What Causes Sacroiliac Joint Pain and How Somatics Can Help

I recently taught Somatic Exercises online to T.G., a woman suffering from sacroiliac pain, commonly referred to as SI joint dysfunction or SI joint instability. When we began our sessions, she stood tilted to one side, clearly stuck in a Trauma Reflex. She was unaware of the severity of her tilt; she told me that her posture although technically out of balance, felt normal to her. She knew from reading my book, Move Without Pain, that her tilt was an unconscious habit that her brain had set as "normal" because she'd been standing like that for a very long time. She had a few falls, accidents, and a particularly difficult childbirth and labor.

How SI joint pain arises

"After working with me and watching me move, do you think the SI joint is the issue? I'm so amazed at the changes taking place in my body after learning Somatic Exercises. The psoas release you taught me made me feel so much more relaxed in my torso."
T.G., New Mexico

To answer her question: her Trauma Reflex — not her SI joint itself — was causing her pain. The painful joint was merely a symptom; the underlying cause of her pain was Sensory Motor Amnesia (SMA) in the muscles that attach into, and move the pelvis and SI joint. These muscles were pulling unevenly on her pelvis so that whatever activity she did caused pain in the joint. Her hamstrings were also tight because she had to alter normal, natural use of her legs to compensate for the tilt in her center. Because her muscles were in a state of chronic contraction, her movement was inefficient and painful.

How the 3 Stress Reflexes affect the SI joint

Some symptoms of SI joint dysfunction are:

  • low back pain on both sides

  • a feeling of weakness and instability at the bottom of the spine

  • sciatic pain

  • pain at the waist, towards the center of the back

  • aching in the front of the thigh and down into the groin

One-sided SI joint pain suggests that the muscles that connect the SI joint and the center of the body are pulling unevenly on the joint. An asymmetrical muscular pull often rotates one side of the pelvis. There is an feeling of being "jammed up" in the sacroiliac joint because the Trauma Reflex puts a painful torque on the pelvis, inhibiting it from moving up, down, forward, and back.

Bilateral SI joint pain suggests habituation to the Green Light Reflex, which creates excessive contraction through the muscles along our spine; this puts excess pressure on the SI joint and lumbar spine. If the Red Light Reflex is habituated, the pelvis doesn't move freely when walking; the iliopsoas is tightly contracted and the joint feels stuck.

These are all cases of Sensory Motor Amnesia and can be eliminated through Somatic Educationpandiculation, and a daily practice of Somatic Movements.

The key to regaining stability and mobility

A critically important aspect of reversing SI joint instability and pain is to learn to move the pelvis freely again. It is precisely that lack of freedom in the pelvis that is absent in those with SI joint (as well as hip and pelvic) pain. In order to regain stability and mobility, you must be able to sense, feel, and control yourself fully from within.

T.G. learned quite a few Somatic Movements (in this order):*

* These Somatic Movements were taught over the course of several sessions*

Through consistent repetition of these movements she learned to slowly and intelligently reduce muscle tension in the muscles of the back, waist and front of her body so she could extend, flex, bend, and rotate her body with ease and comfort. These Somatic Movements pandiculated the muscles causing SI joint pain and reconnected her brain to her muscles, and reset muscle length, function, sensation, and control.

How to eliminate and prevent SI joint pain – on your own!

Below are some options for learning to prevent and eliminate SI joint pain and instability and learn to move freely again. It is highly recommended that you seek the help of a skilled Clinical (Hanna Somatic Educator) for more precise guidance and rapid improvement:

Heal Herniated Discs with Hanna Somatics

I've gone to an acupuncturist, pain medicine doctor, sports medicine doctor, massage therapist, physical therapist - and they all told me, "you'll never get rid of this. It will never go away."

This is what my client, Joanne (not her real name) told me before her first clinical Somatics session. She had a herniated disc, severe back pain and sacroiliac joint pain. She had a feeling that "life's impacts," as she called them, had more of an effect on her than anything else. I agreed with her. I explained some basics about muscles and bones in order to demystify what up until then had been an elusive problem for her:

  • Muscles attach to bones and muscles move bones.
  • The brain and nervous system senses and moves your muscles.
  • The brain reflexively responds and adapts over time to stresses in the environment by tightening muscles in specific, full body patterns.
  • If these stress responses are on-going or severe enough (i.e. an accident), the brain and muscles learn to stay chronically contracted as if the stress were still occurring, even as if has stopped.
  • Because muscles learn to be really good at contracting and holding the body tightly, they must learn to relax and release. This can only be achieved through improving one's ability to sense and control one's muscles and movement.

Herniated discs are the structural result of poor muscle function.

With the exception of a traumatic accident, discs herniate because the muscles attach to them are so strongly contracted - and unable to relax - that they push the disc material out.  sciatica An X-ray can show a protrusion in your spine - but the question doctors fails to ask is, "What is happening in the muscles, that is putting excess pressure on the spine and discs?

Herniated discs are one of the most common muscle pain conditions I see in my clinical practice; they are yet another example of Sensory Motor Amnesia. More specifically, herniated discs are the result of habituation to two Somatic Stress Reflexes:

Trauma Reflex: The brain's response to an accident, injury, surgery or one-sided functional task (such as holding a baby on one hip). The muscles of the waist and trunk rotators contract on one side in order to avoid pain.  There is always a slight side bending or twist apparent in people with a trauma reflex. The waist muscles (the internal and external obliques, the quadratus lumborum, which "hikes" the pelvis on one side) cause an uneven pull on the lumbar spine (or on the cervical spine in the case of a cervical herniation). This, in affect, herniates the disc.

Green Light Reflex: This reflex contracts all the muscles of the back of the body, from sacrum to occiput, is a "call to action" response, invoked hundreds of times a day in our busy industrialized society. It is the cause of most chronic back pain. The muscles of the back contract strongly, yet feel weak and fatigued.

Over the course of five clinical Somatics sessions Joanne learned to release, relax and regain control overthe muscles of her waist, back and pelvis, all of which had become rigid and contracted over the years. She learned to pandiculate rather than stretch her muscles, restoring full muscle function and length to her weary muscles. When she learned to release her back muscles her shooting pain began to disappear. Once her waist and trunk rotators began to soften she enjoyed moving her hips and pelvis without fear of pain when she walked. "My husband won't know what's walking in the door!" she laughed after one session.

Here are three of the most important exercises that Joanne did to help her relax her back and waist muscles - Arch and Flatten, to release tight back muscles, the Side Bend and the Washrag.

Joanne now understood that her loss of body awareness and muscle control - the very thing that had contributed to her muscle pain - had developed over time due to stress. The next step for her is to continue to improve her ability to self-sense and self-correct through her practice of Hanna Somatic Exercises. Life is movement, and the learning is hers to explore for the rest of her life. She will only get better and better.

Her doctors were wrong and she knew it all along. Her pain has gone away.