Pelvis

Sacroiliac Joint Pain

The sacroiliac joint is located in your buttock area, between the sacrum (tail bone) and ilium (or the outer part of your pelvis). This joint can be the source of pain in your buttock area, lower back, hip, groin and thigh. The surrounding soft tissues can become painful due to excessive movement occurring in the joint. This excess movement can occur due to pregnancy, major trauma (a fall or car accident), or repetitive minor trauma (landing from a jump repeatedly on the same leg). Stiffness in the opposite SIJ or hip could also cause excessive movement on the symptomatic side.

Treatment includes correcting any misalignment of the joint, strengthening particular muscles that help to keep the joint stable, possible use of a special belt to increase compression across the joint and addressing other more remote contributing factors.


Sacroiliac joint and over-lying ligaments

Pubic Symphysis

The pubic symphysis is the joint between the two halves of your pelvis and is positioned in line with your naval. Pain from this joint can be felt directly over the joint, but it may also radiate into your lower abdomen or groin area. Pregnant women may experience pubic symphysis pain as their pelvic ligaments become more elastic, allowing more movement to occur within the joint. Athletes who are involved in field sports that have a high volume of running, changing of direction and kicking may also develop pain through this joint or in the soft tissue that blends into the joint.

Treatment of the pregnancy related pubic symphysis pain involves local soft tissue treatment, correcting any misalignment of the joint and the use of a pelvic compression belt to increase stability. Treatment of the athlete’s overuse pubic symphysis pain requires identification and correction of the contributing factors. These factors may include insufficient strength and/or flexibility through the hip, pelvis and lower trunk, as well as inappropriate training loads.


Pelvis with labelled Pubic Symphysis

Bursitis

Bursae are small sac-like structures that consist of a flexible membrane and are filled with a fluid that is similar to raw egg in its viscosity. The main function of bursae is to reduce friction between the structures that the bursa is found to lie between. However, if too much pressure is placed on the bursa, they can become inflamed (bursitis), and therefore painful. In the area of the hip, there are three main areas where bursitis can occur:

  • At the front of the hip, deep to the hip flexor (psoas) muscle
  • On the side of the hip, over or around the area of the bony protuberance (greater trochanter)
  • Over the sitting bones (ischial tuberosities)

Effective treatment for bursitis requires identification of the cause of the excessive compression of the bursa. This can include a lack of flexibility or strength in certain muscles, habits of movement pattern and posture, or in the case of ischial bursitis, not enough padding on the seat! To accelerate the recovery we may ask you to consult your family doctor regarding the use of either non-steroidal anti-inflammatory tablets or a cortisone injection.


Bursae of the hip region