Blocked sacroiliac joint (SI joint)

WHAT IS SACROILIAC JOINT?

IMG 2058It is the transfer between the sacrum bone and the hip bone (os ilium). We often meet with the term SI joint (derived from its latin name). Apart from most joints, where the surface is consisted of socket and the head, this joint consists of two rough surfaces, which are in close contact. It is therefore a stiff joint.

Even though the sacroiliac joint is considered a stiff joint, it performs an important movement in the direction of its horizontal axis. The movements are small but important for a correct position of the pelvis. That is confirmed during the blockage. The movement in this joint is restricted and we feel an unpleasant pain, especially when we walk and generally when we move our legs.

MANIFESTATION OF THE BLOCKAGE

Sharp pain in the upper part of the hip restricts the affected person during a basic activity (such as walking, walking into the stairs, stepping out of the car…), the disabled person is instinctively restricting the pressure on the affected side, which can be manifested by a waddling gait. After the person gets used to the new burden the SI joint will start to hurt even on the other side. Extensive pressure on the joint can cause overload in the ligamentous structures of the pelvis, the pubic symphysis, groins, buttocks and back of the thighs can start to hurt extensively.

EXAMINATION

After determining the blockage of the sacroiliac joint, doctors and physiotherapist use various tests (e.g. Yergasson’s test, Patrick’s tests…) and palpation technique (examining patient by touch), by which they will determine the diagnosis. They usually find trigger point in the muscles, especially in the outer rotators of the hip joints and iliopsoas muscles (m. iliopsoas). It is important to differ whether it is a disorder coming from the hip joint or the spine in order to apply a correct treatment technique. The cause of the blocked SI joint can be caused by the wrong position of the leg, knee or hip, but it can also result from carrying a heavy backpack on one shoulder. It can be also caused by an „incorrect” movement, which subsequently affects the buttocks and hips.

Diagnosing pelvis

TREATMENT

After the examination, physiotherapist will start to affect your muscles, which are closely related to this problem, it is also optional to use radial shockwave therapy, which relaxes the muscles more easily. Subsequently we can use mobilizing techniques and unblock the SI joint, and you will be also taught exercises which will enable you to keep your pelvis in a correct position. Last but not least, the physiotherapist will be also interested in the cause of this blockage, especially if the blockage keeps returning. The cause has to be revealed and subsequently dealt with, either with a physiotherapist, that is if the problem is in the dynamic of the musculoskeletal system, or by removing the incorrect habits (such as carrying heavy bags, sitting with crossed legs…).

Tilting plevisstretching thighs
Moving the pelvisStretching the Buttocks standing

INSTRUCTIONS FOR EXERCISES

  • First aid during pain of the SI joint
  • Exercises against pain of the SI joint



Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: Anatomy I - R. Čihák, Grada; Rehabilitation in clinical experience - P. Kolář et al., Galen; clinical experience from private practice from the physiotherapeutic field

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