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Sacroiliac Joint Pain (SIJ pain)

Daniela Stoeffin • 24 August 2023


The sacroiliac joints are located between the sacrum and the ilia, the pain is usually felt in your buttocks, it can also be referred to your lower back or radiating down your leg. A common cause can be an injury, e.g. from lifting and turning, others can be osteoarthritis, ankylosing spondylitis (an inflammatory condition), hypo- or hypermobility, or a functional adaptation in pregnancy, following an accident or due to postural imbalances.

Hypermobility – Both, hypomobility and hypermobility, can make the SI joints more prone to injury. In a healthy person there is usually a small amount of movement of the SI joints, e.g. when we walk. If this is restricted the muscles in the buttocks and legs can become strained, tight and painful, and other areas of the pelvis and spine need to compensate for this lack of movement and can become facilitated or inflamed. Hypermobile people, who can hyperextend their elbows or knee joints or touch the floor with their hands when they bend forwards, are more prone to injuries. The ligaments that support and guide the movement in the joints are looser than normal and this can make the joint more vulnerable, leading to earlier wear and tear, and sometimes subluxation of a joint. The SI joints can be painful or become locked. Doing regular exercises or sports that improve the strength of your muscles can prevent injuries and will support healing in SI joint injury.

Core and gluteal muscle strength is important for good posture and will also help you heal from an injury, prevent future problems and improve chronic conditions. You can train your core muscles with regular exercise, e.g. swimming, paddle boarding, pilates, dancing and everything else that involves your whole body like gardening or going for regular walks. 

Trained but short muscles in people who are active but do not use stretches can also cause problems. Doing regular stretches or yoga can help prevent injury.

Pregnancy – SI joint pain can occur during pregnancy and can be a part of pelvic girdle pain. You might have pain in your buttocks or radiating pain down your leg. You can also feel pain at your pubic symphysis, at the front of your pelvis. During pregnancy hormones cause a laxation of the ligaments which will allow more mobility of the joint. This is a necessary adaptation for giving birth, but can also make you more vulnerable to injury. 

If you are pregnant you can continue with most activities if you feel comfortable and avoid overexercising - being active will help your body prepare for giving birth. If you experience pain or discomfort talk to your midwife, therapist, trainer or GP! Don’t be afraid to start a new form of exercise, e.g. yoga or pilates, but find somebody who can recommend the right exercises or adaptations.


This article does not replace an individual assessment by a health professional. Please contact me or another health professional if you have any concerns or questions about your health.


by Daniela Stoeffin 9 November 2024
Good sleep, falling asleep quickly and waking up refreshed, is important for our health. If we struggle finding rest and go to sleep, maybe because of pain or because we have constant thoughts going round our brain, we miss out on important phases in our sleep pattern. Our bodies go through different phases when we sleep and deep sleep is important to feel rested when we get up. Some nights without enough sleep are usually not a problem, but if this continues for a longer time our body’s metabolism can change and we use more of our energy storages. The balance between the different parts of the nervous system can also change and we can exhaust the adrenal system, which means we are more tired and irritable. This can affect how we deal with everyday situations, making us react more intensely to situations we would normally not bother about. It can also be more difficult to find the energy to exercise or go out and meet people, just because we’re feeling low and tired. How can we improve our sleep? There are a lot of things that can help, these are some examples that you can try. Don’t try to force yourself to go to sleep, try to relax and enjoy just lying in your bed. If you are in pain a pillow under or between the knees can help. Concentrate on your breathing and try to let your breaths become a bit longer, maybe counting to 5. If you had an emotionally traumatic experience it can be difficult to relax, because your body associates letting go of control with danger. The moment you are about to fall asleep your body jostles itself back to alertness. In this case it can be helpful to practice relaxation in a controlled environment, e.g. using Jacobson’s muscle relaxation or body mindfulness techniques. Spend some time outside every day, as this will reset your body clock and melatonin system. Try to not eat too much or drink a lot of alcohol for the last two hours before going to sleep. It can help to go to sleep around the same time and set an alarm for the same time every day for a while so that your body develops a routine and resets its inner clock. If you are travelling a lot or working shifts it is difficult for your body to stay in balance. Spending some time outside and trying to follow a normal activity pattern as well as drinking enough water and avoiding comforting fatty/sugary meals can help. The latter as well as caffeinated drinks can help you feel alert for a while but over time they will exhaust your body’s energy levels even further because they’re just mimicking what your body really needs – rest and healthy food. Almonds, raisins, and a glass of water or juice can be a better alternative if you need a quick energy boost.
by Daniela Stoeffin 6 October 2024
Exercises to keep your back healthy Lie on your back - on the floor if possible, or on the bed. You can use a pillow under your head if that feels more comfortable. If you feel pain or discomfort doing these exercises, please don't do them. Knee hugs Bend both knees, feet on the floor and about hip width apart. Bring both knees up to your chest and hold for a few breaths. Then place both feet on the floor again. Bring one knee up to your chest and hold for a few breaths. If your back is not arching off the floor, you can also extend the other leg. Switch sides. Pelvic tilts Bend both knees, feet on the floor, hip width apart. Roll your pelvis up slightly so that your buttocks are lifting off the floor, then do the opposite, slightly arching your back. Relax your shoulders so you can feel a gentle movement through your whole spine up to your head. Breathe, don’t hold your breath! A few times Bridge Roll your pelvis up and continue lifting your spine until you only have your shoulder blades touching the floor. Then roll down again. If it feels ok, stay up for a moment on the last rep to improve strength in your gluteal and posterior leg muscles. Keep breathing normally! 6 – 10 x Leg Raises sidelying Lie on your side with the lower leg bent, the upper leg straight. Lift the upper leg to hip height, then slowly lower it down again. If it feels ok, hold the leg up for a moment on the last rep. This exercise helps improve strength in your core, gluteal and leg muscles. Keep breathing normally! 6 – 10 x Cat/Cow On all fours, hands under the shoulders, knees under the hips. Bend your head and look at your belly button, drawing your belly in slightly, then look up and arch your back, letting your belly drop to the floor. Avoid looking up too much, hyperextending your neck! 6 – 10 x Flight Lie on your belly, forehead on the floor. Have your hands next to your hips, palms facing up. Breathe in and lift your forehead, shoulders and arms, breathe out and relax everything back down. You can stay up for a few breaths on the last rep if it feels comfortable. Avoid looking up too much, hyperextending your neck! 6 – 10 x If you have any questions, please let me know. Daniela Stoeffin Osteopath 07470984853 daniela@dsosteopath.co.uk
by Daniela Stoeffin 6 October 2024
If you have been suffering from headaches for more than a few months, they will be classed as chronic. The headaches can be constant, or you can have episodes lasting from a few minutes to a few days. The membranes surrounding your brain and nervous system can hold tension from physical impacts, a longer illness, or emotionally difficult events. They are innervated by nerves originating in the head and the neck and if there is reduced mobility this can cause an irritation of these nerves and cause headaches. Reduced drainage from the head related to a reduction in movement, increased tension of the membranes and muscles can be another pathway leading to headaches. An osteopath can do an assessment of your neck and cranial membranes for strains that can be causing the headaches. Sometimes these are related to a bump or fall on the head in the past, a car accident, or a difficult birth. Osteopathic treatment can help reduce or release these strains. Important to note: The above refers to ‘ordinary’ headaches that have been more or less the same over a longer period. If you are suffering from new headaches that are progressing in intensity, especially if they are accompanied by other symptoms like nausea or vision changes, tiredness, weakness in your arm or legs or difficulty speaking, your face looks different on one side, or you are feeling uncertain and something feels wrong, it is important that you call your GP or go to A&E as soon as possible as this can be a sign of a bleed, blood clot or tumour.
by Daniela Stoeffin 16 July 2024
If your life is very busy it can be difficult to find the time to do something for yourself – Maybe some of the below can be some inspiration or a first step 1 Exercise should be fun – find something you like doing 2 Spend some time outside – greet the day with a short walk, spend your lunch break outside, meet people for a walk instead of sitting inside 3 If you struggle walking longer distances – don’t worry, walking 10 minutes regularly is good for your cardiovascular and mental health 4 Exercise at home – walking up and down the stairs is good to bring your heartrate up, use a standing desk instead of sitting the whole day 5 Add a few vitamins to you diet – your favourite fruit or a juice 6 Starting the day with a warm breakfast can help if you feel very tired in the morning (e.g. porridge with some nuts and fruit) 7 Add some quiet time – just 5 minutes for breathing exercises or a short meditation can help you switch off 8 If you don’t like exercising alone – think about joining a class or ask a friend if they would like to join you 9 Bring a refillable bottle to work or on walks, this is good to keep you hydrated during the day and helps the environment 10 Spend some time without your phone, TV or a book – start with a few minutes – do you find this difficult?
by Daniela Stoeffin 1 May 2024
Our bodies go through a lot of changes during the course of our lives. There are phases of transition where our hormonal system changes, and these changes are not always easy and without symptoms. We can experience pain, discomfort, increased or different to normal emotional reactions, headaches, hot flushes, and our bodies might not feel right and uncomfortable. Some of these symptoms can be related to structural problems and in these cases osteopathy can be helpful. Injuries, structural imbalances, or restricted movement caused by scar tissue can influence how we feel and how well our organs function. During an appointment we can look at how osteopathic techniques can help balance your body and ease restrictions to movement, blood supply or drainage to support your health and wellbeing. If you have any questions or would like to make an appointment, please call or write me an email.
by Daniela Stoeffin 5 November 2023
This is an article I wrote during lockdown, I think it is even more relevant now. If you have any comments or would like to share your experiences, please write me an email. Keeping your Roots - (Re-)connecting with nature When I think about emotional well-being one thing that comes to mind is how important it is for me to be able to be outside, amongst trees and fields and to feel the earth below my feet. Just going for a short walk increases our energy levels. As an osteopath, I find that the better my own roots are, the easier it is for me to work. My concentration is better, and I am less tired at the end of the day. Just close your eyes for a moment and imagine yourself walking barefoot, feeling the earth below your feet, or lying on a patch of grass, insects buzzing around you. Notice the difference this makes on how you feel. Sometimes our lives can be so busy that we forget to look after our own needs, depleting our energy levels. Taking short mental breaks like this can help. I like the idea that being amongst trees cleanses our energy field. There is scientific evidence that trees not just provide oxygen (essential for life) but also help us stay physically and emotionally healthy. The term ‘forest bathing’ or Shinrin-yoku was coined by Japanese scientists. They found that spending time in forest environments helps lower cortisol levels, pulse rate and blood pressure, and encourages greater parasympathetic and lower sympathetic nerve activity. It also has a positive effect on heart rate variability and the left prefrontal cortex (an area important for decision making, planning, short-term memory and our reaction to other people). Trees help us relax and deal with tension, depression, anger, confusion and fatigue. Pictures of natural environments make us feel positive emotions and can have similar effects on blood pressure and the nervous system. Cortisol is released by the HPA axis in response to stress and can make us more vulnerable to infections. I find that this is very relevant for my work as a cranial osteopath. A lot of my patients have problems like high blood pressure and high cortisol levels and suffer from stress related conditions like heart disease, depression, etc. Many people are prescribed statins or other medication to help with these problems. I also see a lot of people with sleeping difficulties. Some are caring for parents or children and find it difficult to find time for themselves. They say that treatment helps them be more patient and relaxed, so it feels that I’m already helping them be more grounded and centred. In addition, I encourage them to look after their own needs, spend some time outside, go for walks, to help them de-stress and improve their energy levels. - If you work in an office/from home, consider placing a nice picture on your desk to look at. I would like to share an exercise that helps me (re-)connect with the earth, ground and recharge my batteries. It is especially useful in emotionally difficult and stressful times. Either find a nice spot outside or imagine yourself in a place you love or create one in your mind. Close your eyes. Feel your feet firmly planted on the earth and feel through the soles of your feet, connecting with the earth. Imagine roots growing from your feet into the earth, branching out as they grow. Let your roots grow as deeply as you want. Then when you feel you’re deeply connected, feel how energy moves up through your roots, filling your body – first your feet, then moving up your legs, your torso, filling your arms and head. Stay with this for as long as you like. Then slowly let the roots ‘grow backwards’, back into your body. To finish just stay with your breath for a moment. Feel the earth below your feet, the air around you, hear the sounds of the leaves rustling, insects buzzing around you. Be very present in your own body before you slowly open your eyes. 1 Park, B. J., Tsunetsugu, Y., Kasetani, T., Kagawa, T., & Miyazaki, Y. (2010). The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environmental health and preventive medicine, 15(1), 18–26. https://doi.org/10.1007/s12199-009-0086-9 2 Seplaki CL, Goldman N, Weinstein M, Lin YH. How are bio-markers related to physical and mental well-being? J Gerontol Biol Sci Med Sci. 2004;59:B201–B201.
Fascia are a network of fibres and fluids that connect every part of our body. It plays an important
by Daniela Stoeffin 15 August 2023
Fascia are a network of fibres and fluids that connect every part of our body. It plays an important role in our health and wellbeing.
by Daniela Stoeffin 9 August 2023
The TMJ (temporomandibular joint) is located to the front of your ear and is involved in movements of the jaw when you open your mouth to eat or speak. The movement is guided by muscles and ligaments that surround the bones and connect the jaw to the base of the skull and side of the head. Clicky or painful TMJs can have different causes. Physical trauma, e.g falls, accidents, or blows to the head or face can cause strain on the tissues surrounding the TMJ. Dental treatment like a tooth extraction or a root canal treatment, where you have to hold your mouth open for a long time or that involve a lot of pulling, can have a similar effect. A lot of stress can play a part as well, somebody who is prone to clenching or grinding their teeth can develop TMJ problems over time. The body is a functional unit, all parts are connected via ligaments, muscles and fascia (a network of soft tissue). This means that imbalances or restrictions in other parts of the body can also influence the TMJs, and problems involving the TMJs, the base of the skull or the top of the neck can cause or affect problems in other parts of the body, like the shoulders or pelvis. Cranial osteopaths are trained to assess and treat the head and face as well as the rest of the body and can help if you are suffering with clicky or painful jaws. If you have any questions or would like to book an appointment, please call or send an email.
by Daniela Stoeffin 11 October 2021
This is a breathing exercise to help you relax and breathe more deeply.
by Daniela Stoeffin 11 October 2021
This is a video with a few exercises to help loosen up your shoulders. They are useful if your muscles are tight from sitting at a desk a lot or if you've been carrying something heavy, after gardening, etc. Doing the arm circles with the elbows bent as in the video is usually easier (less painful) if you've had a shoulder injury. I've put this version in because a lot of patients feel pain when they try lifting their arms to the ceiling or doing wide circles. You can of course do wide arm circles :-) Please don't do anything that hurts or feels uncomfortable, these exercises are not meant to replace treatment. If you have any questions, please contact me or another practitioner.
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