Thread by @Retlouping

I have been pondering on the Sacroiliac Joint and some clinicians fascination with it. I think that it is the source of more “evidence based ostriches” than any other joint.
Yes a brief thread
The SI joint and pelvis are not a “pubics cube” we do need to stop the madness.

That said yes the SI joint can be sensitized and produce nociceptive output when stressed. But so many hypotheses abound about positional faults, laxity, dysfunction and fixation that it is bizarrely paradoxical

Fact YOU can not alter the position of the SI joint by manipulation, you just can’t. Study here pubmed.ncbi.nlm.nih.gov/9615363/

You can’t alter the SI joint motion either by manipulation.

sciencedirect.com/science/articl…

YOU can not palpate it’s motion either, it’s too small, it is a creaking joint with give not an active joint with muscles that move it.

You are not convinced well read the science 👇

https://twitter.com/Retlouping/status/870034540743544833

“Motion of the SIJ is limited to minute amounts of rotation and of translation suggesting that clinical methods utilizing palpation for diagnosing SIJ pathology may have limited clinical utility.”

ncbi.nlm.nih.gov/pmc/articles/P…

How many more studies do we need to say “you can not reliably or validly detect SI joint motion via palpation?”

https://twitter.com/PhysioMeScience/status/1387070815766724610

Here is a bibliography of palpation studies to read at your leisure

https://twitter.com/retlouping/status/937486104063823872

Even pain provocation tests have recently been brought into doubt. They are not good for ruling in the SI joint as a source, but are good for ruling it out jospt.org/doi/pdf/10.251…

Imagine thinking that a joint that is a transit stress point for the hips and spine can be held together with a bit of stretchy Kinesiotape?

In 2008 I wrote a letter to the editor about the nonsense around the SI Ilial rotation. My thoughts are still the same except for maybe the manipulation CPR.

https://twitter.com/retlouping/status/975147489941708805

One more time, the SI joint is built to transmit large forces and allows for a non rigid more pliable pelvis along with the symphesis pubis.

https://twitter.com/retlouping/status/688352981075398656

To be pretty blunt SI joint tests suck big time on their validity.

To sum up, the SI joint is built for stability and force transmission, it has extremely strong ligaments, there are no muscles that work directly to “move this joint” it is a creaking joint which protects the pelvis from rigidity and unwanted forces.

Time to stop the nonsense.

As always thanks for reading this far.