The goal with the belt is not to restore left-right balance. The belt is not going to make your pelvis level. The only job of the belt is to squeeze the SI joint together. The vast majority of SI joint problems are related to instability. If you're in an extreme case where your SI joint's clicking and popping all over the place every movement you make, you definitely need an SI belt.
I would highly recommend that as almost a necessity. because your pelvis is right in the middle of your body and it's hard to do any movements without involving your pelvis. And if it's clicking and popping with every movement you do, you're constantly loosening up that SI joint when we want to stabilize it.
Not everyone has success with an SI joint belt, so we're going to talk about how to use the SI joint belt. We are trying to get ligaments to heal and ligaments take time, just like an ACL or an MCL. They take months to heal.
and you have to brace the joint. You have to brace the ligament for it to heal. So that's what we're doing with the SI belt.
So let's talk about placement. This is the back of your pelvis. What is the anatomy that you can feel from the outside? It's these two bumps right here. So this bump on the left, this bump on the right, they are your PSISs.
You know, if there's not too much fatty tissue back there, you can feel a bump on the back of your pelvis. That's these bumps here. So you really want the belt to pretty much go right over them.
If you can see the joint, this is the joint here. It's usually the top of the joint where the ligaments are most injured. We want to strap that together.
We want to brace it like a retrofitting of a house for an earthquake, right? We are just wrapping it in something that squeezes it and holds it together. And so we want to optimize the exact placement of that. We wouldn't want the belt up here because then we are actually torquing the joint and that would make it worse. And look, it's not as a pretty subtle difference in the belt placement, right?
A lot of people probably wear the belt right here and it makes their SI joint hurt worse. Or if you put it down too low, you're not going to be able to be very functional. This is going to be really get in the way of your ability to move and walk around.
So you've got to get it basically as low as possible while you can still function. So let's actually look at a different angle. So this is your ASIS. If you feel the front of your pelvis right now, you can be sitting or standing.
You feel this prominent... bump on each side of your pelvis. Those are your ASISs.
Here's the PSIS that we were pointing at earlier. So if you put it right over that PSIS in the back, it's just above the bottom of that ASIS. That bump on the front of your pelvis is going to be at the very bottom edge of the belt, okay? That's important.
This skeleton, this posture, does not have any anterior pelvic tilt. You can see that the pubic bone is forward. That's very healthy.
in most people that are in a chronic situation with chronic lower back pain, SI joint pain, they're going to be living in a little bit of anterior pelvic tilt, which means this pelvis is going to be tipped forward a little bit. The pubic bone is going to be back a little bit. So it's going to be rotated down. This ASIS will be like down here. And the most prominent thing that you can feel might be here, a little above.
If you imagine rotating it like that, then you can imagine that this part's going to be more prominent. It's going to come forward. and this will come down. In your case, if you have anterior pelvic tilt, you may just want to put the belt right over the most prominent part because that's going to be a little above your ASIS. So just right over the top of it.
This is a three-quarter angle view for SI belt placement. We're right about here. This view is not very telling, but you do see the ASIS, the bottom edge of the belt is right over that prominent point.
And then here's the front view. This is probably the most helpful because you can only see the front of your body. You can see the joint here.
We want to strap the top part of the joints together. And so we're going to take the belt. We're going to put it right over the top of the joint and retrofit your pelvis. And so the ASIS is just right below on either side. And so the bottom edge of the belt is right on that ASIS.
And this will be the least. cumbersome to your movement because the muscles that attach to that AIS run down from it. You'll know if you're pinching those tendons because it'll start to like burn.
They'll get really tired when you're walking and you can put up with that as much as possible but you might end up if you put the belt too low you're going to be causing a lot of friction on those tendons. You can put try to put up with it or you can just raise that belt a little bit so that bottom edge of the belt is on the prominent point and you're not pinching those muscles. I'm wanting you to put the SI belt straight onto your skin, not over your clothing. It's not going to work as well. And the belt that I recommend is the Saunders Group SI belt.
I think it's the most simple and the most, and provides the most stability. And it does have a bit of like a grippy material on. your skin.
So your skin's going to need to breathe. So this belt is stabilizing bones, right? And what atrophies? Muscles atrophy.
So these muscles are pulling the opposite direction of the belt. There is no correlation with what the belt's doing. So these muscles are not going to atrophy at all because it's perpendicular.
The belt's pulling horizontal and these are pulling vertical. They're not overlapping their function. But if we take a look at the back, the pelvis, they're... is some overlap in the direction of pull of these muscles and the belt. So potentially, if you were to wear this belt all the time, I imagine that some of these fibers in the glute and maybe the piriformis would say, I don't really need to pull as hard.
I don't really need to have tension because some other object is doing it for me and I'll just let off a little bit. And that could lead to weakening or atrophy. But if you are complementing the SI belt with specific strengthening exercises for these muscles. So the bridge and that modification that will highly, highly emphasize these fibers to strengthen them with the belt on and doing the exercise, you're not going to atrophy. Any crutch that you give your body has the potential to make your body weaker.
So we want to always complement a crutch like SI belt with exercises that are going to be achieving our goal. Here's the SI belt plan. There's three stages.
The first stage is to wear it all the time. If you're in this category that you're clicking and popping a lot or you're having a lot of pain, you want to wear it all the time. And this, you can't wear an SI belt all the time literally because your skin has to breathe.
So when I say all the time, I mean as much as possible and the times when you let your skin breathe, when you take the SI belt off, would best be when you're sitting on both sit bones, so not like leaning over or crossing your legs, but when you're sitting on both sit bones, SI joints are very stable because you're taking advantage of that keystone shape of the sacrum sitting between the two hemipelvises. When you're sitting on both sit bones, it's basically a fixed structure that's very stable as long as you're balanced and symmetrical. Don't cross your legs. Don't lean onto one sit bone. That's going to stress and shear the joint.
So you can unstrap and loosen the SI belt when you're sitting to let your skin breathe. And sitting would be one, like during the day. And also sleeping. I don't think you should sleep wearing the SI belt if you can get away with it.
There are some cases where you, or some nights, some people might need to wear an SI belt sleeping one night or a couple nights because it's really bad right now. It's just too much and sleeping on it is really irritating. Everything is going to be to the degree that you need.
Let's go to stage two. So this stage one is going to be maybe, could be a week. could be two weeks.
It's going to all depend on the severity of your SI joint pain and clicking and popping instability and your ability to follow the steps. It's going to be different for everybody, but listening to your body is going to tell you. So you're going to feel like ready to introduce more activity or to wear the SI belt a little less often based on your body's communication, the symptoms that you're feeling.
You're going to start feeling more stable. So stage two of the SI belt is wearing it during all activities. activity, but not really during like passive things.
So if you're walking, potentially, yeah, wear it. Activities of daily living, like cleaning the house, yard work, whatever. Yeah, wear it. But if you're just standing casually, symmetrically, you don't want to be leaning on one leg or the other.
That's going to shear the joint and stress it. You can not wear it. Or if you're just sitting, you know, you know, you're going to be at your computer for the next hour.
You can take it off completely. And then stage three, you're going to wear the belt only during exercise. And this is a gradual progressive stage as well, because early on, you're going to be doing more simple exercises.
And later on, you're going to be doing more complex exercises. And you're going to want to be wearing the belt during the complex exercises later on, but maybe not so much during the simple ones, because you're several weeks or months into this, and you know what your body can handle. So there's going to be a process of listening to your body.
I didn't really mention stage two could be anywhere from a month to two months. It's going to depend on your body. And stage three is...
is going to be the longest. It could be two to three months. This is a slow process. We are trying to get ligaments to heal and ligaments take time, just like an ACL or an MCL. They take months to heal.
So we got a pelvis that's out of alignment. Should I strap a belt on this or do I need to look like this in order to successfully use an SI belt? Obviously this is optimal.
This is ideal to strap a belt around, but most people are living in this situation. So Should we put a belt on this? And I think my answer is yes to the degree that you listen to your body and keep adjusting it relentlessly to find a way of wearing it that doesn't increase your pain. So the belt might look something like this.
We have to work with what we've got. And that includes our fitness level and our posture and everything. So I don't necessarily think you should put the belt on perfectly straight if your pelvis is crooked.
I think that would potentially be a problem. So match the belt a little bit. Maybe split the difference. Something I would want to make clear is the goal with the belt is not to restore left-right balance.
The belt is not going to make your pelvis level. The only job of the belt is to squeeze the SI joint together. It's a retrofitting. It is okay to change the angle of the belt, to move the belt down, to move the belt up.
Find a way to make it work for you. This is a long-term process to get those ligaments to heal and tighten up and stabilize. And really, it's going to be a long-term process.
For most people, that's the case. Something about the SI joint makes it very possible to stabilize. It's inherently shaped to be a very stable joint. And so if you give it what it needs, there is so much hope for you to...
not only get out of pain, but to be able to get potentially stronger than you were before. We appreciate you here at Core Balance Training for leaning into your health, and we'll see you again next week.