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What is S-I Joint Dysfunction?
By Dr. Robert V. Duvall, DPT, MPT, ATC, MGFI
The S-I joint is one of the most misunderstood areas of the human body.
It has been the source of much controversy in the medical community for
many years. Much of the debate relies on the fact that there are few
reliable evaluation methods for the S-I joint.
Contrary to disc injuries, which can be evaluated using many types of
diagnostic tools, examining the S-I joints has proved to be quite
unreliable. Clinicians need to rely mostly on their experience rather
than simple methods used to examine the low back. Most medical
professionals do not acknowledge it as a source of pain and dysfunction.
So patients leave a medical office with an incomplete evaluation and
often times, an inaccurate diagnosis.
The S-I (Sacro-Iliac) joint is comprised of two bones; the sacrum and
the ilium. You have two S-I joints (left and right). They are located
basically where the spine meets the pelvis. Look for the two dimples in
your low back. These two joints allow for very little movement overall
as compared to other more prominent joints such as your hip or shoulder.
The pelvic girdle is generally described as the two S-I joints, the
pubic symphysis (pubic bone in front), the two hip joints, and the
bottom two vertebrae (L4, L5).
What do you feel?
Pain located at or near the S-I joint on one side or both sides. Pain
located in the low back, buttock, and/or groin area. Another common
symptom of a S-I joint dysfunction is "sciatica". Sciatica is best
described as a sharp, often shooting pain that begins in the buttocks
and goes down the back of one leg. S-I joint dysfunction may also cause
nerve irritation of the nerves that supply the groin or front of your
thigh.
Other symptoms include:
1. Weakness in one leg or both legs; difficulty standing on one leg and
raising the other leg (like marching)
2. Numbness and tingling in one leg (pins & needles)
3. A burning pain located near the "dimples"
4. Difficulty raising from a chair
5. Muscle discomfort in the buttock, hip, or low back (over 30 muscles
attach to the pelvis; from the hip, buttock, thigh, low back.
How does this happen?
S-I joint dysfunction is usually caused by an imbalance in the muscles
of the hips and glutes and it can also be caused by a fall or other
traumatic event, such as a car accident.
A condition known as "hypermobility" may also predispose an individual
to S-I joint dysfunction. "Hypermobility" is best described as a
condition in which the joints have too much mobility. This condition
generally affects women more than men. Different hormone levels present
in women, specifically "relaxin", can influence hypermobility. This
hormone is released to prepare the body for pregnancy, and its level in
the blood changes throughout pregnancy process. It basically causes the
ligaments to "relax" and allow for more movement to occur in the pelvic
girdle region.
The best treatment options
First of all, the evaluation is critical to the success of treating a
S-I joint dysfunction. Most dysfunctions can be treated with manual
techniques that generally involve “mobilizations”, “manipulations”, or
“muscle energy techniques”. These techniques must be applied by a
skilled medical professional, such as a physical therapist. These
techniques can prove to be quite helpful when utilized appropriately
following a thorough evaluation.
Once appropriate manual techniques have been administered, a
comprehensive exercise program must be implemented to address the
following areas, specifically muscle imbalances:
1. Lumbar stabilization program: strengthening abdominals and buttock
muscles
2. Improve flexibility in lower extremity musculature
Some S-I joint dysfunctions may linger on for months and even years.
Remember, if you are engaged in a current treatment plan with little to
no improvement, seek other options. If you think you may have a S-I
joint dysfunction, the first step is to find a healthcare professional
who is skilled and experienced in addressing muscle imbalances.
Article courtesy of
http://www.losethebackpain.com
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