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SIJ pain and Hip injury

Question: SIJ pain and Hip injury

A client of mine presents with the following symptoms.
Shooting pain from hip into the SIJ upon twisting the lumbar spine when getting up from lying down position into sitting position. He had an Iliac wing fracture last year, but had no problems until now.
He is very active, surfing etc. He also has pain in the buttocks traveling down the back of the leg. I treated with trigger point deactivation in SIJ,Pririformis, Glutes med and min, QL, Hamstrings, Gastrocs and Soleus. I only found severe activity in semimembranosus and semitendinosus, Pririformis, Gastrocs and soleus. Hardly any in Glutes and around SIJ and QL. Practically no activity around the iliac spine.
Would any one be able to help me with this, since after treatment the pain is still there upon rotation of the lumbar spine? Any suggestions would be very welcome. Thanks. Marlene

Answer:

Hi Marlene
The pain has to be traced back to the lumbar spine - and possible disc pathology annular tear etc. The movement causing the pain is of a forward bending in conjunction with rotation - one of the annular fibres of discs worst positions. Perform some standard tests like Straight Leg Raise (SLR) and Slump test to see if the pain can be reproduced. Also check if there are any valsalva signs (discomfort on laughung, coughing, sneezing etc) . Also perform active and passive assessments of the lumbar spine to see if there is any disfunction movement.
Let me know how you get on
Dan