Sacroiliac Joint Evaluation and Treatment

Sacroiliac joint pain prevalence has been estimated to be as high as 30% in patients with low back and buttock pain. (Schwarzer et al., 1995) Local causes of sacroiliac joint pain can be created from the joint itself, the dense ligaments that cover the joint surfaces, surrounding muscles, or nerves. Pain in the sacroiliac region can also be referred from the low back, buttock muscles, abdominal organs, or the hips. The SI joint is frequently injured by a fall or trauma, and is at increased risk of dysfunction during pregnancy and postpartum. One in four women who have pelvic girdle pain (PGP) during pregnancy may develop chronic postpartum PGP. (Ostgaard, 1991)

This two-day course will present a reference-based, clinically applicable approach to the evaluation and treatment of the sacroiliac joint and pelvic ring. Pain in the lumbopelvic-hip complex can be challenging as there are many potential sources of biomechanical dysfunction and pain generation. The course will cover the direct and indirect anatomy that influences the sacroiliac joint, and provide a means of deducing the source of pain and dysfunction. Direct treatment of symptoms and techniques for symptom amelioration will be presented. During lecture and laboratory sessions, participants will have the opportunity to practice two different SIJ tests; movement impairment vs. symptom reproduction. The participants will also analyze which spinal joints may be referring pain, and assess the role that sacral discs play in initiating and perpetuating pain. The information presented is immediately applicable to the clinician's patient population and the techniques presented will be able to be incorporated seamlessly into the participant’s clinical practice.

An emphasis on specific exercise and stabilization approaches will be instructed throughout the course. As research by Hungerford et al (2003) has pointed out that patients who have sacroiliac joint pain have altered patterns of muscle recruitment that may affect load transfer strategies, movement re-training, muscle awareness training, and muscle activation strategies will be instructed for both clinical application and home program management..

Audience:

This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.

Prerequisites: None

Required Readings: This course has no required readings, but a practitioner who is new to pelvic rehabilitation may find it useful to renew the anatomy and physiology of the pelvic floor/pelvic girdle prior to the course.

Lab Attire: Comfortable, loose-fitting clothes. Course attendees will be participating in labs as both practitioner and practice patient. There is no internal evaluation in this course.

What to bring: Mobilization Belt, Yoga Mat, Foam Roller

Are you treating patients with Sacroiliac Joint pain? Herman & Wallace's offers a Home Exercise Manual for Patients with Sacroiliac/Low Back Pain

References
Hungerford, B., Gilleard, W., & Hodges, P. (2003). Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine,28(14), 1593-1600.
Ostgaard, H. C., Anderson, G. B. J., & Karlson, K. (1991). Prevalence of back pain in pregnancy: A review. Spine, 16(5), 549-552.
Schwarzer AC, Aprill CN, Bogduk N. The sacroiliac joint in chronic low back pain. Spine. Jan 1 1995;20(1):31-7