How To Sleep With SI Joint Pain - How To Modify Each Position For SI Joint Pain Relief

hey there Sam bisnick here release Muscle Therapy in today's video I'm going to walk you through how to sleep with SI joint pain so stay tuned [Music] all right welcome back and again in this video we're going to be covering how to sleep with SI joint pain now real quick before we get started it is important to always note what the sacroiliac joints are that's where these ilium bones here on the side of the pelvis connect with that bone in the middle called the sacrum and it creates a joint there now what you're going to read online and I've talked about this in a number of other videos as well there are a lot of arguments on the ability of the sacroiliac joints to be pain creators or to be the cause of pain that's because in a lot of people these joints do not move they move very little if at all so whenever we're having a conversation about the sacroiliac joints we have to have that conversation about its relationship to the lumbar spine and of course the hips so when I we go through these positioning movements we are going to you think about the sacroiliac joints as one big package with the lumbar spine and the hips because that's how we work with that area so regardless of whether or not you're having direct pain from the sacroiliac joints or it's referred pain from the lumbar spine or some contribution from the hips and or the muscles it's all one big package deal and that's how we address it so the important parts about these sacroiliac joints are in particular if you've not come across this before pelvic movements are generally in multiple planes of motion forward and backward tipping we call this anterior pelvic tilt and posterior pelvic tilt and of course we have as we walk or we ambulate these alternating and reciprocal activities of the pelvis moving from side to side so we have both a rotary aspect and a side bending aspect we have to keep these things in mind as we position ourselves so that we can get the optimal sleeping position without having too much discomfort so when we look at the different sleeping positions there are a couple of options here most people are going to be either sleeping on their back sleeping on their stomach or on one or the other side and some people sleep in some funky positions I won't be covering those here but if we're looking at pain here let's start with the Supine position and generally speaking you know most people will say that laying on your back is the best position for your back in my opinion the best position is the one that causes the least amount of discomfort and allows you a good night of sleep but of course that's going to depend upon the underlying Orthopedic situation so if you're having discomfort while laying on your back from the SI joints the majority of the time this situation is because of shortness or tightness in the hip flexor muscles the hip flexors obviously referring to the psoas the iliacus muscle and the rectus femoris and or tfl so these muscles are covered on additional videos on my channel be sure to check those out but that's oftentimes what's causing that feeling of being jammed up or extended when you're laying on your back there's two ways to solve this situation very easily so first and foremost what we can do is to soften the position of the pelvis is to place a bolster or pillows underneath the knees so if we lay in this position here by softening or reducing the tension on the hip flexor muscles it will allow the pelvis to be able to rock back in a more comfortable way and then it will reduce the amount of extension Force going through the lumbar spine and thus reduce the symptoms in the sacroiliac joint region so the pillow height is does not have to be very much this bolster here is probably about six or seven inches so oftentimes just stacking up a couple of pillows and then draping the knees over the top can provide a great degree of relief so that's usually all that is necessary in the Supine position when you're positioning your head and neck in this position oftentimes I recommend just one maybe two pillows Max oftentimes sleeping with high angles stacked up with too many pillows is going to additionally add more flexion to the upper portion of the spine that may cause more discomfort in the lumbar spine maybe or maybe not it depends on the person but if we're putting an adequate amount of bolster underneath the knees we should not need to keep jacking up the upper body so that is an ideal position here for laying on your back for SI joint pain okay so let's now take a look at these side lying position so when we're laying in the side lying position first and foremost we should be laying on a pillow so that we can keep our head and neck in a neutral position that's obviously one of the most important pieces in this position and as we go down the spine here we're going to note a few different things now when we are laying in a side lying position we have to keep in mind that the pelvis is fairly wide relative to the spine in the middle so in this situation this individual will be laying on the left side and then laying on the left side of course this is a model so the spine looks stiff and it looks straight but this is technically not what's happening in the side lying position the lumbar spine has a bit of a drag down toward the ground so technically there's a little bit of right side flexion going on in this position now again for most people this may make no difference at all but for some individuals with lower lumbar spine pathology and or sacroiliac joint region pain this may not be very tolerable so this light amount of drag down toward the ground might create some stress down there on the joints and be a source of discomfort now it is possible that also women have this a little bit more than men because of the width of the pelvis so that's something to note so how do we address this well one of the easiest ways to do this is to use a rule or a bolster underneath the side of the lumbar spine not as high as the ribs it's down below the level of the ribs so I oftentimes do this in my office is use this nice little rule that I have right here but certainly a nice soft squishy pillow can help make a difference so as I position this here I now have a bolster obviously it's not going to be making contact with the spine on you but over the side of this area and it can provide a little bit of bolstering in the side bending aspect of the spine for a lot of people this can provide a great deal of improvement and comfort in this position now the challenge with this is is that as you sleep you'll want to roll around there are some types of devices available I believe McKenzie still makes one that has this kind of a roller it looks like in a tube and you can put it around your waist and tie it so that as you roll from side to side it's going to be there no matter what to keep you in a relative neutral position okay so this is oftentimes quite helpful as we scan down to the next piece now if that lumbar spine is in a good position in the pelvis now we have to consider what's going on with the hips now most people generally are going to feel not a whole lot of comfort in the sideline position with the top leg draped all the way down toward the bed the reason for this is because of the stretch that is going to put on the tissues that are going on the back side of the hip those are the glute muscles but as we keep going that way there's connective tissues that cross the sacroiliac joint region now as we move into this position if there's too much stretch being placed here it can pull down on this ilium and you might feel some distress or discomfort in the lower lumbar region or in the s-i joints so for this reason we always want to prop this knee up so that at least it is the level of the hip ideally and that way we can put some slack in these tissues here so they don't have so much tension on them so the knees are oftentimes going to be bent to at least around a 60 degree angle they don't have to be at 90 degrees by any means and we would place pillows underneath here now in my office I just make things simple I use a couple of these super soft mats just for demonstration purposes but you can see now that the knee is approximately at the height of the hip that's going to reduce the amount of tension on these tissues and reduce any translation tension going toward the lower back now of course in this situation some people like to just have a pillow between the knees I am also a fan of a full body pillow and that way the arm can be draped over the pillow too in case there ends up being any discomfort in the shoulder region in the side lying position so this is going to be an ideal position for sleeping on the side as we talked about here there is a device for wrapping around the pelvis and roll or the Torso waist I should say and rolling from side to side there's also a gizmo here that actually attaches to the knee between the knees and you can roll from side to side so if you're constantly rolling and flipping the pillows out all over the place and having to readjust either you deal with that and still get a better night of sleep or two you could figure out some of those other gizmos if they work for you but this is about the ideal position for sleepings in the sideline position for SI joint pain okay now let's talk about lying prone with SI joint pain now laying in the prone position generally speaking despite what you might have read in other places is not necessarily bad for your spine or anything else my main concern in working with individuals who have to lay prune when they sleep is putting a lot of rotational stress on their neck if they have pre-existing aches and pains in the neck area that oftentimes can lead to a stiff neck sometimes so I do have additional positioning items for this but let's just talk about the SI joint region here so when you're laying face down as we talked about previously in the Supine position a lot of the extension stress that's where the pelvis is going forward into an anterior pelvic tilt and the arch in the back is creating discomfort that same type of issue is going to be present in the prone position and oftentimes exacerbated because as you're laying face down the spinal joints as things relax down with gravity are going to be extended and if you're one of these individuals who has difficulty for example laying on a massage table getting a massage because just by laying in the pruned position you get up and you feel like your lumbar spine is stuck and you have to unglue yourself then sleeping in this position is not going to be comfortable and can lead to a pretty achy back so as we're over extending or extending I should say those joints down there that is going to provide that anterior pelvic tilt type stress and may increase or exacerbate this SI joint region pain so one of the things that I recommend doing if you are laying face down is number one have your head comfortably rested into a position because if you're holding tension in your neck that's probably going to increase tension in the lower back as well so make sure your neck is comfortable number two is to place a pillow or a bolster this is the exact one that I use here underneath the hips now if we place this underneath the hips in just the right spot and to me it's going to be roughly at just below belly button level what it's going to do is it's going to open up the joints in the lumbar spine and allow the pelvis into a little bit more posterior pelvic tilt and that posterior pelvic tilt is going to reduce the extension in the lumbar spine and reduce the amount of stress in that sacroiliac joint region so as we do that this position is oftentimes made to be way more comfortable I've had individuals who've had constant problems with getting massages in the pruned position because of their low back this alone eliminates the entire problem they can take a lot more pressure down into the lower back muscles without irritation now when we scan down to the legs then we also want to make sure that the feet and the hips are in the most comfortable position if you're putting your feet flat most people don't have the flexibility on the top of the foot for their foot to lay straight out so their leg end up having to be internally or externally rotated and that may or may not pose an increased amount of stress up there in the SI joint region so we use a bolster so the bolster here is going to be placed just like this so the feet are elevated here that way we have reduced stress down here at the lower extremity and the hips we have the bolster underneath the pelvis which is going to add a little bit of posterior pelvic tilt and the upper body is positioned well so in the worst case scenario I have recommended as you could tell how useful a massage table is when individuals are dealing with a lot of pain or discomfort or and they're an acute rehab situation it may be best advised to get a massage table that has a face cradle so that you can actually lay face down and get more hours of comfortable sleep mostly because of the softness of the table the ease of getting on and off here and of course the face cradle positioning which is very very useful but this is the best position for sleeping in the prone position for SI joint pain okay that wraps it up I hope you've enjoyed this video on how to sleep for SI joint pain be sure to like this video comment below with any questions you might have I'll include any of these additional bolsters here and links below the video in case you'd like to Source those and have those for home use and of course be sure to subscribe to this channel so you can get notifications of new videos coming up soon Sam biznik thanks for watching

Channel: Sam Visnic

Views: 92,794

Keywords: sacroiliac, sacroiliac joint, si joint, si joint pain, si joint pain sleeping, si joint pain at night, how to sleep with si joint pain, si joint bed, back pain in bed, back pain sleeping, si joint pain in bed, si joint support, si joint instability, si joint brace, si joint mattress, low back mattress, sleeping with si joint pain, sacroiliac joint pain when sleeping, sam visnic, athlean x, paul chek, nasm, physiotherapy, exercise, sleep, sleeping, pregnancy, low back pain, posture

Id: dA6ZvhEIK8A

Length: 13min 36sec (816 seconds)

Published: Mon Dec 12 2022