Sacroiliac Joint Dysfunction

Do you have pain on one side of your lower back (in the small dimple) that sometimes travels into your buttock, upper thigh or groin?

Do you also have issues with transitional movements such as rising after sitting, getting in and out of a car, going up and down stairs or rolling in bed?

If you can relate to these questions above then you may have problems with your sacroiliac joint.

What is the Sacroiliac Joint?

The sacroiliac joint also known as the SIJ is the meeting point between two bones; the sacrum (the tailbone) and the ilium (largest part of the pelvis). This joint is very stable and as such should have very little movement. This joint is involved in shock absorption and helps to transmit forces from the lower body to the upper body and vice versa.

What are the Symptoms of Sacroiliac Joint Dysfunction?

Dysfunction of the sacroiliac joint can be painful and disabling. Patients who suffer from this condition will report having pain around the dimple of their low back (where your tail bone and pelvis connect). Pain can also radiate from this joint into the buttock, the thigh and even the groin. This is why it can sometimes be difficult to diagnose and pinpoint the exact root cause. A physiotherapist and/or chiropractor can help determine the cause and differentiate it from the lower back and hip.

What are the Types of Sacroiliac Joint Dysfunction?

A few different things can occur in a dysfunctional sacroiliac joint:

  • The joint can be too mobile and unstable in which case it’s called a hypermobile sacroiliac joint.
  • The joint be stiff and/or can shift out of place and become stuck. This is called a hypomobile sacroiliac joint.
  • The joint can be inflamed (consistently sore, throbbing, warm, swollen) and this is called sacroiliitis.

What are the Causes of Sacroiliac Joint Dysfunction?

There are many different causes of sacroiliac joint dysfunction. Often patients can recall a big fall on their buttock. It can also be caused by consistently placing more weight through one side of your pelvis such as when crossing your legs, leaning on one arm rest or putting one or both legs under your buttock while you sit for long periods. People who by habit stand with their weight on one leg can also be victims of this condition. This is common condition in young moms who carry a child on their hip when standing.

Other causes of sacroiliac joint dysfunction include:

  • Osteoarthritis: Wear and tear of the cartilage between the two bones the sacrum and the ilium.
  • Pregnancy or Post-Partum Hormones: The hormones present during pregnancy and while breast feeding relaxes the ligaments that hold the sacroiliac joint tight. This makes the joint too loose and increases the chances that it shifts and becomes stuck out of place.
  • Leg length discrepancy: If your legs are two different lengths, then there will be more pressure on one side going up your knee, hip and into your sacroiliac joint.
  • Arthritis: Various kinds of arthritis’ including gout, rheumatoid arthritis, psoaratic arthritis, and anklylosing spondylitis can affect the sacroiliac joint causing inflammation and pain.

How can a Chiropractor and or Physiotherapist Help with Sacroiliac Joint Dysfunction?

If you believe that you may have sacroiliac joint dysfunction then you should visit a trusted chiropractor and/or physiotherapist. They will help you determine the source of your pain. If the Sacroiliac joint is causing pain there are typically compensations going on in the hip and lower back. Rehab specialists can use a variety of techniques including hands on manual therapy, individualized exercise prescription, shockwave therapy, acupuncture or dry needling and other therapeutic modalities. They also have the insight to refer you for other services such as massage therapy or a consult with a physician. Their ultimate goal with treatment is to alleviate your discomfort and correct the biomechanics of your sacroiliac joint, allowing you to get back to your lifestyle.

How can you Treat Sacroiliac Joint Pain at Home?

If you suspect that your Sacroiliac joint is the source of your pain, you can try to following strategies to help relieve it:


Start with applying ice over the area. We suggest applying it for 10 minutes, ON/OFF, for a total of 5 repetitions up to 2x/day.

Change your sitting habits

Do not sit with a wallet in your pocket, crossed legs or legs tucked under the body.

Log roll in bed

Move your truck as one unit when rolling in bed. Don’t separate the shoulder movement from the pelvis movement.

Sacroiliac joint belt

This belt is created to help support a irritable or hypermobile joint and provide a similar input to the system as the deep core muscles would provide. There are also specialized belts for late stage pregnancy which fit better with your growing hips and abdomen.

What are the Best Exercises for Sacroiliac Joint Pain?

Depending on the cause of the pain your rehabilitation exercise goals will change.

Hip stretching


  • Knee to chest, repeated on other side.
  • Hamstring stretch- lying on your back, hold the back of your knee and straighten your leg
  • Hip flexor/quad stretch- lying on your stomach reach back and pull your heal towards your buttock (use a towel to assist in the reach if needed) once your feel a nice stretch on the front of your thigh you can try to lift your knee slightly off the ground. (make sure you keep your core engaged and do not arch or strain in your lower back)

Perform all these stretches 3 repetitions, 10 sec hold, up to 2x/day. If you feel shaky or pain with the stretch back off to feel a more comfortable pulling sensation.

Core strengthening


  • Transverse abdominis activation in crook lying
  • Modified Dead bug
  • Bird-Dog

Perform 3 sets of 10-15 reps daily of one of the above exercises depending on your stage of healing.

If any of these exercises cause pain or if you don’t notice a change in your symptoms after a few days, we recommend seeing an experienced physiotherapist or chiropractor who will be able to conduct a thorough assessment and offer individualized exercise prescription as part of their treatment program.

What Should be Avoided with Sacroiliac Joint Dysfunction?


When you divide your legs this distance apart it can put a lot of torsion in the pelvis


Of course, if you have stairs at home, you may not be able to avoid them, but try your best to limit your use of stairs and definitely do not use the stair master or run up and down stairs for exercise. For the same reason as above, stairs can increase strain and torsion through the pelvis and further aggravate your symptoms.

Jumping or running

The Sacroiliac joint is a shock absorber and with running or jumping there is more force/load that is being transferred from the lower body through the sacroiliac joint into the trunk. If the sacroiliac joint is already in an irritated state you will provoke the symptoms even further causing more joint irritation.

Crossing your legs or shifting your weight to one side of your pelvis

This will put extra stress on the irritated joint.

Also, listen to your body. It is best to avoid anything that causes your pain to increase. You may have to monitor your activities and modify them to shorter durations or change them all together. Your chiropractor or physiotherapist can help you learn what things may have contributed to the development of pain in the first place and will work with you to find a solution to fits your lifestyle.

How Long Does it Take to Recover from Sacroiliac Joint Dysfunction?

Once you are aware and start to manage your symptoms, modify your lifestyle, and perform rehab exercises you should see improvements in your symptoms within 2-3 weeks with full resolution in 6-8 wks. However, if you delay seeking treatment or have episodes of irritation during the rehab process it can take even longer to resolve.

In some cases, especially if you had some trauma to the sacroiliac/pelvic region, you may experience flare ups or re-aggravations in your lifetime. It is important that you understand your injury very well and that you are in tune with your body so that you can stay on top of the condition and practice prevention strategies. A good physiotherapist or chiropractor is an educator and will teach you about your condition, your body and will show you where your vulnerabilities are and what exercises/strategies you can utilize to keep your sacroiliac joint functioning well.

Contact us if you are looking for a good chiropractor or physiotherapist in north Edmonton.

Urinary Incontinence

Urinary incontinence is defined as the involuntary loss of urine, having both social and hygienic implications. There are different kinds of urinary incontinence with urge (loss associated with the strong uncontrollable need to void) and stress (involuntary loss of urine due to an increase in intra-abdominal pressure i.e. from a cough, laughing or a sneeze) being the most common.

Up to 3.3 million Canadians suffer from some form of urinary incontinence but the private and embarrassing nature of the topic causes many people to pause before discussing the problem with their healthcare professionals. Up to 50% of women at some point in their lives will experience urinary incontinence, with 33% of those going on to develop regular problems. Not only does urinary incontinence burden the Canadian healthcare system with physician care expenditure as well as hospital and drug expenditures but it can have significant social consequences for the individual.

Incontinence can impede social and physical activity which in turn can lead to decreased self-esteem, depression and social isolation.

True or False…

  • It is normal to have permanent urinary leakage after childbirth
  • Loosing bladder control is a normal part of the aging process
  • Once you have incontinence there is nothing you can do about it

The answer to all of these statements is FALSE!

These are common misconceptions that have been fostered as truth because of the lack of conversation around incontinence.

What Causes Urinary Incontinence?

Urinary incontinence can be linked to the health of one’s pelvic floor, a series of muscles, ligaments and fascia that provide support and stability for the pelvis and play a role in sexual function and continence.

If these muscles are too weak you may experience stress incontinence, urge incontinence and pelvic organ prolapse. This is common in the pre and post-partum population. If theses muscles are too tight they may be contributing to urge incontinence, pelvic pain, prostatitis and interstitial cystitis.

How can Pelvic Health Physiotherapy help?

Pelvic floor dysfunction leading to incontinence can be diagnosed by specially trained physicians and physiotherapists who use an external and internal exam to determine the health of your pelvic floor.

Externally they will look at the movement and function of the low back, pelvis and hip joints to understand how their function may influence your symptoms.

Then they will perform an internal exam through the vagina and anus in women and the anus in men.

Currently the literature states that pelvic floor strengthening and retraining taught by a specialized physiotherapist using internal assessment and treatment techniques should be the first line of defense against incontinence.

This means that pelvic floor physiotherapy should be trialed before someone considers surgery.

A pelvic floor physiotherapist uses manual therapy, education, postural awareness and exercise to improve the health of your pelvic floor and improve continence. 

What are the Best Exercises for Incontinence?

Depending on what type of dysfunction is occurring in your pelvic floor there are going to be two exercise strategies.

  • Strengthening: The commonly known “Kegel” exercise. However, there is a large misconception about how it is performed. A pelvic health physiotherapist will help you understand the proper technique and give you individualized cues to think about. With internal pelvic physiotherapy, you will really be able to connect with the right muscles and know how to isolate them properly.
  • Relaxation exercises: which uses breath and mental imagery to relax the pelvic floor.

If you are suffering from incontinence or urinary leakage know you are not alone and you can do something about it! Speak to your family physician or contact us today to book an appointment with one of our skilled pelvic floor physiotherapists today.

Pelvic Organ Prolapse

A pelvic organ prolapse (POP) is a protrusion or bulge at the vaginal opening caused by weakness of the pelvic floor or stretched pelvic floor muscles and connective tissue. This may happen after childbirth or as we age and our pelvic floor weakens. The POP is defined by which organ is protruding through the vaginal canal and may include:

  • Cystocele: bladder prolapse
  • Rectocele: rectum prolapse
  • Urethrocele: urethral prolapse
  • Uterine Prolapse: Prolapse of the uterus

What Does a Pelvic Organ Prolapse Feel Like?

It can be described as:

  • Feeling like you have a bowling ball between your legs.
  • A “bulge” down there.
  • Difficulty emptying your bladder or having to strain while having a bowel movement.
  • Feeling like your insides are coming out.

Specific symptoms vary depending on the type of prolapse but may include: pressure or pain around the vagina or perineum with prolonged standing or activity, difficulty evacuating one’s bowel and or bladder, or a visible protrusion at the vagina opening. These symptoms can very annoying and can limit everyday functional activities.

What can a Pelvic Health Physiotherapist do for a Pelvic Organ Prolapse?

If you suspect you may have a POP it is important to be assessed by your physician or gynaecological specialist so you can be properly diagnosed.

In some POP cases surgery may be necessary. However, many surgeons agree that surgical intervention is usually the last resort.

What Type of Treatment will a Pelvic Health Physiotherapist Provide?

Conservative management with your pelvic floor physiotherapist may include:

  • Postural education
  • Pelvic floor muscle strengthening and core exercises
  • Lifestyle modifications
  • Pessaries

What Exercises Should You Perform with a Pelvic Organ Prolapse?

It is important that you preform appropriate core engagement exercises for your injury.

Kegel exercise

Gentle activation of the deep core while lying on your back, feet flat, knees bent. On an exhale draw up your muscles in your pelvis like you are picking up a blueberry with your vagina and or anus. Hold this sensation while continuing to breath for 10 seconds and release, repeat 10x/3day.

It’s important to note, that you may not be performing the exercise correctly and you may need some feedback and help from a pelvic floor physiotherapist. Pelvic floor physios are specially trained to assess your pelvic floor internally so they can assess and feel the actual pelvic floor (right at the source of dysfunction). They will be able to assess whether you are contracting your pelvic floor symmetrically and evenly. They will also be able to cue you with internal feedback so that you can better engage your pelvic floor.

Your physiotherapist will help you advance your exercises as it is indicated with your ability to activate correctly while taking into consideration your level of pain and severity of your condition.

What exercises should be avoided with a pelvic organ prolapse?

  • Sit ups
  • Heavy weight lifting
  • High impact, jumping
  • Any intense exercises where you tend to hold your breath
  • Any exercise that involves leg raises or lifting your head and shoulders off the floor.

These maneuvers tend to increase pressure in your abdominal cavity and push down on your pelvic organs and pelvic floor. This can further aggravate your pelvic organ prolapse and may weaken the ligaments that support your pelvic floor.

If you have been diagnosed with a pelvic organ prolapse and are looking for a gentle and knowledgeable pelvic floor physiotherapist in north of Edmonton, be sure to contact us today to book an appointment with one of our amazing pelvic floor physios.

Piriformis Syndrome: A Real Pain in the Butt!

Do you have a dull ache or pain in your buttock when you sit down for a long time or when you are walking up stairs or an incline?

Does your hip feel stiff, with limited mobility?

Does your pain occasionally go down the back of your thigh or your leg?

If you answered yes to these questions, it’s possible that you may have piriformis syndrome.

What is Piriformis Syndrome?

The piriformis muscle is a deep muscle in your buttock region that connects your thigh bone at the hip to the tailbone and lower back. This muscle runs diagonally upwards from the hip and is located beneath the gluts.

When this small muscle tightens up and/or spasms, this can cause a pain in the buttock. This is called Piriformis Syndrome. In addition to pain in the buttock, the sciatic nerve can become irritated and symptoms of sciatica such as pain down the back of the thigh, leg and foot can appear.

The sciatic nerve runs vertically from your low back down the back of your thigh and can either pass behind the piriformis muscle or right through this muscle. The close relationship of the sciatic nerve and piriformis muscle is the reason why many individuals with Piriformis syndrome are misdiagnosed. The sciatic nerve can get compressed and/or irritated in many different places: 1) The low back, 2) The Piriformis Muscle, 3) Anywhere along the back of the leg.

It is important that a qualified health care professional, such as a chiropractor and/or physiotherapist assess you to determine where your sciatica is originating from so that treatment can be specific to the site of dysfunction.

What Causes Piriformis Syndrome?

Below are some reasons why your piriformis muscle may be in spasm and leading to your buttock pain:

Fat wallet

Piriformis Syndrome The problem is you might actually have a fat wallet. Many men often put thick wallets in the back pockets of their pants. Being creatures of habit you usually put your wallet in the same back pocket every day. When you sit on your thick wallet it puts extra pressure on the piriformis muscle and shifts your pelvis. If you sit for long periods of time like a truck driver or office worker you may be aggravating your piriformis muscle and giving yourself piriformis syndrome. The easy solution is to take the wallet out.

Fall on your Buttock

If you have recently fallen on your buttock, you may have either bruised your piriformis muscle or caused damage to the structure of the muscle which may have healed inappropriately and with scar tissue. This can cause spasm in the piriformis muscle. Additionally, a fall to the buttock can shift the bones in your pelvis (including your tail bone) which the piriformis connects to. If the bones are shifted, they could be putting additional strain on the piriformis muscle because the muscle is forced out of its optimal length in order to accommodate a new resting length position. The piriformis will react to this by going into spasm or developing trigger points.

Hip Dysfunction or SIJ Dysfunction

If you are experiencing issues with your hip or sacroiliac joint, your piriformis muscle may need to overcompensate or work harder in order to help you manage with this pain or injury. Limping can also put more strain on your piriformis muscle. Ultimately, correcting your hip problem or SIJ dysfunction and improving the muscle control and balance in this region can take some of the strain off the Piriformis muscle and allow it to work the way it was made to.

Improper Sitting

For some of you, sitting long periods will tighten the piriformis muscle. Many of you put more pressure on one buttock or sit bone in comparison to the other side . Crossing your legs or shifting your body to one side repeatedly can cause this. This will put increased pressure on your piriformis muscle as well as your sciatic nerve. And you will end up with piriformis syndrome.

Treatment for Piriformis Syndrome

How can a Physiotherapist or Chiropractor help with Piriformis Syndrome

If you suspect you have piriformis syndrome you may need help from an experienced and skilled health care practitioner like a physiotherapist and/or chiropractor. They will determine what the root of the problem is and if it is in fact Piriformis syndrome that you are suffering from. Once you have been correctly diagnosed, your chiropractor or physiotherapist will be able to apply treatment strategies that include manual therapy and acupuncture as well as muscle strengthening to correct the issue.

Manual Therapy

Your physiotherapist or chiropractor may work on releasing your piriformis muscle or mobilizing the joints that are contributing to the tight piriformis muscle such as your hip, your SIJ or your low back joints.

Shockwave Therapy

Shockwave therapy is one of the best alternative to  release your piriformis muscle, eliminate pain, speed up healing, and improves mobility quickly.

Acupuncture or Dry Needling

Medical acupuncture can be used to stimulate the piriformis muscle and restore normal nerve conduction to the muscle. Acupuncture will also help to stimulate the sciatic nerve and increase blood flow to the nerve, bringing it back to health. Dry needling can decrease the tension in the piriformis and other tight hip muscles releasing tension on the nerve.


Your health provider will determine what muscles are too tight and which are not strong enough and might be placing additional load on the piriformis muscle. It is important to note that everyone is unique and your muscle imbalances will be assessed individually. This means that the prescriptive exercises that you are given will be unique to you and will help only you!

What are the Best Exercises to Help with Piriformis Syndrome?

The “Figure 4” Stretch

This stretch that is also known as thread the needle in yoga is performed by lying on your back with your knees bent and feet flat. Take the leg to be stretched turn the heel inwards and place it across your thigh of the other leg, you should look like your legs are making the number “4”. Then grab behind the knee of the leg with the foot flat and pull it up towards your chest. You should feel a deep buttock stretch in the leg that is crossed. Hold 30 seconds, repeat 3x, 3x/day.

Sciatic Nerve Flossing

Lying on your back, holding the thigh of the sore leg with your hands clasped around. Start with your knee bent and your foot flexed, then slowly and smoothly transition to your knee being straighter and your foot pointing. You do NOT want to pull your leg into a range with pain or heavy tension but you should feel a gentle stretch along the back of the thigh. Your movement might start off limited and then increase as you rhythmically go slowly in and out of the movements 15x.

Bird Dog Exercise

Perform 10 reps 3sets a day.


Perform 10-15 reps, slow and controlled 3xday.

What Should be Avoided with Piriformis Syndrome?

  • Crossing your legs or ankles when sitting
  • Not stretching
  • Prolonged periods of sitting, without movement breaks
  • Take your wallet out of your back pocket
  • Avoiding treatment while the symptoms are getting worse

How Can You Treat Piriformis Syndrome at Home?

You will want to first try making some lifestyle modification by avoiding the above-mentioned habits and trying to adapt a daily exercise routine. If your self-diagnosis is correct and you are on top of these exercises you should see improvement in symptoms in the first week. However, do not stop the exercises, keep performing them daily until the pain has subsided and then try to maintain them on an ongoing basis 3-4xwk.

If you are not seeing results with these strategies in 2 weeks of implementing them, it is best you book a consult with your trusted chiropractor and/or physiotherapist. The injury may be misdiagnosed or more complicated and require the expert care of a treating professional.

How Long Does it Take to Recover from Piriformis Syndrome?

Estimated recovery from this condition is 6-8 weeks. With the proper treatment and directed rehabilitation exercises recovery can occur sooner.

It will be important to strengthen the core and glut muscles while stretching in the deep hip rotators. This process will show some immediate gains but then take about 6 weeks of committed exercises for the desired outcome.

For more information or to book an initial consultation with our health care practitioners please contact us or request an appointment online. Our team of qualified and highly skilled chiropractors, physiotherapists and sports massage therapists are here to help you recover from your injury. Our team has a lot of experience dealing with Piriformis Syndrome as well as a wide variety of other conditions and you can be rest assured that we are 100% committed and dedicated to our work and to helping you feel your best! Book today.

Interstitial Cystitis

You have a heavy burning sensation in your bladder, you have an urgency to urinate and you notice you have been increasing your frequency of visits to the washroom. When you do urinate you feel burning pain which persists in your genital area. These symptoms may have come out of the blue, or maybe you can identify a particular event which triggered your pain such as an infection, childbirth or surgery. If a visit to your family physician has cleared you of infection or anything more sinister, you may have Interstitial Cystitis (IC).

Causes of IC

The cause of IC is still unknown but researchers think it may be linked to an event which caused trauma on the bladder lining. This may include but is not limited to:

  • pelvic surgery
  • bladder distension (possibly linked to long periods without bathroom use)
  • pelvic floor muscle dysfunction
  • bacterial infection

What do you do if you have been diagnosed with IC?

First Line Treatment:

  1. Education – patients armed with the knowledge about normal bladder function, what is known about IC, and the available treatments as well as their effectiveness, generally fair the best.
  2. Self Care and Behavioral Modifications – this may include changing your diet and water intake, avoiding your known triggers, meditation and muscle relaxation techniques.

Second Line Treatment:

  1. Physical Therapy! Most IC patients have some form of pelvic floor dysfunction – increased tightness in the muscles and connective tissue of the pelvic floor, hips and abdomen.
  2. Pain management including pharmacological, manual therapy, and stress reduction techniques.

Further recommendations for treatment continue with more invasive procedures being recommended only as a last resort when conservative management fails.

Contact one of our pelvic physiotherapists today to learn more about what pelvic physiotherapy can do to help you manage your IC symptoms.