SIJ & Pelvic Pain + Physio in Sydney CBD

Your diagnosis is Sacroiliac Joint (SIJ) dysfunction

When pain in this region (that is enclosed by the sacrum, the lower back and the hip), and it is not caused by:

  • The lumbar spine pain,
  • The hip joint, or
  • The proximal hamstring tendon

Your Diagnosis is quite likely to be Sacroiliac joint dysfunction.

How does it feel?

It presents to you as a rather deep, very diffuse pain, and it generally exists on one side only.

This pain is aggravated by sudden changes in physical activity levels.

Specific activities that can aggravate this pain include:

  • Sitting, particularly sitting with legs crossed
  • Walking, when weight is fully transferred to your ‘sore side’
  • Sporting tasks, &
  • Various single leg activities, like walking up stairs.

What we physiotherapists will look for

Patients with a presentation of symptoms in this region will be taken through a thorough examination that assesses the lumbar spine, the hip joint and the SIJ (particularly sacral mobility). Moreover, joint resting position will be observed and global & intrinsic muscle strengths tested. We will look closely at the strength and length of your hip flexors, your hamstrings, and your gluteal muscles. Your ability to appropriately activate your core muscle function will also be evaluated.

A combination of the Laslett 5 testing battery (a special testing cluster for the SIJ, defined by Mark Laslett) will be completed to rule in a diagnosis of SIJ dysfunction.

The Laslett testing battery may comprise of:

  • SIJ Compression
  • SIJ Distraction (opening)
  • Sacral thrust
  • Femoral thigh thrust, &
  • Gaenslen’s test.
    • We require 3 positive tests from the cluster above before we begin to suspect the SIJ as your true source of pain.

How does physiotherapy treat SIJ pain?

Treatment of SIJ dysfunction requires a multifaceted and personalised treatment program that is mindful to alleviate symptoms whilst treating the cause. In some SIJ cases, where distraction or opening the joint is symptomatic, it is important to avoid stretches and trigger point releases in the associated soft tissues, as this may result in increased body load being transferred to the SIJ – and this in turn would increase your pain experience.
We will look closely at your work life, your home life, and your sporting life, and we will analyse your SIJ pain behaviour inside each of these aspects of your life. You can expect that we physios will:

  • Modify your activity and begin to make some biomechanical improvements at your low back, SIJ and hip joints
  • Address your strength deficits such that we can see a significant increase in your surrounding tissue tolerance to load, shear and strain, &
  • Prescribe exercises specific to stabilising your SIJ, so that we may prevent the recurrence of this pain.