If you’re experiencing lower back pain, hip discomfort, or even issues like pelvic pain and incontinence, your sacroiliac (SI) joint could be playing a bigger role than you think. Often overlooked in favor of the lumbar spine or hip joints, the SI joint is a crucial link between your spine and pelvis. But how does it relate to your pelvic floor, and why should SI joint dysfunction lead you to consider pelvic floor physical therapy (PT)?
What Is the SI Joint?
The sacroiliac (SI) joint connects the sacrum (the triangular bone at the base of your spine) to the ilium (the large, wing-shaped bones of your pelvis). You have two SI joints, one on each side, and they play a vital role in transferring weight between your upper body and legs. They allow for slight movement, absorbing shock and providing stability.
When functioning properly, the SI joint supports healthy movement and alignment. However, dysfunction—whether from too much movement (hypermobility) or too little (hypomobility)—can lead to pain in the lower back, hips, buttocks, and even the groin.
The SI Joint and the Pelvic Floor: A Crucial Connection
The SI joint doesn’t work in isolation. It has a direct biomechanical and neuromuscular connection to the pelvic floor muscles, which support your bladder, bowel, and reproductive organs. Here’s how they interact:
- Shared Stability Function: The SI joint and pelvic floor muscles work together to stabilize your core and pelvis. Dysfunction in one often leads to compensation or weakness in the other.
- Nerve Overlap: The same nerves that supply the SI joint also affect the pelvic floor muscles. SI joint dysfunction can cause altered nerve signaling, leading to tightness, weakness, or pain in the pelvic floor.
- Impact on Pelvic Floor Dysfunction: If the SI joint is not moving properly, it can create an imbalance in the pelvis, leading to issues like pelvic pain, urinary urgency, or even constipation due to poor pelvic floor coordination.
Signs That SI Joint Dysfunction May Be Affecting Your Pelvic Floor
- Lower back or buttock pain that worsens with prolonged sitting or standing
- Hip or groin discomfort that doesn’t resolve with stretching
- Pelvic pain or pressure, especially during activities like walking, bending, or climbing stairs
- Urinary or bowel issues, such as urgency, leakage, or difficulty emptying completely
- Pain with intercourse or vaginal pain in women
If you have SI joint dysfunction and are experiencing any of these symptoms, it’s time to consider how your pelvic floor might be involved.
Why Pelvic Floor PT Can Help
Pelvic floor physical therapists don’t just treat incontinence and pelvic pain—they also assess how the entire pelvic region functions, including the SI joint. Here’s what they can do:
- Assess SI joint mobility and stability to determine if the joint is moving too much or too little
- Strengthen and retrain core and pelvic floor muscles to improve overall stability and reduce compensatory patterns
- Manual therapy techniques to release tension in overactive muscles or mobilize stiff joints
- Postural and movement retraining to ensure that your body is properly supporting your SI joint and pelvic floor function
If you’re dealing with persistent SI joint pain, don’t overlook the pelvic floor’s role in your discomfort. Dysfunction in one can directly impact the other, leading to chronic pain and pelvic health issues. A pelvic floor physical therapist can assess both areas and create a targeted treatment plan to restore balance, improve mobility, and reduce pain.
Have you been dealing with SI joint pain or unexplained pelvic symptoms? Consider reaching out to schedule a FREE discovery session to talk with one of our pelvic floor PT’s and see how we can help you!
