Part 2 - Treating SIJS

Last month we focused on the biomechanics of sacroiliac joint syndrome and the difficulties of diagnosing this condition. This month focus will include some causes and treatments of sacroiliac joint syndrome. (part one is here)

Sacroiliac Joint Syndrome (SIJS) can be caused by a variety of physical traumas and depending on age and structural component (healthy or weak bone structure) injuries to SIJ vary. SIJS may occur from trauma incurred through the hamstring, especially from the most lateral of the hamstrings, the biceps femoris. Its pull has a direct correlation to ligaments attached  to the sacrum (base of the spine). Any form of heavy lifting, rotation with strain, or bending can also damage the (SIJ). Clients who have fallen on their buttocks, or have been hit posterior in an auto accident, or repeatedly raised themselves from a sitting position with weak, limited glute musculature, may also damage the SIJ. There are also numerous ways in sports related activities to damage the SIJ. Bad postural habits during activity will cause or aggravate SIJS, a common complaint from clients that are athletes with distorted postures who continually play their sport without stretching prior to participating.

Several things can aggravate the SIJ too. Continual sitting or lying on the affected side will impinge nerves and skew the pelvis. Remember, the body will adopt a bad posture and accept it as normal after a period of time.  The pain often worsens when riding in a car, sitting in a movie theater or putting weight on the hips while walking (for example, carrying a child).

In Active Isolated Stretching protocol, there are three steps to consider in treatment of SIJS sacroiliac joint syndrome: assessment, restoring range of motion (flexibility) and strengthening (re-educating muscle tissue). In the initial assessment which includes verbal and physical protocols, the therapist must get a basic handle on the integrity of the SIJ. There are several simple manual test designed to assess SIJ dysfunction.  It is important that the therapist know which movements initiate pain before treatment can continue.

The assessment includes testing the current range of motion before attempting to restore range of motion (ROM). Remember, the range of motion for the SIJ depends on the surrounding muscle tissue as well as the ligaments and tendons of the joint itself.  Thus, Active Isolated Stretching (AIS) protocols suggest that the therapist start by stretching superficial muscles before making to deeper muscles to open the clients (ROM). One tight and compromised muscle or ligament is enough to skew the pelvis, and in time cause complete dysfunction in the entire body. Therefore, Active Isolated Stretching (AIS) and Active Isolated Strengthening are effective solutions for increasing (ROM) flexibility and strengthening (re-educating the muscle tissue) to bring you back to balance until next time….