hey everybody it's doctor Jo and mr. spider bear, and today I'm going to show you my
top seven treatments for SI joint pain. so let's get started.
so the first thing that I like to do with SI joint pain is to do some muscle
energy techniques and that's MET for short. and basically what you're doing is
you're using your muscles to get everything back into place. so if your SI
joint is out of place, this is what you would want to do. now don't ask me which
one is out because I can't tell without getting to evaluate you, you need to have
your doctor or physical therapist tell you what side is rotated. if it's an
anterior rotation or if it's a posterior rotation. so what you're gonna do is if
it's let's say a posterior rotation on my left leg here, then you're gonna bring
your left leg up and then you're going to put your hands on your leg here.
you're gonna have the other one down. you can put a little roll underneath if you
want to as a target, but you don't have to. and so what you're gonna do basically
is use your hip flexors on this side, your hamstrings on the other side to
kind of rotate it back into place. so if I'm this way, I'm using those hip flexors
to rotate it back. so I'm gonna put my hands here and what I'm doing is I'm
pushing up this way and pushing down into the floor here at the same time. I'm
pushing as hard as I comfortably can for about five seconds. so you're not going
anywhere you're pushing into your hands and down into the floor for about that
five seconds hard as you comfortably can and relax. so again make sure you know
which way it's rotated because you only want to do the one side that's rotating.
you don't want to alternate back and forth. that's why it's really important
for this one to know, so if you don't know go ahead and skip this one and then
go on to the other one. so you want to do that three to five times for five
seconds pushing as hard as you comfortably can up this way down that
way. so then the next one is what we call a shotgun technique. so with the shotguns,
you're gonna start off with getting a belt or a strap, but you want it to be
something tight. so this is not those resistive bands. you want it
to be something that doesn't give. and you're just going to take that belt and
put it on your thighs just above your knee. and so while I'm putting this on I
want to take a second to thank my channel members on YouTube. and so if I
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link below. alright so once you get this on, you're going to get back into this
position. and now you're pushing out into the belt. so it's almost like you're
opening up like a clamshell or butterfly. so I'm pushing out this way
with both legs. so it's almost like I'm trying to drop them flat and I'm pushing
into that belt as hard as I comfortably can. again for about that five seconds and
then relax. now sometimes if your SI joint is out of alignment a little bit, you
might feel a little pop with this shotgun technique. as long as it's a pop
and then it goes away, that's probably just that joint popping back into place.
so that's completely normal. so again pushing out this way both sides push
push push hard as you comfortably can for about that five seconds, and do that
3 to 5 times. so then the second part of the shotgun technique is now we're just
going to go the other way. so now when you're squeezing in, you can use a
basketball, soccer ball, something again firm and solid. if you don't have
something like this, you can use a pillow, but you want it to be pretty big where
your knees are kind of still about shoulder width apart. the exact distance
doesn't have to be that much, but you don't want to use like a little lacrosse
ball or tennis ball, you want to be something fairly big. and so now this
time you're pushing into the ball you're squeezing that same thing that five
seconds hard as you comfortably can. most of time when I do this with people the
the squeezing in is the one where they feel a pop if they're going to feel it.
you're not always going to feel it, but if you do,
you a lot of times because this is opening up that joint now and I'm
pushing in it's fanning that pelvic area out, and sometimes you get a little pop.
completely normal as long as maybe it's just a little bit
of pain and then it goes away immediately.
so again five seconds, big push as hard as you comfortably can, and then relax.
and do that three to five times. so then the next one you're gonna lie on your
side with the side that's uncomfortable up on top. so now let's say it's on my
right side just so I can look at you while I'm talking. so I'm going to lie
down kind of get in a comfortable position. I might prop up throughout this
just so I can see you a little bit better, but make sure you're comfortable.
so if you need to lie all the way down, make sure you're comfortable while
you're doing it. so this is kind of a weird technique, but it usually works
pretty well. so you're gonna feel back behind you where your SI joint is where
that SI joint is. it's basically where the spine are that sacrum comes into the
pelvis or that ilium, so sacroiliac joint. and is it's usually if you look at
someone's back where they it looks like they have little dimples on the low part
of their back, that's where that SI joint is. you can usually feel it it's kind of
a little knot back there and that's what I want you to take your thumb and just
push into that joint. so you're going to give it a little pressure there like
you're just trying to push it inwards. so while you're pushing inwards you're
going to take that top leg bring that hip up kind of into flexion and drop it
on the floor in front of you. you can do this on the bed too if you can't get
down on the floor that's fine. you can do these on your bed, or on a couch, so after
you come into this position you're gonna come up, kick the leg out behind you, and
then drop down. now the key is try to be pushing into that SI joint the whole
time. and so by doing this movement again sometimes it helps it just kind of pop
back into place. so just repeat this a couple times .so now I'm going to come up
and then bring that knee up and bring it down. so just nice smooth motions but
always kind of come up, kick it out, and then drop it down. don't just come back
and forth like this because that's going to irritate your IT band. so make sure
when you come back up you're lifting up bending
up that knee, dropping down, up, kick out behind you, and then come back down. so I
would just say you know maybe do about five of these. you don't have to you know
go too crazy with it. you can do five maybe two sets of five a
couple times a day throughout the day just to kind of give that thing nice and
loosened up. so then the next one is going to be a hip flexor stretch. I
usually like doing a hip flexor stretch kind of in the lunge position. if you're
stretching out your hip flexors because sometimes it's tight on one side and
then weak on the other side, so you want to get them nice and stretched out. so
when you get into the lunge position for the hip flexor stretch, I like
putting a pillow underneath my knee just because it protects it a little bit. so
especially if you're on a harder surface make sure you put something under there.
so the the side you want to stretch is going to be the one that's down. so that
my left side is the one that I want to stretch that for that hip flexor. put
your other foot a little bit further out in front of you, and the goal with this
to get the best stretch is keep your upper body straight. so I'm not bending
forward like this. I'm getting no stretch in my hip flexor right now because it's
still kind of straight through there, so I want to keep this upright and then
launch my whole body forward. and I should feel that stretch right through
there. so if that hip flexor is tight and it's pulling on that joint to rotate it
forward, then I'm getting it nice and stretched out. so since this is a stretch,
you want to hold that stretch for thirty Seconds, come back, and do that a total of
three times. now you can do both sides, you probably really want to focus on the
side that's tight, but I always like to stretch both sides if you can just to
keep everything balanced. so then after you stretch out the hip flexors, then you
want to stretch out the hamstrings in the back because it's the same thing, if
you have a tight hamstring on one side is going to then be pulling it into that
posterior rotation. so there's a whole bunch of different ways to stretch your
hamstrings, I'm going to show you standing up. so for the hamstring stretch
standing up, I like it because it's really easy to do. you can do it anywhere.
just take the side that you want to stretch and kind of prop it out in front
of you. just prop up your heel like this. now if you have a little bit of balance
issues make sure you're holding on to something
while you're stretching so you can focus on the stretch and not your balance.
making sure you're bending at your hips and try and keep your back fairly
straight because if I'm just curling down like this, I'm not really getting
much of a hamstring stretch. I want to keep that back straight and kind of
hinge and my hips to get that stretch. yeah I'm getting much more of a stretch
here than when I was going all the way down touching my toes. so again since
this is a stretch, you want to hold it for 30 seconds. you should feel it kind
of through here and then do that a total of three times. so again switching both
sides just to kind of keep yourself balanced three times on each side. I like
to alternate back and forth. if you wanna do them all on one side you can. so to
finish up I'm going to show you a couple exercises once you kind of get
everything nice and stretched out, hopefully get it back into alignment, you
really want to then do some exercises. so the first one of the exercises is a hip
hike. and so with hip hikes it's kind of just how it sounds. you can do it on a
step to give you more of a hike, but when you're starting off I think it's better
just to do it standing on the floor because with the step you're going to
get more of a motion. so really what you're doing is just trying to hike up
your hip. so I usually just put my leg slightly out in front of me and then
what I'm doing is I'm just hiking that hip. so this one's coming up, but I'm also
working this one. so you're really working both sides in different ways.
this is an open chain kind of bringing it up here working that side, and this is
a closed chain. so I've heard people kind of argue the hip hikes what side are you
working, I really think you're working both sides. so this one is really
important to do both sides each way because it's an open chain closed chain.
so just hiking up and coming back down just like that. so it's not bending over
to hike it up, you're using these muscles to hike that hip up. so again make sure
you're switching sides because it's working those hips in different ways. so
I'm just trying to lift that hip up, I'm hiking it up.and so these are a little
tough to master, so I would just start off with five on each side do that a
couple times. and then you can slowly progress from
there. and so the last one is going to be a deep squat. so it's an exercise but
it's kind of finishing off with a stretch too. so if you're still out of
alignment sometimes a really deep squat kind of helps get you back into
alignment as well. so this one if you have something solid to hold on to a lot
of times with a deep squat that's the best way to do is kind of hold on to
something. so spread your feet out shoulder-width apart, maybe a little bit
more than shoulder width apart. so a deep squat is really kind of like when you
see a baby squat. babies do the perfect squat. that's how you're supposed to
squat. for some reason as we grow up we forget how to do it, but as babies you
know when you kind of see them down like this, so that's kind of a deep squat. but
see how my knees are still not going past my toes. so if I'm squatting down
like this, that's a really bad way to squat. you really want to sink that
bottom back. this is really tough for some people, so you might not be able to
get into that deep squat. that's okay this is just another technique to use,
but again when you're coming down you want those knees to still be behind the
toes. so I'm squatting but if I had something to hold on to I could kind of
balance a little bit. I can do it a little bit that's just because I
practice these things every day with my patients, so I can do them a little bit
easier, but if you're doing it the first time this might be a little bit tough.
but again that's gonna sometimes help kind of reset it and then when you come
back up you're really working all those muscles as well. so it's tough. you might
not be able to do it, but it is an option if you can. so there you have it those
were my top seven treatments for SI joint pain. yes it was. if you'd like to
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I hope you feel better soon.