Sacroiliac Joint Dysfunction

Question 1

What is the umbrella term for painful SI joint problems?

Answer 1

Sacroiliac Joint Dysfunction

Question 2

What is too much movement?

Answer 2

Hypermobility

Question 3

What is to little movement?

Answer 3

Hypomobility

Question 4

What is the etiology of HYPERmobility?

Answer 4

1. Trauma
2. Pregnancy
3. Hypomobility in surround joints
4. Increased flexibility due to body type of occupation
5. Pathology

Question 5

What is the etiology of HYPOmobility?

Answer 5

1. Soft tissue contractures
2. Hypermobility in surround joints
3. Decreased flexibility due to body type or occupation
4. Surgical fixation
5. Trauma, surgery and immobilization resulting in articular adhesions
6. Pathology
7. AgingW

Question 6

What are signs & symptoms of hypermobility?

Answer 6

1. Tenderness @ sacral sulcus
2. Grater than normal ROM
3. May be painful if the ligaments are overstretched
4. Will be painless if the ligaments are ruptured
5. Hypertonicity of muscles crossing the joint

Question 7

What are signs & symptoms of HYPOmobility?

Answer 7

1. Decreased ROM
2. Stiffness & pain
3. Adhesions & fibrosing
4. Fascial restriction
5. Myofascial pain including TPs in muscles crossing the joint

Question 8

What are CI’s & precautions for hypermobility?

Answer 8

1. Do not mobilize
2. Do not stretch
3. Do not completely release mm’s that cross

Question 9

What are CI’s & precautions for HYPOmobility?

Answer 9

1. Do not mobilize the joint that has been surgically repaired
2. Do not restore full ROM in ligaments that have been surgically shortened

Question 10

What are assessment findings in HYPERmobility?

Answer 10

1. Abnormalities
2. ROM greater than normal
   - palpate SIJ when performing hip/lumbar
3. Palpation : tender @ sacral sulcus, ropey, cool d/t ischemia, HT, TrPs in mm crossing the joint
4. Strength Test : Weak muscles crossing the joint
5. Length Test : Muscles cross the joint may be long
6. Special Test :
   - aSLR
   - Thigh thrust

Question 11

What are assessment findings in HYPOmobility?

Answer 11

1. Abnormalities may be present
2. Limited ROM
   - Palpate SIJ when performing lumbar & hip
3. Palpation : tender @ sacral sulcus, HT, TrPs, fascial restriction in mm crossing the joint
   Strength Test : mm crossing the joint weak
   Length : mm crossing the joint short
   Special Test :
   - Gillets’s

Question 12

What are massage goals in HYPERmobility?

Answer 12

1. Decrease pain : diaphragmatic breathing
2. Reduce HT & TPs
3. Stimulate & strengthen long, weak, muscles : tapotement, vibrations, cold pack, kneading, stripping, positional release
4. Normalize rom
   Abdominal bolster

Question 13

What are massage goals in HYPOmobility?

Answer 13

1. Decrease pain
2. Reduce HT & TPs
3. Decrease adh & fascial restrictions
   - stripping, kneading, o+i, met/pnf, stretching
4. Lengthen short muscles
5. Normalize ROM & joint mobility
   Abdominal bolster

Question 14

What are homecare exercises for HYPERmobile joints?

Answer 14

1. Strengthening muscles that cross the joint
   - core, hip stabilizers
   - hip flexor strength, glute bridge, deadbugs, bird dogs
2. Cold to decrease pain or stimulate

Question 15

What are homecare exercises for HYPOmobile joints?

Answer 15

1. Self mobilizations
2. Foam rolling
3. Stretching
   - Erectors, adductors, hamstrings, quads, glutes
   - supine knee to chest
   - seated/standing forward fold
4. Heat to decrease tone & muscle pain
5. Contrast to increase circulation
6. Progress to strengthening