Sacroiliac Stretches

September 30, 2008

Summary

“The SI JOINT”

The sacroiliac joint is the area where the sacrum (sacral bone in the center of the upper buttocks) connects to the pelvis. While the sacroiliac joints don’t allow much motion, most people have at least a small measure of motion with normal lower body movement. One reason the sacroiliac joints can become irritated is through abnormal movement occurring on a repetitive basis.

Examples of this are sport-related activities where impact occurs through jumping and twisting. Other activities such as sitting for prolonged periods of time may also cause stiffening and microscopic damage to the surrounding muscle tissue.

The initial approach to treating sacroiliac joints is to support and protect the area, help the muscles to loosen up, lessen the pain, and minimize any inflammation. If injury has occurred, it is important to help accumulated scar tissue to loosen up. This will let the muscle regain its normal flexibility and lessen the chance of further injury.

While exercise is appropriate for breaking down scar tissue once the area has healed, it may further irritate the area during the initial stages. Therefore, other methods such as ultrasound, massage, and gentle adjustments may be safely used to accomplish this early on in the injury.

Muscular stretching can be a very important part of the healing process for tightened muscles of the back. It is essential to lengthen any shortened muscular tissue of the back to help prevent further pulling on the already shortened fibers. Muscular strengthening exercises will be important once the back irritation has subsided.

Back strengthening exercises help to build stability to weak tissue. It should be noted that irritated muscles can become further damaged with strengthening exercises that are premature to the healing of the area. The exercises below are general exercises to increase flexibility and can help to stabilize the back.

However, it should be noted that for most of these exercises, you should not feel the stretch in the back itself. For example, the back of the legs have a group of muscles called the hamstrings. These muscles originate in the lower pelvis and insert into the leg. When the hamstrings are tight, the back itself can be tightened due to the pulling on the pelvis. Therefore, stretching the hamstrings will not only loosen the leg muscles up but they will take the strain off the back.

The following back exercises should never be performed if they cause irritation to your back or any other condition while they are being performed! As each sacroiliac condition is different, always consult your doctor before performing any of these exercises to determine what exercises, if any, are right for your particular condition.

If you have any discomfort after performing any of these exercises, discontinue and immediately and consult a doctor to properly assess your situation.

Gluteus Stretch

Laying down on your back, bend your right knee, and place your left leg over the right leg, resting the outside of the left ankle slightly above the right knee. Place your right hand around the outside of your right thigh and place the left hand around the inside of your right thigh. Lock the two hands together. Now pull forward towards your chest to achieve a stretch in the left gluteus portion of your buttocks. Do the exact opposite to achieve a stretch of the right gluteus portion of the buttocks. Hold each stretch for a minimum of 30 seconds, any less than 15 seconds and the muscle will not conform to the new increase in length. Do 3 reps, 3-6 times a day. Any pain you feel with this exercise should only be a local stretching sensation to the back of your thigh and buttocks area, without aggravating your condition.

Piriformis Stretch

Laying down on your back, bend your right leg and pull up your right knee towards your opposite chest with your left hand. You should feel the stretch in the piriformis portion of the right buttocks. Do the exact opposite to achieve a stretch of the left piriformis portion of the buttocks. Hold each stretch for a minimum of 30 seconds, any less than 15 seconds and the muscle will not conform to the new increase in length. Do 3 reps, 3-6 times a day. Any pain you feel with this exercise should only be a local stretching sensation to the back of your thigh and buttocks area, without aggravating your condition.

Tensor Fascia Lata (TFL) Stretch

Start with stretching the TFL portion of the left hip and outside thigh. While standing, hold your left hand securely on a solid surface to support your body as you place your left leg past your right until you reach a maximum stretch. Follow this with tilting your upper back to the right side while simultaneously pushing the left side of the hip. Do the exact opposite to achieve a stretch of the right TFL portion of the hip and outside thigh. Hold each stretch for a minimum of 30 seconds, any less than 15 seconds and the muscle will not conform to the new increase in length. Do 3 reps, 3-6 times a day. Any pain you feel with this exercise should only be a local stretching sensation to the TFL portion of the hip and outside thigh, without aggravating your condition.

Calf Stretch

Start with stretching the right gastrocnemius portion of the right calf area. While standing, place your right leg in front of you and your left foot directly behind you. Place the toes of your right forefoot up against a door or other flat wall surface, keeping your heel down to the floor. Lean your upper body forward to place a stretch on the back of the calf. Do the exact opposite to achieve a stretch of the left calf area. Hold each stretch for a minimum of 30 seconds. Any less than 15 seconds and the muscle will not conform to the new increase in length. Do 3 reps, 3-6 times a day. Any pain you feel with this exercise should only be a local stretching sensation to the calf area of the leg, without aggravating your condition.

Psoas Stretch

Start with stretching the right psoas muscle. While standing, place your right leg in front of you and your left foot directly behind you as far as you can comfortably stretch it. Shift your lower body forward, while simultaneously pushing your upper body backwards with your arms. Do the exact opposite to achieve a stretch of the right psoas portion of your front upper thigh area. Hold each stretch for a minimum of 30 seconds. Any less than 15 seconds and the muscle will not conform to the new increase in length. Do 3 reps, 3-6 times a day. Any pain you feel with this exercise should only be a local stretching sensation to the psoas area of the upper thigh, without aggravating your condition.

Quadriceps Stretch

Start with stretching the left quadriceps muscle. While standing hold a solid surface for support and bend back your left leg. Grab your left ankle and pull that foot to your left buttocks while simultaneously pulling your left thigh backwards while keeping your back straight. Pulling your thigh backwards is a very important part of this stretch, as it will place the stretch in the mid-thigh instead of overloading the pressure on the knee. Do the exact opposite to achieve a stretch of the right psoas portion of your front upper thigh area. Hold each stretch for a minimum of 30 seconds. Any less than 15 seconds and the muscle will not conform to the new increase in length. Do 3 reps, 3-6 times a day. Any pain you feel with this exercise should only be a local stretching sensation to the quadriceps muscle area of the upper thigh, without aggravating your condition.

Regardless of the current situation your back is in, relaxing could be key to helping it heal. While meditation can always be useful for achieving this, yoga can at times be irritating if caution is not taken. Yoga is a series of slow movements combined with stretches and meditation to allow for an increase in flexibility and relaxation to the muscles and joints, as well as to help optimally integrate the connection between the mind and body. However, what might seem to be easy maneuvers should still be treated cautiously, as your individual situation may prohibit certain moves. One simple meditation practice is visualization… close your eyes and visualize yourself in the most happy and relaxing place you know of. Sometimes just taking the time to do this can be what you need to begin the healing process.

While walking is one of the overall best exercises for your health, the shoes you choose to stroll in may just be the difference between hurting your back and helping to keep it strong and loose. High heel shoes put your spine in extension, impacts the joints further when the vertebrae are already in a compressed state. Lack of shock absorption will further hurt the joints with every step you take. Shoes that contain proper arch support can help take the pressure off those tired feet and help with shock absorption. Shoes with pressurized air or other cushioning chambers are necessary to protect the spine during the much harder impact a person will experience during exercise.

During standing, a proper balance is needed between both hips to keep the back in correct alignment. When one leg is slightly longer, or the hip becomes fixated in a higher position, it may be necessary to supplement the lower side of the hips with a heel lift. When the spine is tilting to the lower hip side, a lift may allow the spine to realign properly, and thus take pressure off the back.

A good mattress will protect the back for the many hours that you are in bed. A mattress that properly supports the body will also be a very important element in helping relieve stress on the muscles and joints of the back. The most important information needed for finding a correct mattress to support the back involves knowing what position you sleep in.

Whether you sit for minutes or hours, you can’t underestimate the value of proper posture while sitting. It has been demonstrated that at times there can be as much as six times the amount of stress on your back when you sit than while laying down. Fortunately you can lower the amount of stress placed on the spine with proper back support. To accomplish this, first you must decide whether the chair you use presently is adequate for your needs. A good chair will be able to provide your lower back with proper lumbar pressure. This pressure will keep the curve of the spine in this area supported in the normal position. When a proper lumbar support is not provided with your chair, a lumbar cushion can accomplish this. The size of the cushion is very important, as too much lumbar support can compress and irritate the spine. A good working ergonomic type of chair can be adjusted to allow tilting and height control of the seat and chair back.

Here are some tips for adjusting your chair properly:

• Adjust the height of the chair to allow your feet to rest comfortably on the floor.

• Adjusting the tilt angle of the seat will change the position of your pelvis, thereby shifting the back towards or away from the seat back. Tilting the front of the seat downward will bring your lower back into extension and thus increase the lower lumbar curve. Tilting the front of the seat upward will bring your lower back into flexion and thus decrease your lumbar curve.

• Combine the seat angle tilt with the seat back tilt for optimal support of the back.

• If the seat back height can be adjusted, make sure the small of your back fits with the part of the seat back which curves outward to support the lower back.

• If these adjustments still do not support the spine properly, you will definitely need a lumbar cushion or more ergonomically correct chair. Lumbar cushions will need to have height adjustability to fit correctly. This is usually achieved with a strap that allows you to set the height of the cushion to the thickest part against the small of your back. Each person’s spine curves differently, so another important feature that some back support cushions provide is the ability to adjust the size of the lumbar thickness to customize the fit.