Sacroiliac Joint Instability and How It Can Affect the Way You Walk by physiotherapist Mlu Kunene

Many people think back pain or walking difficulties only come from problems in the spine, hips, or knees. However, an often-neglected structure called the sacroiliac joint can also play an important role in movement. When this joint becomes unstable or too stiff, it can lead to pain, reduced mobility further in the body, and changes in the way a person walks.

When the sacroiliac joint moves excessively, abnormally or does not offer sufficient support during movement, it has become dysfunctional. Dysfunction al means that the joint has altered movement in contrast to its normal pattern. A dysfunctional joint does not contribute to normal body mechanics, and this can cause strain in the joint concerned and elsewhere in the body. The subsequent strain on the nearby and further away muscles and ligaments may also contribute to a person’s discomfort.

Several factors may contribute to sacroiliac joint dysfunction such as pregnancy, falls or trauma, weak core muscles, previous lower back injuries, and age-related changes.

People with sacroiliac joint instability often experience symptoms such as lower back pain, discomfort around the buttocks, or pain that spreads into the groin or upper thigh. Some people describe a feeling that their pelvis is unstable or ‘giving way’. People will often say they feel worse after prolonged standing, walking, climbing stairs, or changing positions.

One of the most important consequences of sacroiliac joint dysfunction is its effect on gait, meaning the way a person walks. Walking depends on smooth coordination between the pelvis, spine, muscles, and legs. In normally coordinated walking, load is transferred through the body in an efficient manner that is healthy for the body. Muscles strengthen and the impact on spinal discs and bone health is beneficial. When the sacroiliac joint becomes unstable or too stiff, the body often develops compensatory movement patterns to reduce discomfort and maintain balance. This may include taking shorter steps, walking more slowly, or shifting their weight unevenly from one side to the other.

Fortunately, treatment can often improve symptoms and movement quality. Physiotherapy commonly focuses on strengthening muscles that support the pelvis which can improve core stability, and biomechanics of walking. Physiotherapists are trained in techniques that restore mobility to stiff joints and alleviate strain on ligaments. Early assessment and treatment may help reduce pain and reduce long-term problems.

The sacroiliac joint may be overlooked but its contribution to stability and walking is significant. Recognising symptoms early and seeking appropriate care can help people maintain mobility, improve comfort, and support long-term physical function.

To book a physiotherapy appointment phone 031 765 8898 or book online via https://www.debbiecameronphysio.co.za/online-booking.

References

Cohen SP. 2005. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis and treatment. Anesthesia & Analgesia. 101(5):1440–1453.

Hungerford B, Gilleard W and Hodges P. 2003. Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine. 28(14):1593–1600.

Kibsgård TJ, Røise O, Sudmann E and Stuge B. 2014. Pelvic joint fusion in patients with severe pelvic girdle pain – a prospective single-subject research design study. BMC Musculoskeletal Disorders. 15:85.

Vleeming A, Mooney V and Stoeckart R. 2007. Movement, Stability and Lumbopelvic Pain: Integration of Research and Therapy. 2nd ed. Edinburgh: Elsevier.

Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L and Willard FH. 2012. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. Journal of Anatomy. 221(6):537–567.