What is SI Dysfunction? How can Physical Therapy Help?

What is the SI Joint?

  • Sacroiliac joint
  • Lies at the bottom of the lumbar spine and above the coccyx (tailbone).  It connects the sacrum with the pelvis.  SI joints are strong and have very tight, strong ligaments connecting the bony surfaces.

What is the function of the SI Joint?

  • Acts as a shock absorber for the pelvis and low back.
  • It has minimal motion compared to other joints.
  • Transmits forces from the upper body down the pelvis and legs.

Why do I get pain at my SI joint?

  • Pain happens when the SI joint moves too much or too little.
  • Direct strain or trauma to the SI joint ligaments.
  • A fall on the buttox or mis-stepping a descending step.


  • Can be difficult to diagnose because the symptoms can be diffuse and can mimic other common low back and hip injuries.
  • Assessing pelvic alignment, leg length, and palpating bony landmarks may help determine whether this joint is involved.
  • More advanced diagnostic tests like MRI, X-ray, CT scan can help with diagnosis but can also miss the correct diagnosis.


  • Physical therapy can be very helpful with conservative management of SI joint dysfunction.
  • Assess pelvic alignment and use techniques to correct alignment.
  • Stretches to help with pain and lack of mobility.
  • Dry needling, massage, and heat can help with muscle spasms.
  • Ice can help with inflammation and irritation surrounding the SI joint.
  • Strengthening exercises to the applicable hip and core musculature will be given to help stabilize and normalize the proper pelvic alignment.