The Sacroiliac Joint: Dysfunction and Discovery, Part Three.

The previous two parts on sacroiliac joint dysfunction have looked at the origins of this condition, how to identify and diagnose it, and how to treat it. This final part will look at the connection between the SIJ and the hip.

There’s no doubting the relationship-through proximity-of the hip and SIJ/tailbone. They sit very close to one another and dysfunction of one can lead to problems in the other. Many patients of mine report pain at the front of the hip when tucking their knee into their chest. This condition is called ‘femero-acetabular impingement’ (FAI), and the pain is caused by the ball of the hip joint pushing into the socket of the hip joint. When this happens to my patient, if they are lying on their back, I ask them to flatten their back onto the couch. This always leads to the pain in the hip vanishing as if by magic. But, this is actually down to them tilting their SIJ backwards or anteriorly tilting the pelvis. This creates an angle change and a much needed gap between the ball and the socket of the hip which reduces pain and increases pain free hip flexion.

Now, anterior tilting of the pelvis, ‘nutation’ or simply ‘flattening the back’ is a movement that should occur when we walk, run or indeed, just lift our leg up high (such as in hurdling). But very often, clearly, it doesn’t happen. Why this is remains uncertain, but retraining this simple action can reduce the likelihood of FAI and, if all evidence is correct regarding FAI, it will further reduce the likelihood of osteoarthritis of the hip. Got to be worth a go right?

So. If you’re getting pain at  the front of the hip, which is notable when you lie on your back and tuck your knee to your chest. Try flattening the back and see if the pain goes away. If it does, and it’s likely it will, straighten the legs and practice flattening the back-and then curving it naturally again-ten times while lying down. Gym aficionados will know this exercise as a ‘reverse curl’ and it’s key to creating a strong relationship between the hip and SIJ. I get my clients to perform up to six sets of reverse curls, and over a period of six weeks they find their hip pain is gone. They also have lovely flat abs too. If you’re interested, the featured image for this publication shows a fella doing a reverse curl.

So, I hope this odyssey through the SIJ has been informative a enlightening. If you would like to know more and find out how Mold Physiotherapy can fix your back problem, contact us today by clicking the ‘book now’ tab at the top of the page. You can also contact me directly, paul@moldphysiotherapy.co.nz.

We look forward to seeing you soon and helping you out!

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