Wednesday, November 26, 2014

S.I Joints and Pelvic Pain

Key Features
1. Pieces of the Pelvic Girdle
2. Role of the Pelvis and SI Mechanics
3. Relationship between the Pelvis, SI Joint, Femurs and Spine
4. If You Want To Improve Mechanics and Reduce Pain Improve Pelvic Stability


1. PIECES OF THE PELVIC GIRDLE
 
The pelvic girdle consists of the following:

  • Two innominate bones (hip bones), which each consist of the ilium, pubis, and ischium
  • Sacrum
  • Coccyx
  • Femurs (thigh bones)
  • Spine


2. SI MECHANICS AND THE ROLE OF THE PELVIS

  • Where the sacrum and ilium meet is the sacroiliac joint (SI). There are two of them.
  • The primary movements of this joint are nutation and counter-nutation.
  • Function of the Pelvis is to transfer force and load from the ground up through the spine, and from the top down to the hips, knees and feet.
  • The SI joints act as the “bridge” between the femurs and spine. 
  • Health of the SI Joints directly effects pelvic function.


3. RELATIONSHIP BETWEEN THE SI JOINT, FEMURS, AND SPINE

  • The SI Joints are held in place through their skeletal structure (form closure) and through muscular power (force closure).
  • The core muscles (abductors, adductors, external rotators, pelvic floor, transverses abdominus, and multifidus) all contribute to force closure. Notice that the first three muscle groups attach to the femur and pelvis, and the last two attach to the spine and pelvis.
  • If the femurs and pelvis, or the spine and pelvis are not balanced in a neutral position (as in overly extending the low back, or tucking the pelvis under), then compensations will occur – often in the area of the SI joints. Hypermobile vs. locked SI joints are both equally poor techniques of the body to compensate in response to an imbalance and poor alignment.
  • Remember pain is a sign that dysfunction is present.

4. IF YOU WANT TO IMPROVE BALANCE AROUND THE PELVIS AND SI MECHANICS IMPROVE PELVIC STABILITY AND MOVE WITH A NEUTRAL SPINE

  • Improve the functioning of the muscles listed above, both individually and collectively. Some exercise to consider include: side lying clam shells, side leg lifts, side leg kicks, hip lift (bridge)
  • Improve pure bio-mechanical function to reduce compensation and create balance. Meaning move with integrity at the joints, full range of motion without force or shifting of the pelvis, hips and spine. Maintain good alignment and do not push into pain. 


- Become aware of how you hold your pelvis. If you are a tucker release clenching buttocks. If your pelvis is tipped anteriorly draw the deep low abdominals inward and upward to bring the front of the pelvis back to level. Become aware of using both your inner thighs and your outer hips to hold the femurs, knees and ankles parallel. Align your hips over your knees and feet, and lift your spine up and away from the pelvis.