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Sacroiliac Joint Dysfunction The sacroiliac joint (SIJ) is the union of the sacrum with the left and right iliac bones (ileum) that connect the spine to the pelvis.  The sacrum is made up of 5 fused vertebrae and the iliac bones are two large, irregular shaped bones that comprise the pelvic girdle.  Typically, there is minimal rotation or translation allowed at this joint due to several strong ligaments that hold the joint together. Additionally, multiple muscles attach at the sacrum and ileum bones, which further help stabilize the sacroiliac joint.  Stability at this joint is important as it holds the weight of your upper body in a standing position and absorbs shock from your lower body during loading activities. 


Causes

The SIJ can be a source of pain when there is malalignment or abnormal amount of motion in the joint due to ligament laxity, muscle tightness, leg length discrepancy and/or high impact causing shearing forces.  Females commonly experience SIJ dysfunction during pregnancy due to hormonal changes and weight gain.  SIJ pain can also be a result of compensations in someone’s movement or gait pattern due to back or hip pain. 


Symptoms

Pain is usually localized to one side of the joint and can refer to many areas.  Most commonly, symptoms are felt in the low back or posterior region of the hip, commonly referred to as “Fortin’s Point”, although there may be discomfort in the front of the hip.  Symptoms are aggravated with prolonged standing or sitting and the individual may have to shift their weight or lay down to avoid discomfort. 


Treatment

SIJ Dysfunction is commonly treated conservatively with physical therapy through soft tissue mobilization, joint mobilization and stretching to help restore normal pelvic alignment and joint function.  A therapist can prescribe exercises to help improve hip and core stability to decrease symptoms.  Your therapist may also recommend a sacroiliac stability brace to help provide stability during your daily activity until you are symptom free.  It is recommended you rest and avoid high impact activities during treatment of your SIJ dysfunction.

ProSport Physical Therapy, 1000 Bristol St. N, #25, Newport Beach, CA. 949-250-1112
Alyson Hold, PT, DPT, CSCS


References:
Dugdale, D. Sacroiliac Joint Pain. 25 Aug 2012. Medline Plus. Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000610.htm.
Laslett, M. Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint. J Man Manip Ther. 2008; 16(3): 142-152.