Overview

This OVERVIEW will give you a quick understanding of Sacroiliac Joint Pain. We will get into more detail as the workshop progresses

The sacroiliac joint (SIJ) is a region that includes multiple bone, joint, cartilage, muscle, ligament, and nerve structures. Its anatomical integrity and proper interaction enable the individual to perform normal daily activities [1].

SIJ is designed to provide stability and plays a key role in the development of pelvic joint biomechanics [1]. One of its main functions is to transfer weight from the trunk to the lower limbs. Thus, a SIJ dysfunction can lead to an imbalance in the mobility of lower limbs, interfering with the way someone walks and runs [2].

There are numerous intra and extra-articular etiologies leading to a SIJ dysfunction [3]. Risk factors include lumbar sacral spinal fusion, different length of the lower limbs, scoliosis, gait abnormality, and prolonged vigorous exercise [3].

Pain due to this dysfunction can be located at or around the lower back, hip, leg, foot, and toes [4]. Thus, the prevalence of lower back pain due to this sacroiliac dysfunction is at 22.5% in the adult population [5]. The prevalence of chronic lower back pain due to SIJ is 13%–30% [6]. In some cases, however, the dysfunction may be asymptomatic, with the individual not reporting any pain or discomfort [5].

Despite the high prevalence of sacroiliac dysfunction, there are no therapeutic protocols for this syndrome. It has been previously considered as a potential contributor to lower back pain but, according to scholars, there are few studies that have compared the effectiveness of the different therapeutic techniques [7].

Sacroiliac joint dysfunction is a common cause of pain amongst athletes. It is therefore important to consider this population group, since sport can sometimes predispose athletes to suffer from this type of pathology [8]. In particular, SIJ dysfunction in runners may be due to the impact of the lower limbs on the ground, which transfers in turn to the joint, eventually leading to a blockage that interferes with the correct biomechanics [9].

Diagnosis of the etiology is problematic because there are no pathognomonic signs, so a combination of clinical tests is needed in order to make a more accurate diagnosis. It has been proven that the performance of three or more positive maneuvers reports a sensitivity of 94% and a specificity of 78% [10].

The muscle energy technique (MET) and the thrust manipulation technique are among the most commonly mentioned in several studies on the treatment of sacroiliac dysfunction. The MET technique helps correct the dysfunction by means of isometric and isotonic contractions resulting in an improved physiological function of the joint [1,11].

The manipulation technique, or thrust, consists of a high-speed movement aimed at correcting the dysfunction in the direction of correction, which leads to both, joint improvement and periarticular muscle inhibition [3,12]. According to the authors, manipulative techniques have excellent results after short-term manipulation but their long-term benefits and recurrence prevention effects remain unproven [13]. Some authors claim in their reviews that the manipulation technique is the most efficient in the treatment of sacroiliac dysfunction [14].

In the light thereof, we can state that SIJ is an important anatomical element in the stride progression, being key to the correct distribution of body mass in both limbs by maintaining the stability and alignment of the lower limb. The limitation of its mobility can lead to an alteration in the correct execution of the gait and the stride [15]. Therefore, the objective of this study was to compare the effectiveness of thrust and MET techniques in the resolution of SIJ dysfunction in middle-distance running athletes.