SI Joint Pain In Runners: An Overlooked Problem

si joint pain in runnersSI joint pain in runners is often a problem for our patients that sit most of the week but also enjoy running. Frequently, a new patient will enter our office complaining of “back pain” while pointing to their sacroiliac joint. When I ask them about their exercise routine and they tell me they’re a runner, I know where this conversation is headed.

Runners experiencing ongoing back pain that is located to one side and just below their belt level are usually dealing with SI joint pain. The sacroiliac joint can feel like low back pain, just lower and usually just on one side.

These two joints (one on each side) are in heavy use when you run. Ideally, they glide back and forth during a normal stride. If the joint becomes stuck, or just isn’t moving like it’s supposed to, you’ll tend to “swing” that side of your pelvis in order to run.

This “swing” can lead to back pain and even hip, knee, or ankle pain on the side of the malfunctioning joint. SI joint pain is sure to follow as your body compensates for the less than ideal mechanics. You have several options when experiencing SI joint pain, and the treatment is also great as a prevention measure. 

SI joint pain in runners begins with poor mechanics

When I run a 5k or half marathon and have an opportunity to observe the stride of hundreds of runners, I can clearly spot those that have SI joint problems. The movement of the pelvis isn’t symmetrical and you can see the “swing” in action.

If we were to sit and watch how the pelvis moves, you would see one side clearly glide up and down and the other side appear stuck and not moving symmetrically to the other side. It’s only a matter of time before pain will begin for runners with these mechanics. This is how SI joint pain in runners begins.

SI joint pain in runners continues due to tight hip rotators

If your job requires that you sit all day, both your hamstrings and your hip rotator muscles (like the pirformis)

• Stretch your hip rotators.
These are a fan of muscles underneath your glutes. One stretch you may try while seated at your desk is the seated hip rotator stretch. (Video below) Another simple stretch is to lay on your back and pull one knee up to your chest and then slowly across your body. It will feel like you’re stretching your glute, but it’s actually a deeper stretch than that.

Stretching should be done consistently and holding each stretch for several minutes will make a big improvement in your flexibility. Patients that stretch for just 10 – 30 seconds will feel some initial relief, but will not make gains in their flexibility beyond a few minutes. 

• Foam rolling. While many runners utilize the foam roller on their hamstrings or quads, they completely ignore their hip rotators and their SI joints. Move that foam roller a little higher and get the problem areas. Cross one foot over the opposite knee to really zero in on the hip rotators during your foam rolling time.

Foam rolling can be done before and after a run. Foam rolling before will help warm up the muscles and foam rolling after will help with the speed of recovery. 

• Get adjusted. Chiropractors get stuck joints moving again. Adjusting the SI joints is a regular occurrence in our office and needed most often by runners and new moms. If you just can’t seem to get things moving with stretches and foam rolling, a couple of adjustments will usually make the difference.

Long term relief of SI joint pain in runners

SI joint For long term relief of this problem, get on a consistent adjusting plan. This will usually start with more frequent adjustments at the start of care followed by less and less often adjustments as the mechanics of the SI joint improve. 

Managing the right movement of your SI joints can make all the difference in a variety of exercises. Those with this problem have difficulty doing squats, lunges, and just lifting up their leg to tie their shoes. SI joint pain in runners can be avoided if you start now and stay consistent with preventative care.