Physiotherapy and Sacroiliac Joint Pain

SacroiliacJoint Dysfunction & Treatment

Bismillahirahmanirahim, This entry is most related to the woman , is common symptom has been showing for women when their get pregnant and also for man who had a big stomach.

I want to ask why is this going to be important to you?

As we know Sacroiliac Joint pain is a condition that affects 15% to 25% of

patients with axial low back pain , I would like to say it largest axial joint in the body

Diarthrodial synovial joint , the function of this joint is more for designed primarily

for stability.

Function of SI joint ?

This joint is playing as transmission and dissipation of trunk loads to the lower extremity

with Limiting x-axis rotation , for woman it doing a great job as facilitating parturition (giving birth) and it provides a various types of motions as

1.      Gliding

2.       Rotation

3.       Tilting

           The muscle surrounding this SI Joint .

           This SI joint cover up muscles are functionally connected to SI joint ligaments, therefore their            actions can affect joint mobility and the Muscles involved:

·          Gluteus maximus and minimus

·          Piriformis

·          Biceps femoris

·          Quadratus lumborum

·          Erector spinae

Ligament involve in SI joint.

SI ligamentous structure is extensive and functions as a connecting band between the sacrum and ilia

·         Limit motions in all planes of movement

·         These ligaments are weaker in women

Sacrospinous and Sacrotuberous ligament and the function is Resists forward tilting (nutation) of the sacrum on the hip bone during weight bearing of the vertebral column

Interosseous ligament function are to Resists anterior and inferior movement on the sacrum; strongest ligament supporting the SI joint

Posterior (dorsal) ligament function to be Resists backward tilting (counternutation) of the sacrum on the hip bone during weight bearing of the vertebral column sacroiliac

Did you know the status aging of SI joint ?

This will give you the idea what will be happen  when changes begin in puberty and continue throughout life

·         Adolescence

Iliac surfaces becomes rougher, duller, coated in some areas with fibrous plaques

·         30’s – 40’s

Surface irregularities, crevice formation, clumping of chondrocytes

·         60’s

Motion may become markedly restricted

·         80’s

 Erosions and plaque formation are inevitable

Mechanism of Injury at SI Joint.

The mechanism of injuries related in SI joint most common due to combination of axial loading and abrupt rotation

In other problem is related in this mechanism are Pathological changes affecting SI joint structures

·        Capsular or synovial disruption

·        Capsular and ligamentous tension

·        Hypomobility or hypermobility

·        Extraneous compression or shearing forces

·        Abnormal joint mechanics

·        Microfractures or macrofractures

·        Soft tissue injury

·        Inflammation

The risk factor when have SI joint pain are

·         Leg length discrepancy

·         Gait abnormalities

·         Prolonged vigorous exercise

·         Scoliosis

·         Spinal fusion to the sacrum

·         Pregnancy (weight++)

SI Joint pain area and Referral patterns for SI joint pain most commonly can be found as

·          Radiation into the buttock

·          Lower lumbar region

·          Lower extremity

·          Groin area

·          Upper lumbar

·          Abdomen

Pain may worsen with:

·         Riding in a car

·         Weight bearing on the affected side

·         Valsalva

·         Forward flexion in standing position

 Pain may be relieved with:

·         Weight bearing on non affected side

What are the treatment for this problem?

Widely acknowledged to be one of the most challenging problems to treat .

Treatment modalities consist of:

1.       Physical therapy

2.       Orthotics

3.       SI Joint blocks

4.       Surgery

5.       Mobilization

 Treatments can be divided this way:

1.      Correcting the underlying pathology

2.      Alleviating symptoms

Physiotherapy in manage of pain SI I will put 5 area need to be concentrate ,there will be a

·         Stretching and strengthening the weak muscles

·         Pelvic stabilization

·         Restoration of postural and dynamic muscle

·         imbalances

·         Correction of gait abnormalities

Insha Allah , for next entry i will be share the type of the exercise that can be use to deal with the SI joint pain , and i hope this info will give you a clear idea regarding of the symptom and guideline to trace of this problem , wallahuaklam

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