Are you feeling twisted?

Are you feeling twisted?

Every week I have clients coming in with lower back pain who feel “lopsided and twisted.” Although there a number of different biomechanical factors that can result in this feeling, one of the most common reasons is due to a torsion through the pelvis at the sacro-iliac joint (SIJ).

But why would a twist in your pelvis cause so much lower back pain?

Your SI joint is the joint at the base of your spine, where the sacrum (triangular bone at the base of the spine) meets your iliac bones (pelvic bones), therefore the SI joints connects the spine to the pelvis. There is relatively little movement at this joint as it is held together by a number of strong ligaments which help support the body from all the forces coming from the upper and lower body, particularly when we stand erect.

What are some of the causes of sacroiliac joint dysfunction?

1. Damage or degeneration to the cartilage covering the joint surface. Cartilage acts a shock absorber between the bones and aids movement. When the cartilage has become degenerated or damaged, the bones begin to rub together and osteoarthritis can occur. The SI joints are commonly affected by osteoarthritis, like other weight-bearing joints.

2. A muscular imbalance between the quadriceps and hamstring muscles in your legs can cause a torsion through the pelvis. These muscle groups attach directly to the pelvis and act like a pulley system, working with each other. If for example, the quadriceps are particularly tight and the hamstrings are not strong enough to counter-act this tension, then the pelvis can tilt forward causing strain through the lower back.

3. Pregnancy is also a common cause of SI joint dysfunction due to the hormone Relaxin which is released during pregnancy to allow ligaments to relax, to prepare the female body for childbirth. When the ligaments relax, it allows an increased range of movement through the joints which as well as the additional weight and altered walking pattern, can cause further stresses through the SI joint.

4. A leg length inequality or anything that causes an altered walking pattern, can also lead to increase stress through the SI joints. This can include pain in the hip, knee, ankle or foot that is causing you to avoid weight bearing on the affected side.

5. Pre-existing disorders such as gout, rheumatism, psoriasis (psoriatic arthritis) and ankylosing spondylitis which lead to an increase in inflammation in the body can also aggravate the SI joints.

Associated symptoms
• Pain in the lower back that may refer into the buttock, groin and thighs
• Pain is typically worse for standing and walking or moving from sit to stand
• Usually a dull ache, with sharp episodes on certain movements.
• In some cases it can cause a burning sensation in the pelvis.

If you are worried, it is worth having your spine and pelvis assessed as it may lead to further problems such as ligament sprains and muscle strains, due to the change in posture.

Please do not hesitate to contact me on 

Every week I have clients coming in with lower back pain who feel “lopsided and twisted.” Although there a number of different biomechanical factors that can result in this feeling, one of the most common reasons is due to a torsion through the pelvis at the sacro-iliac joint (SIJ).

But why would a twist in your pelvis cause so much lower back pain?

Your SI joint is the joint at the base of your spine, where the sacrum (triangular bone at the base of the spine) meets your iliac bones (pelvic bones), therefore the SI joints connects the spine to the pelvis. There is relatively little movement at this joint as it is held together by a number of strong ligaments which help support the body from all the forces coming from the upper and lower body, particularly when we stand erect.

What are some of the causes of sacroiliac joint dysfunction?

1. Damage or degeneration to the cartilage covering the joint surface. Cartilage acts a shock absorber between the bones and aids movement. When the cartilage has become degenerated or damaged, the bones begin to rub together and osteoarthritis can occur. The SI joints are commonly affected by osteoarthritis, like other weight-bearing joints.

2. A muscular imbalance between the quadriceps and hamstring muscles in your legs can cause a torsion through the pelvis. These muscle groups attach directly to the pelvis and act like a pulley system, working with each other. If for example, the quadriceps are particularly tight and the hamstrings are not strong enough to counter-act this tension, then the pelvis can tilt forward causing strain through the lower back.

3. Pregnancy is also a common cause of SI joint dysfunction due to the hormone Relaxin which is released during pregnancy to allow ligaments to relax, to prepare the female body for childbirth. When the ligaments relax, it allows an increased range of movement through the joints which as well as the additional weight and altered walking pattern, can cause further stresses through the SI joint.

4. A leg length inequality or anything that causes an altered walking pattern, can also lead to increase stress through the SI joints. This can include pain in the hip, knee, ankle or foot that is causing you to avoid weight bearing on the affected side.

5. Pre-existing disorders such as gout, rheumatism, psoriasis (psoriatic arthritis) and ankylosing spondylitis which lead to an increase in inflammation in the body can also aggravate the SI joints.

Associated symptoms
• Pain in the lower back that may refer into the buttock, groin and thighs
• Pain is typically worse for standing and walking or moving from sit to stand
• Usually a dull ache, with sharp episodes on certain movements.
• In some cases it can cause a burning sensation in the pelvis.

If you are worried, it is worth having your spine and pelvis assessed as it may lead to further problems such as ligament sprains and muscle strains, due to the change in posture.

Please do not hesitate to contact me with any questions you may have or to book an appointment.

Mel Harrison

Osteopath

Mel Harrison Osteopath

How can Osteopathy help you with your sport injury?

How can Osteopathy help you with your sport injury?

Many sport injuries that we develop are often a result of playing too hard and too often, for example tennis or golfers elbow and biceps tendinitis.

Overuse injuries are quite often directly related to poor training techniques. In my opinion, from what I see in the clinic, inaccurate warming up and warming down before and after exercise, is one of main reasons that people suffer from injuries.

A warm up should generally involve slowly raising your heart rate and dynamic stretching, whereas a warm down should slowly lower your heart rate and consist of static stretches to every muscle group, holding the stretch for a minimum 10 seconds!


Another common cause of injuries is incorrect equipment. Ill fitting footwear can cause hip, knee and foot injuries such as Achilles injuries. If you exercise regularly you need to replace your trainers frequently- not waiting until there are holes in them!


A reduction in joint flexibility may cause injury and also affect your performance. This is often more relevant for all the older athletes of us! It is great if you are as enthusiastic about sport as you were when you were 18, but unfortunately your knees and other joints are not.

It is not all good for young people though unfortunately, you can be more vulnerable as your growing bodies are often expected to perform to high standards, which cause you to put excess physical demands on yourself.

The good news is that although sport injuries are common, those who are fit tend to recover more quickly and easily from their injuries.

So how can osteopathy help?

Osteopathy is particularly useful in the prevention and treatment of sport injuries as it looks at how the body works as a whole.

We can help restore structural balance, improve joint mobility and reduce adhesion’s and soft tissue restrictions, so that ease of movement can be restored and your performance enhanced.

Even if you aren’t injured and you just wish to keep fit, osteopathy can help keep you supple and improve your muscle tone to reduce the risk of injury- why wait to be injured to come and see me?

Osteopaths can also give you specific exercises and dietary advice.

Top tips!
• Begin slowly and build up, especially after injury.
• Warm up first, and then warm down with stretches afterwards.
• Drink plenty of water when exercising.
• Exercise regularly and try to alternate the types of exercise that you are doing everyday.
• Following a joint injury- Rest, Ice, Compress, Elevate (Ice for 15 mins, every hour).
• Learn to do your sport correctly!
• Strive for a total body workout- cardiovascular, strength training and flexibility exercises.