Sacroiliac Joint (SIJ) dyscfunction is becoming more frequent than ever.  Dr. Rick Serola suggests the following tips to avoid opening the sacroiliac joints and/or stressing the sprained ligaments of the SIJ.


  1. Do not bring the knee across the midline.  For example, crossing the legs while sitting by placing the knee of the upper leg on the opposite leg.  However, crossing the ankle or lower leg over the opposite knee while sitting is okay.  Also, while lying in bed; do not let the knee of the upper leg touch the bed.  Rest the upper knee on or behind the lower knee or, better yet, place a pillow between your knees.
  2. Follow the 90 degree rule.  The prohibited actions will cause the sacral base to rotate forward and the ilia to rotate relatively backward, opening the SI joint.
    • With knees straight, do not flex the truck to, or past, a 90 degree angle with the legs.
    • With knees bent, do not flex the knees closer than a 45 degree angle between the legs and chest:
      • When tying shoes do not bring knee to chest.  Both arms should go inside the knee.
      • Bringing the foot up to the truck is okay if they bring the knee out to the side.
  3. No trunk twisting past 25 degrees or to the point where mild tension is felt in the low back.  This action causes the sacrum to rotate away from the ilia.
  4. No hanging by the arms or feet.  No lumbo-pelvic traction, with the exception of the Sacrotrac because its pull is from the sacrum.  Hanging and conventional lumbo-pelvic traction pull the ilia and the spine apart, stressing the SI ligaments.
  5. No extending the back past neutral.  For example, you can do back strengthening exercises, but you should not bend backwards at the waist past neutral; this action causes both the sacral base and ilia to rotate forward, but the lumbo-sacral area becomes compressed, and this causes the sacral base to go farther than the ilia, opening the joint.
  6. No heat on the low back.  Ice is fine at 20-minute-intervals every hour for three hours or more.