Key takeaways:
- Sacroiliac joint pain is a common issue characterized by one-sided pain below the lumbar spine, often related to pregnancy or repetitive activities.
- Diagnosis typically involves a series of physical therapy tests (Ilick cluster) and may require diagnostic injections to confirm.
- Treatment focuses on rehabilitation exercises that improve overall capacity and ability to tolerate specific activities, rather than targeting specific stabilizing muscles.
Sacroiliac joint pain is a common issue, often characterized by one-sided pain below the lumbar spine that may radiate into the buttock or thigh[^1^]. This pain can result from traumatic events, repetitive activities, or pregnancy, and is typically diagnosed through a series of physical therapy tests known as the Ilick cluster[^1^]. Imaging is not usually warranted, as degeneration is normal in asymptomatic individuals and becomes increasingly common with age[^1^].
Contrary to popular belief, the sacroiliac joint is not fragile, unstable, or dysfunctional[^1^]. Research has shown that the average movement of the sacroiliac joint is 2.5 degrees of rotation and 7mm of translation, with no differences between symptomatic and asymptomatic joints[^1^]. Clinicians cannot reliably feel changes in the position or movement of the sacroiliac joint, and manipulations or adjustments do not alter its position structurally[^1^].
Rehabilitation plays a crucial role in managing sacroiliac joint pain. If you've experienced a traumatic incident like a motor vehicle accident or fall, the goal of rehab is to restore your prior level of function[^1^]. If you're struggling with a specific activity like running or lifting, rehab aims to improve your overall capacity and ability to better tolerate that activity[^1^]. If you can't recall a distinct mechanism of injury and have no activity-related goals, regular exercise can still help you better tolerate daily demands[^1^].
Exercises should focus on training all the muscles around the sacroiliac joints, low back, and hips, rather than specific stabilizing muscles[^1^]. These exercises can be tailored to meet individual needs and goals, with options ranging from sit-to-stands and bridges to planks and deadlifts[^1^]. It's essential to start easy and build slowly, as rehab takes time, patience, and consistency[^1^].
While external pelvic compression or sacroiliac joint belts can help reduce pain, they do not change the mobility of the sacroiliac joint[^1^]. Similarly, stretches and self-adjustments may provide relief, but they do not alter the joint's mobility[^1^]. The pop experienced during self-adjustments is simply a gas bubble being released[^1^].
In summary, understanding sacroiliac joint pain, dispelling common myths, and focusing on actionable steps like rehabilitation exercises can significantly improve symptoms and overall function.
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