Pelvis main focus

Question 1

SIJ pain

Answer 1

Felt in the low back and buttocks. The pain is caused by damage or injury to the joint between the spine and hip

Tight ligaments
Uneven pelvic movement
Arthritis, scoliosis, traumatic injury, pregnancy

Young/middle aged women who are or have recently been pregnant

Pain is most commonly felt in the low back and one side of the buttocks but can also be referred into the thigh and leg.
Stiffness and limited ROM in lower back and hips/pelvis region
Instability, may cause pelvis to feel like it will give way
Pain can be aggravated with prolonged sitting or standing, standing on one leg, stair climbing, going from sit to stand, and with running.

Question 2

IlioPsoas Bursitis

Answer 2

Inflammation of the bursa located beneath the iliopsoas muscle

Result of multiple mini traumas caused by vigorous hip flexion and extension - friction from the overlying tendons.

Most common in women 40-60
Commonly seen in individuals participating in strength training, rowing, uphill running and competitive track and field.

Pain located in the anteromedial aspect of the thigh, radiating into the knee, leg and lower back

Develops during walking or specific movements like crossing the legs
Worse while performing activities
Relieved by rest
Tenderness in superior proximal aspect of the quadriceps muscles
Stiffness or pain after a rest or in the mornings.

Question 3

Piriformis Syndrome

Answer 3

Piriformis muscle, spasms and causes buttock pain. Can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).

Most common <45

Sitting for prolonged periods (taxi drivers, office workers, bicycle riders)
Trauma to the hip or buttock area

Chronic pain in the buttock and hip area
Pain when getting out of bed
Inability to sit for a prolonged time
Pain in the buttocks that is worsened by hip movements
Pts will often present with symptoms of sciatica

Question 4

Osteitis Pubis

Answer 4

Painful and chronic condition affecting the pubic symphysis and/or parasymphyseal bone that develops after athletic activity. Most common men 30-50

• Lower abdominal pain
• Groin pain, with radiation to inner thigh/adductor muscles
• Often associated with gait disturbances
• Discomfort exaggerated by any activity that puts pressure on the pelvic griddle, e.g. walking, especially up and down the stairs, couching/sneezing
• Pain described as dull ache

Question 5

Ischiogluteal bursitis

Answer 5

Inflammation of the bursa, which lies between the ischial tuberosity and the gluteus maximus muscle

Question 6

Levator Ani Syndrome

Answer 6

Rare but exquisitely painful condition characterised by intermittent burning pain and the feeling of an incomplete bowel movement in the rectum and perineal region.

• pain high in the rectum that may be:
• irregular and spontaneous, a dull ache
• relieved when standing or lying down but felt when sitting
• unrelated to bowel movements
• severe enough to interrupt sleep
• Episodes of chronic or recurrent rectal pain or aching that last for at least 30 minutes
• Tenderness of the puborectalis muscle (which wraps around the rectum and the pubic bone) when it is touched

Question 7

Coccydynia

Answer 7

Pain in the bone at the base of the coccyx.
injury or accident, such as a fall onto your coccyx
Repeated or prolonged strain on the coccyx – for example, after sitting for a long time while driving or cycling
Pregnancy and childbirth

dull and achy pain at the base of spine most of the time, with occasional sharp pains:
* The pain may be worse:
* when you sit down or stand up
* when you bend forward
* when using the toilet