When clinical signs of
reduced force closure have been identified (positive Active SLR)
, the increased movement is identified at the symphysis pubis -not the sacroiliac joints .
Pain from the sacroiliac joints is located
primarily over the joint (inferior sulcus) and may refer distally
, but not to the low back [23,24,25,26,27,28,29,30].
Sacroiliac joint disorders can be
diagnosed using clinical examination
[29,31,32,33,34] which includes finding of pain primarily located to theinferior sulcus of the SI joint, positive pain provocation tests for SI joints andabsence of painful lumbar spine impairment.
The SI joint has many muscles that act to compress and control it (forceclosure), thereby enhancing
pelvic stability allowing for effective load trasnfer
via pelvis during a variety of functional tasks[7,8,9,35,36,37,38,39,40,41,42,43,44].
» Motions at Sacroiliac Joint:
Three types of motion are available to the inominate bones:
- Movement of both innominates as a unitrelation to the sacrum [45,46,47,48].
During trunk flexion or bilateral hip flexion, the
(rotates anteriorly), so that the promontory movesventrocaudally while the apex moves dorsocranially.
This motion is resisted by following structures:
Wedge shape of the sacrum
Ridges & depressions of the articular surfaces
Friction coefficient of the joint surface
Integrity of the interosseous & sacrotuberous ligaments
, or moves in opposite direction,during trunk extension or bilateral hip extension.
This motion is resisted by the long dorsal sacroiliac ligament.
Combination of rotation and translation is angular movement of the sacrum, during which the iliac crests move closer together while the iliac tuberosities move further apart.
Greatest amount of movement, as much as 5.6+/-1.4 mm,occurs when going from recumbent to standing and reverses indirection when moving from standing to recumbent .
Rotation is accompanied by translation, which results inincreased ligamentous tension and absorption of energy .The SI joint thereby function as