Physical Therapy, Atlanta & Sports Medicine and Therapy, Atlanta

ATLANTA OFFICE
550 Peachtree Street, Suite 1760
Atlanta, Georgia 30308
404.817.0734
info@bodymechanicsatl.com

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Articles

Overuse Injuries

Are You Misdiagnosing Sacroiliac Joint Dysfunction?

The Value of Medical History and Physical Examination in Diagnosing Sacroiliac Joint Pain

Neural Therapy By Hunere

Epidemiology of pelvic pain and low back pain in pregnant women

A Randomized Controlled Comparison of Stretching Procedures for Posterior Shoulder Tightness

A Controlled Trial of Weight-Bearing Versus Non-Weight-Bearing Exercises for Patellofemoral Pain

An Integrated Model Of "Joint" Function And Its Clinical Application

Analysis of Hip Strength in Females

Pelvis and Sacral Dysfunction in Sports and Exercise

Role of Manual Therapy in the Evaluation and Treatment of a Surgically Stabilized Pelvis

Structural Rib Dysfunctions

The Sacroiliac Joint: An Underappreciated Pain Generator

Core Stability Measures as Risk Factors for Lower Extremity Injury in Athletes

Evaluation and treatment of the most common patterns of sacroiliac joint dysfunction

Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint

Hip Abductor Weakness in Distance Runners with Iliotibial Band Syndrome

Lumbar back and posterior pelvic pain in pregnancy

Management of Patellofemoral Pain Targeting Hip, Pelvis, and Trunk Muscle

Percutaneous Fixation of the Sacroiliac Joint

Renewed Treatment for Low Back Pain

Prolotherapy

Quadrupedalism, bipedalism, and human pregnancy

Reliability and Validity of the Active Straight Leg Raise Test in Posterior Pelvic Pain Since Pregnancy

Sacroiliac (S-I) Joint Dysfunction and Low Back Pain

Sacroiliac Joint Dysfunction in Athletes

The Effect of Manipulative Techniques on the Central Nervous System and Muscle Tone

* Please Note: The following article is provided by Body Mechanics for the sole purpose of educating and informing our current and future patients.

SACROILIAC JOINT DYSFUNCTION and LOW BACK PAIN

Sacroiliac (S-I) joint dysfunction is understood by clinicians as one of many causes of the general category of low back pain. S-I joint dysfunction may wholly be responsible for the low back pain syndrome and/or may be contributory to low back pain in concert with other pathology of the lumbar spine. It is often an overlooked and underappreciated diagnosis.

Brief Anatomy: The S-I joint can be thought of as the bottom joints of the spine relating to the hip bones. The sacrum (bottom of the spine) relates on each side to the ilia (hip bones) to form the sacroiliac joints. The ilia accept the femoral shafts of the lower extremities to form the hip joints. Therefore, as a person walks with reciprocal motion of the legs, the S-I joints also reciprocally move. There are muscles and ligaments that transverse the S-I joint in the front and the back, all of which can be causes of pain and inflammation if these joints are in dysfunction.

Patient Symptoms: Pain is usually reported as being on one side of the low back; however, occasionally there is pain on both sides. The patient reports posterior low back pain, hip pain, buttock pain, groin pain, lateral thigh pain, knee pain and occasionally leg and calf pain. He also reports the need to limp, leg length difference and increased pain with walking, standing or sitting. He may report improvement with resting recumbently or changing positions often.

Clinical Findings: Anatomically leg length differences are demonstrated. There is asymmetry or nonequalized right and left hip bones when compared to each other. There is tenderness to palpation of the posterior S-I joint ligaments. There is associated muscle guarding of the muscles of the low back. There is pain with end range of motion of the hip joints as they stress the S-I joint.

Kinetic tests by the therapist will reveal differences in mobility of the S-I joints when comparing one joint to the other. The therapist may assess the affected joint is moving too little (hypomobile) or moving too much (hypermobile). The therapist will evaluate generalized motion of the lumbar spine and mobility of its associated joints. The therapist will also assess gait pattern deficiencies. Diagnostic testing such as x-ray, CT or MRI do not usually demonstrate abnormalities, and therefore cannot be used for diagnosis of S-I joint dysfunction.

Clinical Treatment: Initial treatment by the therapist will involve joint mobilization of the affected S-I joint to attain symmetry of the pelvis and improved mobility of the affected joint. The lumbar spine will also be treated according to the deficiencies found during assessment. Following mobilization, the therapist will instruct the patient on proper biomechanics to avoid unnecessary and improper strain of the injured joints. Therapeutic exercise will be taught to improve neuromuscular stability of the low back and pelvis. Applications of neuromodulation modalities to decrease muscle spasm during the early stages of treatment will likely be utilized.

Too much movement of the S-I joint may indicate a laxity of ligaments which would normally hold these joints within normal range of motion. Therefore, additional stabilization procedures (i.e., pelvic belt fixation, non weight-bearing gait with crutches, taping techniques) may be required. With those patients who continue to demonstrate hypermobility after failing to attain stabilization by conservative means of rehabilitation, an orthopedic consultation for surgical fixation may be necessary.

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We understand that your goal is to return to an active lifestyle. That is why Body Mechanics Physical Therapy, located with an office in Atlanta, focuses on putting you back in motion quickly and enabling you to feel better for good.

Every patient receives caring, personal attention by our team of highly trained specialists. Our facility is fully equipped to provide a comprehensive spectrum of treatment modalities for all orthopaedic conditions to improve mobility, strength, balance and pain relief. Our hands-on approach and customized treatment program is designed to assist you in making a full recovery.

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