped completely and immediately This happens a lot. Am I out of alignment or is it bursitis. Remember both sides same time and tender to touch high on leg in the area where my palms lays flat on both sides.

Leave a Reply

Your email address will not be published. Required fields are marked *