What can Rolfing do for Sacrum & SI joint issues?

What causes SI joint issues?

The SI, or Sacroiliac joint, is the joint between the two primary bony structures of the hips - the Sacrum and the Ilium. The sacrum is located at the base of the spine and forms the foundation upon which the entire spine rests. The ilium is generally what people refer to when they say “hip bones.”

SI issues can come in a variety of forms: partial or full dislocation of the Sacrum, irritation from a previous injury, a pinched nerve due to dislocation/misalignment, inflammation in the area, etc. These issues can cause either pain directly in the SI joint, referral pain further down the body from a pinched nerve, or low back pain from misalignment causing irregular muscle use.

These issues generally arise from direct injuries such as a fall, prolonged imbalances such as incorrect sitting or standing posture, or complications from pregnancy. During pregnancy, hormones in the body are released to allow the ligamentous tissues around the hips to relax in order to accommodate the stretching necessary to give birth. However, this can lead to instability during and after the course of pregnancy.

As you can see, there are numerous layers of ligaments that hold the sacrum in place. If these are over-stretched, or worse, if one side is over-stretched, it can cause some serious instability or imbalances.

Other times, issues will arise from long-held patterns in the body that cause the muscles or fascia to pull the sacrum in an imbalanced fashion. This can start as nothing more than feeling a little tight along one side, but can eventually progress into arthritic conditions from imbalanced overuse if not properly addressed.

What do we work on during a Rolfing session or series?

In a Rolfing session or series of session, we generally take two approaches to dealing with SI issues.

The first is a slow direct pressure to allow the sacrum to “settle” back into proper alignment. This is something that is generally done at both the beginning and the end of Rolfing sessions. The sacrum itself often needs little more than this in order to restore its normal range of motion.

The second approach is an indirect one, but is often of equal or greater importance than the direct work. By working the areas around the sacrum - everything from the erector muscles which affect the sacrum from above to the glutes and hamstrings which affect the sacrum from below.

As you can see from this image, there are numerous layers of muscles and fascia that overlap in the low back to help stabilize and move the back and sacrum. Postural issue that may be affecting the sacrum are addressed by balancing these layers of muscles and fascia on either side of the spine.

Immediately beside and below the sacrum are the gluteal and external rotator muscles, a complex series of muscles that are generally considered some of the strongest in the body. These can pull on the sacrum in various ways, so we generally address the balance between the smaller rotator muscles and the larger gluteal muscles as well as the balance between the right and left sides. After all, a balanced body is a happy body!

What do I do after Rolfing?

For sacrum issues, one of the most important things you can do after the fascial and muscular imbalances are addressed is work on stabilizing the joint. This is generally done through various exercises and learning to properly contract the muscles that help to stabilize the area. You’ll be shown several types of abdominal activation techniques to help to stabilize the sacrum from above, as well as leg/gluteal/hamstring exercises to stabilize the joint from below.

As always, if you have any specific questions about your issues, feel free to contact me or schedule a free consultation to discuss your situation.

Disclaimer: Every body is different. As a Rolfer, I work to help people based on their individual needs. There is almost never a one-size-fits-all technique when it comes to balancing the body. As such, what is said here is very generalized, and is meant to give you a better understanding of what is going on rather than diagnose or treat any specific ailment.