Sacroiliac (SI) Joint Dysfunction

Orange County Postpartum Physical Therapy
 

The SIJ, or sacroiliac joint, is what we commonly know as the pelvis.

Sarton Physical Therapy successfully treats a high volume of Sacroiliac Joint (SI joint) dysfunction. As pelvic floor physical therapists, we have the advantage of being able to treat this common pathology from a unique perspective—blending traditional orthopedics with advanced external and internal pelvic manual therapy skills.

Often, we find that many patients with SI joint dysfunction (particularly sacroiliac joint hyper-mobility) will manifest pelvic floor hypertonic muscular dysfunction, as this is a compensatory strategy used to stabilize the SI joint. While this strategy can create stability, patients often experience further low back pain, sciatic or pudendal nerve compression, and other pelvic pain symptoms as a result. The pelvic floor muscles should, therefore, always be evaluated in any patient with SIJ dysfunction.

The goal is to make sure that these muscles have normal length and the appropriate strength to be able to do their job in an efficient and healthy way.

We know through literary evidence that the pelvic floor muscles play a direct role in contributing stiffness and stability to the SI joints.

Read More

As one of our key inner core muscle groups, the pelvic floor works closely with the transversus abdominus, the multifidus, and the diaphragm to provide force closure through the all the joints of the entire bony pelvis. This then allows us to walk, run, and participate in higher level activities and sports without pain. We also know that SI joint and pelvic stability is further created through the pelvic ligamentous system, and (again) these ligaments should be thoroughly evaluated by a highly skilled physical therapist who has expertise in both orthopedics and pelvic health. For example, the long and short sacroiliac joint ligaments blend with the fibers of key muscles such as the hip flexors, hip extensors, hip rotators, back extensors, and abdominals. In addition to the pelvic floor, all of these these muscles need to be routinely evaluated and treated if found to be dysfunctional.

 

What causes SIJ dysfunction?

 

+ Pregnancy

In the event of pregnancy, the SI joint may be a victim of relaxin, a hormone that is released in the second and third trimester to allow the pelvis more mobility to prepare for birth. SI joint pain during pregancy is a common but treatable condition we routinely see at Sarton PT.

+ High Velocity Sports

High velocity sports such as gymnastics, dance, cheerleading or volleyball will often set the stage for SIJ dysfunction. Additionally, dancers—particularly ballet dancers—are also also at higher risk for SI joint and/or pelvic dysfunction due to the extreme positions they routinely undergo which over time can contribute to ligamentous laxity.

+ Genetic Hypermobility or Ehelrs-Danlos Syndrome

Some patients are born with overly flexible joints. Because the connective tissue that holds joints together is looser for some, the SI joint as well as other joints can move far past the normal range of motion. Joint pain and dislocations can be common when this occurs setting the stage for the muscular system to compensate with muscle spasm.

+ Trauma

Falls, motor vehicle accidents, and other traumas to the pelvis such as pelvic or prior back surgery can also cause SI joint dysfunction.

+ Biomechanical Dysfunction

Biomechanical dysfunction such as scoliosis or a leg length difference may cause you to take uneven strides when you walk. Foot pronation is another common dysufcntion that sets the stage for altered forces to come up through the kinetic chaing and manifest at the SI joint.

 
 
 

Let us help you recover with pelvic floor physical therapy.

If you are experiencing low back pain and/or pelvic pain, and have not been evaluated and treated for SIJ dysfunction, Sarton PT can help get you back on track and out of pain. Come experience one of the most comprehensive and thorough evaluations in Orange County available for sacroiliac joint dysfunction. Unlike other practices out there, you always get 1-on-1 for an entire hour with our our Advanced Board Certified PTs in both orthopedics and pelvic health (no aides).

Evaluations include a thorough oral history and physical examination. The physical examination includes an internal and external evaluation of the muscles for trigger points and motor control, evaluation of connective tissue and neural tension, and a structural and biomechanical evaluation. To ensure the best possible results, the therapists at Sarton Physical Therapy always spend an hour with each patient during every appointment. 

Let our expert Physical Therapists with advanced board certification in pelvic floor physical therapy help. Please contact Sarton Physical Therapy with any questions or to have your patients schedule an appointment.

 

References

Cappaert, Thomas A. “The Sacroiliac Joint As a Factor in Low Back Pain: A Review.” Human-Kinetics, www.humankinetics.com/home.

Hungerford B, Gilleard W, Hodges P. Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine. 2003;28(14):1593-1600.