SI Joint Pain: The Pelvic Floor Connection You’re Missing
If you’ve been dealing with nagging SI joint pain, you’re not alone. That deep ache in your lower back, that sharp catch when you stand up too fast, or the dull, persistent discomfort while sitting too long—it’s frustrating and, frankly, exhausting. You might have been told you have SI joint dysfunction, or maybe someone labeled it as piriformis syndrome. But what if I told you that the missing piece isn’t just your SI joint or hip muscles? What if the real culprit is your pelvic floor?
Common Symptoms of SI Joint Dysfunction
SI joint pain often presents as:
Pain on one side of the lower back or deep in the buttock
Sharp pain with movements like rolling over in bed, standing from a seated position, or walking
Radiating pain down the leg (sometimes mistaken for sciatica)
A feeling of instability or “catching” in the pelvis
Discomfort with prolonged standing or sitting
Often, people experiencing SIJ pain are sent down a road of external hip and core treatments. They’re told to strengthen their glutes, stretch their hip flexors, and foam roll their piriformis. And while these strategies can provide temporary relief, they fail to address the root of the problem.
The Piriformis Diagnosis—and Why It’s Only Half the Story
Piriformis syndrome is commonly diagnosed when someone has deep glute pain, often with radiating symptoms down the leg. The piriformis muscle sits near the sciatic nerve, and when it’s tight or overactive, it can compress the nerve, leading to pain, tingling, or numbness down the leg.
Traditional treatment for piriformis syndrome includes:
Stretching and foam rolling the piriformis to reduce tension
Hip mobility exercises to improve range of motion
Strengthening the glutes and core to provide better pelvic support
And while these treatments can help, they often don’t provide lasting relief because they don’t address why the piriformis is overactive in the first place. The answer? Pelvic floor dysfunction.
The Real Problem: Your Pelvic Floor
Here’s the truth: Your pelvic floor plays a huge role in SI joint stability. The pelvic floor muscles are deep stabilizers of your pelvis, and if they aren’t functioning properly—either because they’re weak, tight, or uncoordinated—your SI joint becomes unstable.
When this happens, your piriformis and other external hip muscles step in to compensate. They work overtime to try to stabilize your pelvis, leading to tightness, pain, and dysfunction. Until you address the pelvic floor directly, you’re only treating symptoms, not the cause.
The Missing Piece: Foot Mechanics & SI Joint Function
If pelvic floor dysfunction is the hidden cause of SI pain, foot mechanics are the often-overlooked piece of the puzzle. The way your foot moves affects the entire kinetic chain, including your SI joint. When your foot lacks proper stability or mobility, your pelvis has to work harder to compensate, increasing stress on the SI joint and pelvic floor.
At Refine, we take a whole-body approach to SI joint pain. We don’t just look at your hip or your piriformis; we assess how your pelvis, pelvic floor, and feet work together to provide true stability. Our treatment approach integrates:
Pelvic floor therapy to restore proper function and coordination
SI joint stabilization strategies to improve alignment and reduce pain
Foot mechanics correction to address the foundation of your movement
The Bottom Line
If you’ve been stuck in a cycle of SI pain, chasing hip tightness, and stretching your piriformis without long-term relief, it’s time to look deeper. SI joint pain isn’t just a hip issue—it’s a pelvic floor issue. And at Refine, we specialize in getting to the root cause so you can move freely and confidently again.
Are you ready to finally resolve your SI pain? Book an assessment with us today and let’s get to work!
