Although not very common, problems with the pelvis can be extremely painful and disabling affecting all aspects of your life from caring for your family to dressing to waking (including going up and downstairs) to work and to social activities.
Fortunately these conditions respond well to the appropriate physiotherapy treatment.
The types of pelvic problems we treat at Walker and Hall are
Sacroiliac joint dysfunction
Symphysis pubis joint pain
If your condition is not listed above please contact us
We have extensive experience in treating these conditions and managing your recovery.
To see how Walker and Hall can help you please click on the links below:
Sacroiliac Joint Dysfunction (also known as Sacroiliac Joint Pain, Sacroiliac Joint Sprain, SIJ Dysfunction, Sacroiliac Joint Inflammation, Sacroiliac Joint Injury, Sacroiliac Joint Disorder, Sacroiliitis)
At Walker and Hall we know through personal experience how painful and disabling a problem with the sacroiliac joint dysfunction can be. It can affect all aspects of your life from caring for your family, sleeping, sitting, driving and working to leisure activities such as sport and gardening.
Fortunately sacroiliac join dysfunction responds well to the appropriate physiotherapy treatment.
The sacroiliac joint is located in the lower part of the back and joins the tail bone (sacrum) to one of the pelvic bones (ilium). There are two sacroiliac joints – one on either side of the spine. The sacroiliac joints act to transfer weight from the spine to the pelvis and allow a small amount of movement to occur.
During certain movements of the spine and hips, stretching and compressive forces are placed on the sacroiliac joints and the surrounding ligaments. If these forces are excessive and beyond what the sacroiliac joint can stand, injury to the sacroiliac joint may occur. This is known as sacroiliac joint dysfunction.
Causes of Sacroiliac Joint Dysfunction
Degeneration – as a weight bearing joint the sacroiliac joint can develop age related “wear and tear”
Pregnancy – during pregnancy hormones are released that allow the ligaments of the sacroiliac joints to relax, this allows for increased movement during childbirth. However this increased movement can cause increased stresses and abnormal wear of the joint leading up to childbirth. Also the additional weight and altered walking pattern (altered gait) associated with pregnancy may also place additional stress on the sacroiliac joints.
Excessive force – movements such as bending, sitting, lifting, arching and twisting of the spine can all affect the sacroiliac joint
Weight bearing forces – activities such as running and jumping
Trauma – Injury to the sacroiliac joint may occur traumatically or due to repetitive or prolonged forces over time.
Signs and symptoms of sacroiliac joint dysfunction
- Pain – usually experienced on one side of the low back around the top of the buttock and may be associated with referral into the lower buttock, groin or thigh. In rare cases, pain may be felt on both sides of the lower back. It is generally increased with activities that involve lower back or hip movements and often you will experience pain on rolling over in bed, putting on or taking off your shoes and socks, walking up and down stairs and running
- Asymmetry of the pelvis due to muscle tightness, joint stiffness, altered leg length and/or joint laxity associated with pregnancy
How can Walker and Hall help you?
A thorough musculoskeletal examination is required to determine the extent of the sacroiliac joint dysfunction. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for sacroiliac joint dysfunction include:
- joint mobilization techniques to improve the range of movements
- soft tissue massage to reduce pain and muscle spasm
- electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
- postural education including the use of a lumbar roll for sitting
- the use of an appropriate pillow for sleeping
- the provision of sacroiliac joint braces/support
- the correction of leg length discrepancy
- a home exercise programme to improve flexibility, strength, core stability and posture
- activity modification advice
- anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist
Symphysis Pubis pain (also known as Osteitis Pubis, Pubic Symphysitis)
Symphysis pubis pain is often an overuse injury characterized by tissue damage and inflammation to the pelvis at the site where the two pubic bones join at the front of the pelvis (pubic symphysis), resulting in groin pain.
At Walker and Hall we know through personal experience how painful and disabling this can be affecting all aspects of your life from weight bearing to work to social and sporting activities.
Fortunately it is a condition that responds well to physiotherapy treatment.
The pelvis is made up of two bones which join together at the front to form the symphysis pubis joint. Each bone in the joint is covered with cartilage and this helps absorb the forces between the two bones.
There are a number of muscles that attach near the joint i.e., the adductors and the abdominals. As these muscles contract (such as during running, kicking or performing sit-ups) a pulling force is exerted on the symphysis pubis joint. When these forces are excessive due to too much repetition or high force, damage to the pubic bones or symphysis may occur. When this results in inflammation to the symphysis pubis the condition is known as symphysis pubis pain.
Causes of Symphysis Pubis pain
- Overuse – symphysis pubis pain is often associated with overuse injuries where strain is placed on the joint as a result of repetitive or prolonged activities e.g., repetitive running, kicking or change of direction activities. It is commonly seen in running sports such as football, hockey and athletics (particularly marathon runners).
- Excessive abdominal muscle contraction – activities such as repetitive sit ups or following inadequate rehabilitation of other injuries, such as adductor tendinopathy can cause this condition
- Pregnancy – during pregnancy the body releases a hormone called relaxin which causes “loosening” of the pelvic ligaments to allow slight movement of the pelvic joints during childbirth. Occasionally the ligaments loosen too much and too early before the birth. This means they can’t keep the pelvic joints stable and so the pelvis moves, especially on weight bearing, and this can be aggravated by the increased weight of the growing baby.
Signs and symptoms of Symphysis Pubis pain
- Pain – usually experienced in the groin and may develop gradually overtime. It may be experienced on one or both sides of the groin, in the lower abdominals and at the front of the hips. You will usually experience pain on firmly touching the pubic bone at the front of the pelvis. It may also increase when squeezing the legs together or when moving the affected leg away from the midline of the body (abduction). It is usually aggravated by exercises such as running, kicking, performing sit-ups or change of direction activities
In less severe cases you may only experience an ache or stiffness in the groin that increases upon rest following activities such as running (particularly involving change of direction) and kicking. It may also warm up with activity in the initial stages of the condition
As the condition progresses you may experience symptoms that increase during activity and affect performance. In severe cases you may be unable to continue the activity and may limp as a result of the pain
- During pregnancy the pain tends to appear from the first trimester onwards i.e., from 12 weeks and is most commonly felt when walking. Often you may feel that your pelvis is coming apart. It is made worse when turning in bed or doing something that involves standing on one leg, such as climbing up stairs, getting dressed and getting in and out of a car. It is generally felt in the pubis and/or the sacro-iliac joints, but can also be experienced in the groin, the inner side of the thighs, the hips and in one or both buttocks
How Walker and Hall can help you
A thorough musculoskeletal examination is required to determine the extent of the inflammation of symphysis pubis joint. This is essential if the optimum recovery is to be achieved.
Following the diagnosis a treatment plan is devised and discussed with you.
The types of physiotherapy treatment used at Walker and Hall for a Symphysis pubis pain are
- Ice or heat treatment (providing this is comfortable)
- Pain relieving techniques e.g., gentle joint mobilising techniques, electrical therapy e.g., ultrasound therapy and soft tissue massage (particularly to the adductors, abductors, abdominals and psoas muscles) to reduce pain and muscle spasm
- Joint mobilising techniques – to the hip joint, lumbar spine and sacroiliac joints e.g., gentle stretching and muscle release techniques.
- Home exercise programme – a graduated strength, core stability, pelvic stability, flexibility and balance programme to ensure an optimal outcome
- Provision of sacroiliac joint braces/support e.g., “Fembrace” – particularly useful during pregnancy
- Anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist