Sacroiliac Joint Dysfunction Overview

Lumbar, buttock, hamstring, or groin pain.

Lumbarization of S1 occurs when the S1 segment is mobile, resulting in a sixth lumbar vertebra.

SIJ mobility decreases progressively with age.

<p>The lumbosacral angle is formed by a line parallel to the sacrum and a horizontal line; increased angles lead to higher shear stresses.</p> Signup and view all the answers

<p>In childhood, articular surfaces are flat and smooth, becoming irregular and puzzle-like in post-pubertal individuals.</p> Signup and view all the answers

<p>The sacrum is covered with hyaline cartilage, while the ilia are covered with fibrocartilage.</p> Signup and view all the answers

<p>The SIJs change from being relatively mobile to progressively stiffer with age.</p> Signup and view all the answers

<p>The auricular facets of the sacrum articulate with the inferior facets of the fifth lumbar vertebra.</p> Signup and view all the answers

<p>To test the mobility of the sacroiliac joint.</p> Signup and view all the answers

<p>It tests the mobility of the sacrum moving on the ilium while eliminating the influence of the lower extremities.</p> Signup and view all the answers

<p>It assesses sacroiliac hypomobility.</p> Signup and view all the answers

<p>True leg length discrepancies cause asymmetry and pain, while functional discrepancies result from SIJ and/or pelvic dysfunction.</p> Signup and view all the answers

<p>The examiner's left thumb moves upward instead of downward.</p> Signup and view all the answers

<p>SIJ pain is classically described as deep, dull, and undefined, often unilateral and located below L5.</p> Signup and view all the answers

<p>Relaxin hormone causes softening of ligaments, which may take 3 to 4 months to return to normal after childbirth.</p> Signup and view all the answers

<p>The patient stands with feet shoulder-width apart while the examiner stands behind, grasping the patient's shoulders.</p> Signup and view all the answers

<p>Stiffness and pain with prolonged walking or standing, and pain with standing from a sitting position.</p> Signup and view all the answers

<p>Reproduction of the patient’s symptoms localized to the PSIS area.</p> Signup and view all the answers

<p>The examiner applies outward and downward pressure on the ASISs while the subject is supine.</p> Signup and view all the answers

<p>Palpation of SI joints and PSIS, and functional tests including mobility and pain provocation tests.</p> Signup and view all the answers

<p>Anxiety and depression can exacerbate the perception of pain and contribute to dysfunction in the SIJ.</p> Signup and view all the answers

<p>Unilateral pain at the SI joint or in the gluteal region.</p> Signup and view all the answers

<p>Levels of iliac crests, ASIS, PSIS, and assessment for leg length discrepancies.</p> Signup and view all the answers

<p>Climbing or descending stairs, turning in bed, or getting out of bed may cause pain.</p> Signup and view all the answers

<p>Tight psoas and rectus femoris muscles.</p> Signup and view all the answers

<p>To increase ROM, decrease pain, and correct positional faults in the sacroiliac joint.</p> Signup and view all the answers

<p>Grade I involves small amplitude movements at the beginning range, while Grade II involves large amplitude movements at midrange.</p> Signup and view all the answers

<p>To alleviate tension and restore function in tight muscles.</p> Signup and view all the answers

<p>The mobilizing hand glides the iliac crest posteriorly while the guiding hand moves the ischium anteriorly.</p> Signup and view all the answers

<p>They have not been shown to provide significant help in clinical studies.</p> Signup and view all the answers

<p>It reduces pain, increases periarticular extensibility, and corrects positional faults.</p> Signup and view all the answers

<p>It refers to the small, voluntary movements that contribute to the joint's overall function.</p> Signup and view all the answers

<p>The ASIS is lower and the PSIS is higher on that side.</p> Signup and view all the answers

<p>Form closure refers to the inherent stability provided by the specific shape and close fit of joint surfaces, independent of external loads.</p> Signup and view all the answers

<p>The force of body weight generates a nutation torque on the sacrum, influencing pelvic stability.</p> Signup and view all the answers

<p>The quadratus lumborum, erector spinae, gluteus maximus, gluteus minimus, piriformis, and iliacus muscles.</p> Signup and view all the answers

<p>The biceps femoris, often found shortened during SIJ dysfunction, compensates to help stabilize the joint.</p> Signup and view all the answers

<p>The posterior oblique muscle system includes the latissimus dorsi, gluteus maximus, and thoracolumbar fascia.</p> Signup and view all the answers

<p>Tight psoas and rectus femoris muscles are commonly associated with SIJ dysfunction.</p> Signup and view all the answers

<p>Leg length imbalance can contribute to dysfunction and instability of the sacroiliac joint.</p> Signup and view all the answers

<p>Superficial and Deep.</p> Signup and view all the answers

<p>It absorbs vertical forces and transmits them to the pelvis and lower extremities.</p> Signup and view all the answers

<p>Forward motion of the base of the sacrum into the pelvis.</p> Signup and view all the answers

<p>The ASIS will be higher and the PSIS will be lower on that side.</p> Signup and view all the answers

<p>The anterior sacroiliac ligaments, sacrospinous ligament, and sacrotuberous ligament.</p> Signup and view all the answers

<p>Counternutation is the anterior rotation of the ilium on the sacrum, occurring when the base of the sacrum moves backward.</p> Signup and view all the answers

<p>They connect the ischial spines and tuberosities to the sacrum and coccyx, forming borders of the sciatic notches.</p> Signup and view all the answers

<p>All ligaments of the pelvis become loose under the influence of hormones.</p> Signup and view all the answers

Abnormal function of the sacroiliac joint, leading to pain and discomfort due to altered mechanics and stresses on surrounding structures. It can cause pain in the lower back, buttocks, hamstrings, or groin.

The triangular bone formed by fused sacral vertebrae, situated at the base of the spine. It supports the pelvis and connects to the coccyx.

The S1 segment of the sacrum is able to move independently, creating an extra lumbar vertebra,

The fifth lumbar vertebra fuses with the sacrum, reducing the number of lumbar vertebrae.

The angle formed by a line drawn along the top of the sacrum and a horizontal line. A larger angle correlates to increased stress on the lumbosacral joint.

The joints where the sacrum meets the ilium bones of the pelvis. The SIJs have unique structural and functional changes throughout life.

The C-shaped, concave cartilage surface found on the sacrum, joining with the pelvis's ilium, forming part of the SIJ.

The large, wing-like bone forming part of the pelvis, articulating with the sacrum at the SIJ

A type of synovial joint where the articulating surfaces are mostly flat, allowing for gliding motions.

A type of cartilage that is more resistant to stress and can withstand more force than hyaline cartilage

The structure and function of the sacroiliac joints change significantly from birth to adulthood.

A strong and massive ligament on the sacroiliac joint, having superficial and deep parts.

A ligament connecting the sacrum and pelvis, superficial to the interosseous SI ligament.

A stronger ligament than the anterior ligament, connecting the sacrum to PSIS.

Connects ischial spines to sacrum/coccyx, forms the inferior border of greater sciatic notch.

Connects ischial tuberosities to sacrum/coccyx, forms inferior border of lesser sciatic notch.

Connects spine to pelvis, absorbs forces, stress-relieving junction, and transmits forces to lower extremities.

Nutation (base moves forward, apex posterior).

Counter-nutation.

Very slight rotational motion (2.5°) and translational motion (0.3-0.7 mm).

Ligaments loosen under hormonal influence to aid delivery.

Forward motion of sacrum base, backward ilium rotation.

Limited by anterior sacroiliac ligaments, sacrospinous, and sacrotuberous ligaments.

Unilateral nutation causes ASIS higher, PSIS lower, apparent short leg.

Opposite of nutation, anterior ilium rotation, backward sacrum base.

Limited by posterior sacroiliac ligaments.

A situation where one side of the sacroiliac joint (SIJ) is lower and the other is higher, causing an abnormal position.

The ability of the sacroiliac joints to support the body's weight and maintain proper positioning during movement.

The stability of the SIJ due to the shape and fit of the joint surfaces.

Stability of the SIJ due to compression forces, like weight.

Importance of the ligaments in reinforcing and holding the stability of the sacroiliac joints.

The role of muscles in reinforcing SIJ stability, including the quadratus lumborum, erector spinae, and gluteus maximus.

Incorrect muscle actions can contribute to sacroiliac joint disorders, with hip flexors and extensors being frequently implicated, often including tight psoas and rectus femoris muscles.

A difference in the lengths of the legs, can cause SI joint problems.

Muscle system that includes the latissimus dorsi, gluteus maximus, and thoracolumbar fascia. This system helps with load transfer to stabilize the lower lumbar spine and pelvis.

Muscle system involved in load transfer during trunk rotation. Includes external and internal obliques, transverse abdominals and contralateral adductors of the thigh, and anterior abdominal fascia

A test to assess the mobility of the sacroiliac joint, involving forward bending and observing the movement of the PSIS.

Deep, dull, and poorly defined pain, typically unilateral, below L5 in the low back, buttock, groin, or posterolateral thigh.

Asymmetric pain stemming from a true difference in leg length.

A mobility test for the sacrum, isolating its movement relative to the ilium by eliminating lower extremity influence.

Leg length discrepancy resulting from SIJ or pelvic dysfunction, not a true difference in bone length.

A test for sacroiliac hypomobility focusing on iliac movement and posterior rotation.

May be acute (sudden) or insidious (gradual).

Hip position defined by flexion, adduction, and internal rotation—used in passive movement testing.

A test for anterior SI ligament sprain, involving outward and downward pressure on ASISs to assess for pain.

May be directly related to known injuries, such as falling, stepping down from a height or stress.

Conditions like excessive subtalar pronation and scoliosis can affect SIJ.

Reproduction of patient symptoms during a SIJ mobility test.

SIJ stabilization may take months after giving birth, due to hormone changes.

Pain and stiffness, especially with prolonged standing or walking (unilateral). Single leg squat may induce pain.

Difficulty with sitting, standing from sitting (getting up), climbing/descending stairs, turning in bed, getting out of bed, stepping up with affected leg.

Pain can be felt over the SI joints, PSIS, pubic symphysis, or the surrounding area.

A treatment method that uses a patient's own muscles to create a controlled movement and improve muscle tone and joint mobility.

A manual therapy technique used to improve joint movement, reduce pain, and restore normal joint function.

A manual therapy technique using controlled force to restore joint movement and reduce pain.

A method to increase flexibility and range of motion by elongating tight muscles.

Strengthening exercises to improve core strength and support the spine.

Small amplitude movement at the beginning range of joint play, used when pain and spasm limit early ROM.

Large amplitude movement at the midrange of joint play, used for pain control and spasm reduction.

Large amplitude movement at the end-range of joint play, to target pain, increase periarticular extensibility.

Small amplitude movement at the end-range of joint play, to target pain and increase periarticular extensibility.

Technique to correct ilio-sacral joint anterior rotation.

Technique to correct ilio-sacral joint posterior rotation.

Common soft tissue abnormalities associated with unilateral anterior tilt.