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Sacroiliac Joint Dysfunction
By: Dyan Quesada MPT,ATC

The Sacroiliac Joint (or SI Joint,) is the joint between the sacrum and the ilium (one of the bones on the pelvis– see figure below.) The movement in this joint is very little, unlike the movement available in your shoulder. Sacroiliac Pain can occur secondary to the following diseases: ankylosing

spondylitis, Paget’s disease, or tuberculosis. More commonly, Sacroiliac Pain occurs from dysfunction- either stresses on the joint or too much movement (hypermobility.)

Side view of sacroiliac

Stresses to the SI Joint can occur from the following activities: persistent standing on one leg, falling on your “SITS” bone, swinging a golf club, lifting something, or even bending over. If the joint is hypermobile, pain occurs anytime the joint is displaced. This occurs more commonly in females due to their joint structure, hormonal changes, and childbirth strains.

Pain is experienced not only at the joint, but also in the muscles around the SI joint. Pain can also be present in the back of the thigh, in the lower abdomen, or in the groin. Coughing can increase symptoms at the SI joint. Diagnosis of this dysfunction is difficult to see on x-ray because there is very little movement at the joint. Physicians and physical therapists can confirm a diagnosis in their examination.

Physical therapy is very successful in treating SI Joint Dysfunction. The therapist can treat the pain and muscle spasm with modalities such as ultrasound, electrical stimulation, massage, and heat. Gentle mobilizations are performed, and then the patient can be taught them to perform at home. The key to prevent a reoccurrence of this is to perform specific stretches on a regular basis. Also, if the abdominals are strengthened properly, they will support the trunk and pelvis. Other strengthening exercises may be prescribed if there are any muscle imbalances present. Lastly, good posture is emphasized.

References

DonTigny, Richard. “Mechanics and Treatment of the Sacroiliac Joint,” The Journal of Manual and Manipulative Therapy. Vol.1, No. 1, 1993, pp.3-12.

Paris, Stanley V. Introduction to Spinal Evaluation and Manipulation. University of St. Augustine for Health Sciences, St, Augustine, FL, 1997.

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