Pelvic floor dysfunction is a dysfunction in the pelvis with many presentations, one of which being saco-iliac joint pain and dysfunction. In this blog, we’ll explore the basics of the sacroiliac joint, identify symptoms associated with SI joint pain, discuss potential causes, and see the connection between the SI joint and pelvic floor dysfunction.

Where Is Sacroiliac Joint?

The sacroiliac joint is on the back of the pelvis, connecting the sacrum (the triangular bone at the base of the spine) to the ilium (the wing-shaped bone on either side of the pelvis). It transfers forces between the upper body and the legs, is directly involved in movement, and provides trunk stability.

Pelvis bones

What Are The Symptoms Of Sacroiliac Joint Dysfunction?

You don’t have to be old to experience Saco-Iliac joint dysfunction. Simple injuries like skateboarding, cycling, skiing, surfing or accidents like auto accidents, or even traumatic pregnancy and childbirth are simple, mundane occurrences that we write off as no big deal! Symptoms associated with sacroiliac joint dysfunction may be:

  • Pain:

Pain in the back of the pelvis that can be achy generally. It can go down the leg mimicking Sciatica.

  • Stiffness:

Stiffness in the lower back and pelvis can make it hard to perform everyday activities like standing up, sitting, or walking. Bear in mind that other issues can also have similar symptoms.

  • Instability:

If there is a feeling of¬† “giving way” when walking or trying to get up, you may have sacroiliac joint dysfunction.

  • Pain during Movement:

Activities like climbing stairs, running, or getting out of bed might exacerbate SI joint pain.

  • Painful Sitting:

Prolonged sitting can intensify SI joint discomfort, leading to aches and pain. Once again, the sacroiliac joint is not always the culprit but may be the cause.

What Causes Sacroiliac Joint Pain?

One of the most commonly treated areas in my practice is the sacroiliac joint. It is the base of your torso, it is where the lower extremities are connected and it directly impacts the integrity of the pelvis and pelvic floor dysfunction. I see patients with hypermobility, non-bendy individuals, and people of all genders and ages. The most common causes of sacroiliac joint pain are:

  • Trauma Or Injury:

A fall, impact, or sudden force to the pelvis can result in SI joint dysfunction and pain. This can happen to anyone and at any age.

  • Pregnancy:

The hormonal changes during pregnancy can affect the ligaments supporting the SI joint, leading to instability and pain. The sheer increase in size of the abdomen as the baby grows automatically puts quite a bit of stress on this joint and conditions such as hypermobility along with the increased hormones and pregnancy complicate the matter even more.

  • Arthritis:

Inflammatory conditions such as ankylosing spondylitis or osteoarthritis can contribute to SI joint pain. Please understand that the most common arthritis is osteoarthritis which is from wear and tear. Blaming the age for it is far from the truth given that the misuse of joints can start early on and with how sedentary our society has become, seeing arthritic changes in people in their 20s and 30s is not uncommon.

  • Leg Length Discrepancy:

An inequality in leg length can disrupt the biomechanics of the pelvis, potentially causing SI joint problems. This goes with both functional and anatomical leg length inequality.

  • Degeneration:

Over time, wear and tear on the SI joint, can contribute to pain and dysfunction. Degeneration happens as a result of dysfunctional patterns of movement. For instance, with so much sitting, we live most of our days not using our legs; the legs, when used do not have a history of ‘working’ with the rest of the body, muscles are tight and weak and their performance decreases. Their lack of proper biomechanics means the connection to the pelvis is compromised which creates instability in the SI joint and pelvis. How can the floor of the pelvis be strong when the ‘house’ is unstable?

How Are Sacroiliac Joint And Pelvic Floor Dysfunction Related?

The pelvic floor refers to a group of muscles, ligaments, and connective tissues that support the organs in the pelvic region, including the bladder, uterus, prostate, ovaries, and rectum. The pelvic floor is not suspended in air but connected to the walls of the pelvis and the pelvis consists of 2 bones, ilium and sacrum forming the Sacroiliac joints. Anything that makes the pelvis unstable, jeopardizes the SI joints and leads to pelvic floor dysfunction. There is no other way to look at it even though pelvic floor dysfunction can have many symptoms. These symptoms are described in detail in my blog.

The SI joint decline impacts the pelvis by one or more of the following paths:

  • Muscle Imbalances:

SI joint dysfunction can lead to muscle imbalances in the pelvic region, affecting the pelvic floor muscles and the muscles of the walls of the pelvis. This can show up in so many different ways as outlined in my blog.

  • Nerve Irritation:

The SI joint is close to nerves that innervate the pelvic floor. Irritation or inflammation in the SI joint can affect these nerves, potentially leading to pelvic floor dysfunction. My blog on Pudendal Neuralgia explores some of the symptoms of this commonly affected nerve.

  • Altered Biomechanics:

Changes in the alignment and movement of the pelvis due to SI joint dysfunction can alter the biomechanics of the pelvis, influencing its function and contributing to dysfunction. How can you have a stable ‘floor’ when the ‘house’ is unstable?

How Is Sacroiliac Joint Related To Pelvic Floor Dysfunction?

If you have chronic sacroiliac joint pain, you do have pelvic floor dysfunction! This is a bold statement and I stand strong by it because once you know how the symptoms of pelvic floor dysfunction vary and how incontinence is not necessarily present in all cases of pelvic floor dysfunction, then you realize that looking at the pelvis and pelvic floor dysfunction as early as possible, will save you a lot of time and distress.

If you have sacroiliac joint dysfunction, or pelvic floor dysfunction and are not happy with the results you are getting or are ready to start treatment, don’t hesitate to contact me.

Recommended Reading:

Who Diagnoses and Treats Pudendal Neuralgia?

Who Treats Pelvic Floor Dysfunction?