What Is the SI Joint?
Short for sacroiliac joint. There are two of them in your lower back, and they sit on each side of your spine. Their main job is to carry the weight of your upper body when you stand or walk and shift that load to your legs
Sacroiliac (SI) joint pain is felt in the low back and buttocks. The pain is caused by damage or injury to the joint between the spine and hip. Sacroiliac pain can mimic other conditions, such as a herniated disc or hip problem. Accurate diagnosis is important to determine the source of pain.
Gillet’s Test 🔊 .
Purpose: To assess mobility limitation in the sacroiliac region.
Test Position: Standing.
Performing the Test
The examiner palpates the inferior aspect of the PSIS of the tested side with one hand and the S2 spinous process with the other. The patient flexes the hip past 90 degrees. The examiner should feel the PSIS move inferiorly and laterally relative to the sacrum. A positive test is when this motion is absent.
The examiner should then compare this to the opposite side. An alternate method for this test is to palpate both PSIS's at the same time and compare the end position.
What are the symptoms?
Some signs and symptoms of SI pain may start in the lower back and buttock and may radiate to the lower hip, groin or upper thigh. Often the pain is usually one-sided, but it can occur on both sides.
Patients may also experience numbness or tingling in the leg or a feeling of weakness in the leg.
Symptoms may worsen with sitting, standing, sleeping, walking or climbing stairs. Often the SI joint is painful sitting or sleeping on the affected side.
Some people have difficulty riding in a car or standing, sitting or walking too long.
What are the causes?
The SI joint can become painful when the ligaments become too loose or too tight. This can occur as the result of a fall, work injury, car accident or hip/spine surgery
Sacroiliac joint pain can occur when movement in the pelvis is not the same on both sides. The uneven movement may occur when one leg is longer or weaker than the other, or with arthritis in the hip or knee problems.
Aggravation of the sacroiliac joint can commonly result in inflammation, also called sacroiliitis. This condition may be the primary cause of pain, stiffness, and other symptoms.
SI JOINT REHAB AND SELF CARE by @infinitemotionx
SI joint gapping: Lie on a bed or a table and let the opposite leg dangle to the side. Bend the affected leg and interlock your fingers right below the knee cap. Draw your knee towards your chest and then bring your knee slightly towards the opposite shoulder. Hold. This is a great way to gap the SI joint and reduce pain and inflammation
Child Pose and Cobra Stretch: For the child pose, begin by kneeling on your hands and knees and slowly bring yourself towards the floor. The child pose helps relieve tension on the lower back and also decompresses the vertebrae in the lumbar spine. The cobra stretch takes the lower back through extension and should only be performed if there is no pain associated with the movement. Start off the cobra by going on your forearms and then slowly begin to progress to putting the weight on your palms
SI Joint Gapping 2.0: Start off by laying on your back and swing the affected leg across the body. Use your opposite hand to apply overpressure to the knee and use the same-sided hand to reach towards a wall. This helps gap the joint and you may even hear a few cavitations ( cracks) in the process
APPROACH SI REHAB by @dr.jacob.harden
Now full disclosure, not every single painful SI will tolerate compression well and a good physical exam can tell us a lot there. But a lot of them do really like it. "General" approach if we find this is to do a lot of banded glute work because the glute will add that compression.
This has to be done to tolerance. Some people will do best with a clamshell with no resistance while others will be able to do this while balancing on one leg. You have to figure out where that tolerance line is for you and work with it. But if you start by adding some glute work and temporarily avoiding those big gapping movements, the SI can usually start to calm down a bit. So go get your glute pump on
These treatments usually reduce the inflammation and pain in your joint. But in rare cases, if you're still hurting, your doctor may recommend surgery. In an operation called SI joint fusion, a surgeon uses pins and implants to join the bones near the joint.
Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis, and treatment. Expert Rev Neurother. 2013 Jan; 13(1):99-116.
McGrath C. Clinical considerations of sacroiliac joint anatomy: a review of function, motion, and pain. Journal Osteopathic Medicine 2004; 7(1):16-24