Hip and Pelvic Pain
Sacroiliac Joint Problems:
The sacrum is the triangular bone, sitting at the bottom of the spine, that wedges itself between the two pelvic bones, forming a joint at either side called the sacroiliac joint (SIJ). This area has sparked much controversy between professionals in terms of diagnosis and treatment, given its complex movement patterns, anatomy and unique properties. Its function is extremely important, facilitating normal pelvic movements when we swing each leg forwards during walking and perform activities such as climbing the stairs, and it provides huge stability to the core of the body when it is behaving normally.
Once disruption of the normal movement of the SIJ occurs, it can alter the normal movement of the spine, hips and in fact the dynamics of the whole body and cause pain during everyday activities.
Pain is commonly described just above the buttock, above the tail bone (coccyx) and can also be felt at the front of the pelvis and into the front of the hip. Pain can also refer down into the buttock and back or front of the thigh, usually when walking, striding out, stepping up or down stairs, swinging the leg out of the car, swimming, or turning in bed, (in other words, activities that involve one leg moving independently of the other leg). Pain may be extremely sharp on these movements, or may be conversely present as a dull ache.
Causes of SIJ dysfunction can range from falling directly onto the buttock, abnormal positioning/mechanics of the feet, dominance of one leg (for example during sport or at work) abnormal muscle balance around the hip and pelvic regions / weak core and gluteal muscles, to the changes that occur around the pelvis during and after pregnancy.
As the caused can be so varied, so are the treatments employed to resolve the source of the problem. Physiotherapy commonly involves manual and exercise-based techniques to normalise muscle activity, restore normal movement of the SIJ, and recruit and maintain correct muscle control and stability around this area.