Hi everyone,
I seem to be having problems replying to certain messages... let's hope this
works.
I have come across the article by Sturesson et al, but I question their
research design. They looked at using gentle leg movements and looking at
how much the SIJ moved, and i suspect that is why they obtained such small
values. The literature also points towards individual differences based on
age, gender and culture. However, from anatomical dissections personally, I
have found the SIJ to be very difficult to separate due to so many
ligaments. I have my doubts also about how much the SIJ moves and whether it
can be detected.
I think what these studies point towards is the weak linkage between
biomechanics and joint pain. Mobility testing, which is what a lot of the
examination procedures are, are far from conclusive. Nevertheless, the
information they provide must be integrated with other objective and
subjective signs to get the complete picture. I have found that SIJ
manipulations and MET are useful when done at the right time on the right
individual, and combined with other management strategies. However, I have
learnt that a pure biomechanical explanation to why these techniques work is
unsatisfactory, and other fields must be incorporated, in particular, the
field of neuroscience. It goes without saying that these issues are not
isolated merely to the SIJ, but seems to apply to other joints in the body.
Henry***
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