114:, until many years of the dysfunction being allowed to continue. Injury to the ligaments that hold the sacroiliac joints in proper support is thought to be caused by a torsion or high impact injury (such as an automobile accident) or a hard fall, resulting in the hypermobility. As many as 58% of people diagnosed with sacroiliac joint pain had some inciting traumatic injury based on clinical examination findings. The joint that was once stabilized by strong ligaments, now overly stretched, sprained, or torn, will move beyond its normal range. This is thought to result in the ilium and sacral surfaces "locking" in an incongruent or asymmetrical fashion (one innominate bone is tilted anteriorly; the other innominate bone is tilted posteriorly) causing pain that can be debilitating.
349:, do not usually reveal abnormalities; therefore, they cannot reliably be used for diagnosis of sacroiliac joint dysfunction. There is a new imaging test SPECT/CT which can sometimes detect sacroiliac joint dysfunction. There is also a lack of evidence that sacroiliac joint mobility maneuvers (Gillet, Standing flexion test, and Seated Flexion test) detect motion abnormalities. Given the inherent technical limitations of the visible and palpable signs from these sacroiliac joint mobility maneuvers another broad category of clinical signs have been described called provocative maneuvers. These maneuvers are designed to reproduce or increase pain emanating within the sacroiliac joint.
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the effect of intraarticular prolotherapy injections versus intraarticular steroid injections in proven sacroiliac joint pain. The two interventions were equal in the short term at 3 months, but the prolotherapy group had superior pain relief at the 15 month mark at the end of follow up. This type of trial is considered high level evidence in medical circles. Hoffman et al. in 2018 published a prospective cohort study with positive results in the treatment of those with sacroiliac joint dysfunction.
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pain and the diagnostic injection is performed on two separate visits. Published studies have used at least a 75 percent change in relief of pain before a response is considered positive and the sacroiliac joint deemed the source of pain. However, several other injection studies have compared intra-articular with extra-articular injection, and indicate that the ligament injection behind the joint is oftentimes superior to injection in the joint and seems to be a very underutilized diagnostic tool.
81:), urinary frequency, and "transient numbness, prickling, or tingling". Pain can range from dull aching to sharp and stabbing and increases with physical activity. Symptoms also worsen with prolonged or sustained positions (i.e., sitting, standing, lying). Bending forward, stair climbing, hill climbing, and rising from a seated position can also provoke pain. Pain can increase during menstruation in women. People with severe and disabling sacroiliac joint dysfunction can develop
48:
482:(PRP) injections have shown positive results as a treatment for Sacroiliac Joint Dysfunction, with randomized trials and case reports showing them to be more effective over periods of 3 months than steroid injections. Studies have also shown PRP injections into the sacroiliac joint are able to provide complete relief of symptoms, lasting as long as four years.
468:. The anti-inflammatory effect of injection therapy is not permanent, and the injections do not offer an opportunity to stabilize an incompetent joint. Surgery is often considered a last resort, but for some patients, it is the only method of effectively stabilizing the loose joint. A fixation of the joint (screws or similar hardware only, without the use of
476:, as it is much less invasive, surgically straightforward, and results in a quicker recovery time for the patient. Some experts in the field believe that it is important to make sure the sacroiliac joint is in an anatomically correct position prior to fixation or fusion, but published research contradicts this belief.
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tests, pain along the typical area raises suspicion for sacroiliac joint dysfunction. However no single test is very reliable in the diagnosis of sacroiliac joint dysfunction. It is important to remember true neurogenic weakness, numbness, or loss of reflex should alert the clinician to consider nerve root pathology.
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In the early 1900s, dysfunction of the sacroiliac joint was a common diagnosis associated with low back and sciatic nerve pain. However, research by
Danforth and Wilson in 1925 concluded that the sacroiliac joint could not cause sciatic nerve pain because the joint does not have a canal in which the
101:
SI joint dysfunction is sometimes referred to as "sacroiliac joint instability" or "sacroiliac joint insufficiency" due to the support the once strong and taut ligaments can no longer sustain. When the joint is hypermobile or loose, it is classified as an extra-articular dysfunction because abnormal
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injections performed either intraarticularly or into the dorsal sacroiliac ligaments is sometimes performed as an alternative treatment option. This is a controversial therapy but it does have research evidence to support its use. Kim et al. in 2010 published a randomized controlled trial evaluating
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Thigh Thrust - This test applies anteroposterior shear stress on the SI joint. The patient lies supine with one hip flexed to 90 degrees. The examiner stands on the same side as the flexed leg. The examiner provides either a quick thrust or steadily increasing pressure through the line of the femur.
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resulting in the weakening of the sacroiliac structure. During pregnancy, relaxin serves as nature's way of allowing the female pelvis to achieve distention of the birthing canal. Pelvic joint pain in post pregnancy women is thought to be derived from the inability of the stretched out ligaments to
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If the pain does not resolve in the first 1–2 weeks, then the patient may benefit from a steroid and anesthetic mixture fluoroscopically injected into the joint (this also serves in confirming diagnosis), as well as manipulative or manual therapy. For the most severe and chronic forms of sacroiliac
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Muscles and ligaments surround and attach to the SI joint in the front and back, primarily on the ilial or sacral surfaces. These can all be a source of pain and inflammation if the SI joint is dysfunctional. The sacroiliac joint is highly dependent on its strong ligamentous structure for support
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The current "gold standard" for diagnosis of sacroiliac joint dysfunction emanating within the joint is sacroiliac joint injection confirmed under fluoroscopy or CT-guidance using a local anesthetic solution. The diagnosis is confirmed when the patient reports a significant change in relief from
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There is also a notable incidence of lumbar spinal fusion patients that present with sacroiliac pain and hypermobility, potentially due to the adjacent lumbar joints being fixed and unable to move. Clinical studies have found up to 75% of post-lumbar fusion patients develop SI joint degeneration
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Cautious interpretation is warranted because there are no biomechanical studies showing that the Thigh Thrust test isolates forces in the SIJ when performed at 90 degrees and due to intra-individual variation in body type, hip flexibility, general flexibility of the trunk and pelvis. In all the
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Certain biomechanical or muscle length imbalances may ultimately predispose a person to sacroiliac dysfunction and pain. Likely, this is a result of altered gait patterns and repetitive stress to the SI joint and related structures. These conditions exist in persons with leg-length inequality,
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The ligaments in the sacroiliac are among the strongest in the body and are not suspected by many clinicians to be susceptible to spraining or tearing. Skepticism of the existence of sacroiliac joint dysfunction within the medical community is furthered by the debate on how little or much the
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Gaenslen test - This pain provocation test applies torsion to the joint. With one hip flexed onto the abdomen, the other leg is allowed to dangle off the edge of the table. Pressure should then be directed downward on the leg in order to achieve hip extension and stress the sacroiliac
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Treatment is often dependent on the duration and severity of the pain and dysfunction. In the acute phase (first 1–2 weeks) for a mild sprain of the sacroiliac, it is typical for the patient to be prescribed rest, ice/heat, spinal manipulation, and physical therapy;
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In some people, the sacroiliac joints reverse the normal concave-convex 'locking' relationship, which can lead to rotational misalignment. The variation in joint configuration results in some sacroiliac joints being inherently weaker or more prone to misalignment.
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on the iliac side. The sacroiliac joint contains numerous ridges and depressions that function in stability. Studies have documented that motion does occur at the joint; therefore, slightly subluxed and even locked positions can occur.
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Borowsky CD, Fagen G (2008). "Sources of sacroiliac region pain: insights gained from a study comparing standard intra-articular injection with a technique combining intra- and peri-articular injection".
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Kim, Woong Mo; Lee, Hyung Gon; Won Jeong, Cheol; Kim, Chang Mo; Yoon, Myung Ha (2010). "A Randomized
Controlled Trial of Intra-Articular Prolotherapy Versus Steroid Injection for Sacroiliac Joint Pain".
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of spinal segments L2-S3. The wide possibility of innervation may explain why pain originating from the joint can manifest in so many various ways, with different and unique referral patterns (see "
398:, and external rotation, the clinician externally rotates the hip while the patient lies supine. Then, downward pressure is applied to the medial knee stressing both the hip and sacroiliac joint.
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in 1977. Over-diagnosis and attention on herniated discs has led to the SI joint becoming an underappreciated pain generator in an estimated 15% to 25% of patients with axial low back pain.
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Pathological hypomobility (too little movement) of the sacroiliac joint is an intra-articular disorder in which the joint locks due to wearing down with age or degenerative joint disease.
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and depression. Sacral rotation can be transmitted distally down the kinematic chain and, if left untreated over a long period of time, may lead to severe
Achilles tendinitis.
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MurakamiE Tanaka Y, Aizwa T, et al. (2007). "Effect of peri-articular and intra-articular lidocaine injections for sacroiliac joint pain: prospective comparative study".
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return to normal tautness. Women who have delivered large babies or who have had extended labors also are prone to developing chronic sacroiliac joint pain and instability.
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Maigne, JY; Aivaliklis, A; Pfefer, F. (1996). "Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain".
229:) react to dynamic motions (such as straight-leg raising during physical motion). The long dorsal sacroiliac ligament can become stretched in periods of increased lumbar
2220:"Evaluation of platelet-rich plasma vs steroid in the treatment of sacroiliitis by ultrasound-guided injection in patients with seronegative axial spondyloarthropathies"
642:
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Ha; et al. (2008). "Degeneration of
Sacroiliac Joint After Instrumented Lumbar or Lumbosacral Fusion: A Prospective Cohort Study Over Five-Years Follow-Up".
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Sturesson, Bengt; Uden, Alf; Vleeming, Andry (2000). "A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test".
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Hungerford, Barbara; Gilleard, Wendy; Hodges, Paul (2003). "Evidence of
Altered Lumbopelvic Muscle Recruitment in the Presence of Sacroiliac Joint Pain".
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1963:
1295:"Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women"
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Hoffman, Martin D.; Agnish, Vikram (2018). "Functional outcome from sacroiliac joint prolotherapy in patients with sacroiliac joint instability".
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Iliac
Compression Test - Apply compression to the joint with the patient lying on his or her side. Pressure is applied downward to the uppermost
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Iliac
Gapping Test - Distraction can be performed to the anterior sacroiliac ligaments by applying pressure to the anterior superior iliac spine.
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Common symptoms include lower back pain, buttocks pain, sciatic leg pain, groin pain, hip pain (for explanation of leg, groin, and hip pain (see
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Tullberg T; et al. (1998). "Manipulation does not alter the position of the sacroiliac joint. A roentgen stereophotogrammetric analysis".
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Jee, Won-Hee; et al. (2004). "Sacroiliitis in patients with ankylosing spondylitis: association of MR findings with disease activity".
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Sacroiliac joint disorder, sacroiliac joint disease, sacroiliac joint syndrome, sacroiliac syndrome, sacroilliac dysfunction and instability
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Sturesson; et al. (2000). "A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test".
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1545:"Value of quantitative radionucleotide bone scanning in the diagnosis of sacroiliac joint syndrome in 32 patients with low back pain"
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Perhaps the biggest reason for misdiagnosis or lack of diagnosis of sacroiliac joint dysfunction is based on the inability of common
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with a painful and dysfunctional sacroiliac joint. The SI joint is a pain-sensitive structure richly innervated by a combination of
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Sturesson, Bengt; Selvik, GöRan; UdéN, Alf (1989). "Movements of the
Sacroiliac Joints: A Roentgen Stereophotogrammetric Analysis".
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222:
290:
1030:"Symptom-giving Pelvic Girdle Relaxation of Pregnancy, Postnatal Pelvic Joint Syndrome and Developmental Dysplasia of Hip"
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297:") for individual patients. Patients with sacroiliac joint dysfunction can also develop tightness and dysfunction in the
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Wallace, Patrick; Bezjian
Wallace, Laurie; Tamura, Sarah; Prochnio, Kirk; Morgan, Kyle; Hemler, Douglas (August 2020).
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ligaments, while the joint itself is structurally normal and healthy. The sacroiliac joint itself often will not show
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Sacroiliac joint dysfunction is an outcome of either extra-articular dysfunction or from intraarticular dysfunction.
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and atrophy throughout the body due to limitation of activities and exercise that bring about pain in the low back.
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Bernard, TN Jr; Kirkaldy-Willis, WH (1987). "Recognizing specific characteristics of nonspecific low back pain".
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In 1934, the work of Mixter and Barr shifted all emphasis in research and treatment from the sacroiliac to the
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2165:"Effectiveness of Ultrasound-Guided Platelet-Rich Plasma Injections in Relieving Sacroiliac Joint Dysfunction"
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Foley, BS; Buschbacher, RM (2006). "Sacroiliac joint pain: anatomy, biomechanics, diagnosis, and treatment".
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dysfunction, treatment should proceed with the support of a sacroiliac belt, injection therapy, and finally,
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2063:"Steroid vs. Platelet-Rich Plasma in Ultrasound-Guided Sacroiliac Joint Injection for Chronic Low Back Pain"
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nerves can be entrapped against the joint. The biomechanical relationship between the sacroiliac joint, the
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1969:
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Voorn, Rinus (1998). "Case report: Can sacroiliac joint dysfunction cause chronic
Achilles tendinitis?".
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Many large and small muscles have relationships with the ligaments of the sacroiliac joint including the
1693:
Mixter, WJ; Barr, JS (1934). "Rupture of the Intervertebral Disc with Involvement of the Spinal Canal".
372:) can develop a probable diagnosis of sacroiliac joint dysfunction by using a hands on approach through
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sacroiliac joint moves. A discrepancy as large as 2–17 degrees has been reported in clinical findings.
185:, and at back of the sacrum to form the sacroiliac (SI) joints. Each innominate bone (ilium) joins the
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Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain and Rehabilitation
439:, namely lumbar discs. Medical focus on herniated discs was further forwarded by the invention of the
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ligaments resist the load of the sacrum relative to the ilium. More superficial ligaments (e.g., the
2538:
1965:
Retrospective Evaluation of Minimally Invasive Surgical (MIS) Method for Sacroiliac Joint Arthrodesis
1785:
Smidt, GL; et al. (1997). "Sacroiliac motion for extreme hip positions: A fresh cadaver study".
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Danforth, M; Wilson, P (1925). "THE Anatomy Of The Lumbo-Sacral Region in Relation To Sciatic Pain".
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189:(thigh bone) to form the hip joint; thus the sacroiliac joint moves with walking and movement of the
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2118:"Case series of ultrasound-guided platelet-rich plasma injections for sacroiliac joint dysfunction"
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Sembrano, Jonathan N.; et al. (2009). "How Often Is Low Back Pain Not Coming From the Back?".
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181:(the iliac bones) and the sacrum. The innominate bones join in the front of the pelvis to form the
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Singla, Varun; Batra, Yatindra K.; Bharti, Neerja; Goni, Vijay G.; Marwaha, Neelam (July 2017).
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FABER or Patrick test - To identify if pain may come from the sacroiliac joint during flexion,
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Zelle Boris A; et al. (2005). "Sacroiliac joint dysfunction: evaluation and management".
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Lippitt, AB (1995). "Percutaneous Fixation of the Sacroiliac Joint". In Vleeming, A. (ed.).
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The pelvis is stabilized at the sacrum or at the opposite ASIS with the hand of the examiner
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321:. Individuals with severe and long-standing sacroiliac joint dysfunction can develop muscle
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Smidt, GL; et al. (1995). "Sacroiliac kinematics for reciprocal straddle positions".
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Schwarzer AC, April CN, Bogduk N (1995). "The sacroiliac joint in chronic low back pain".
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Ko, Gordon D.; Mindra, Sean; Lawson, Gordon E.; Whitmore, Scott; Arseneau, Leigh (2017).
1873:"Change in Pelvic Incidence Associated With Sacroiliac Joint Dysfunction: A Case Report"
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Schwarzer, AC; et al. (Jan 1995). "The sacroiliac joint in chronic low back pain".
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177:(pelvic bones) to form the sacroiliac joints. The pelvic girdle is made up of two
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Hypomobility of this kind can also occur with an inflammatory disease such as
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scoliosis, a history of polio, poor-quality footwear, and hip osteoarthritis.
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the painful areas and performing the following provocative maneuvers below:
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Kirkaldy-Willis, WH; Bernard, TN Jr (1999). "Making a specific diagnosis".
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and stability. The most commonly disrupted and/or torn ligaments are the
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joint movement and alignment is a consequence of weakened, injured, or
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913:"Sacroiliac Dysfunction: General Information, Anatomy, and Treatment"
874:. et al. Rotterdam: European Conference Organizers. pp. 369–390.
742:(4th ed.). Philadelphia: Churchill Livingstone. pp. 206–26.
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253:", a condition often related with sacroiliac joint dysfunction),
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The integrated function of the lumbar spine and sacroiliac joint
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Walker J M (1992). "The sacroiliac joint: a critical review".
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Frieberg, AH; Vinke, TH. "Sciatica and the sacroiliac joint".
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imaging to discern the disorder. Diagnostic testing, such as
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The Secret Cause of Low Back Pain: How to End Your Suffering
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American Journal of Physical Medicine & Rehabilitation
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Heller, M (2006). "Sacroliliac Instability: An Overview".
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1440:. Oklahoma City, OK: Freedom From Pain. pp. 206–7.
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A clinician (i.e., a spine surgeon, orthopedic surgeon,
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The Journal of Alternative and Complementary Medicine
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doctor, athletic trainer, medical massage therapist,
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Journal of Orthopaedic & Sports Physical Therapy
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1968:. SAS11. April 28, 2011. Archived from
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715:"What is Sacroiliac Joint Dysfunction"
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1871:Chu, Eric Chun-Pu (13 January 2022).
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1028:MacLennan, AH; MacLenna, SC (1997).
713:Gentile, Julie (21 September 2010).
621:. Georgia: sipress. pp. 11–12.
55:The sacroiliac joint, posterior view
2289:Complementary Therapies in Medicine
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2529:Anterior cruciate ligament injury
200:on the sacral side moves against
65:refers to abnormal motion in the
1997:10.1097/00007632-199805150-00010
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1799:10.1097/00007632-199709150-00003
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818:10.1097/00003086-198704000-00029
679:10.1097/00007632-199501000-00007
165:The sacroiliac joint is a true
1293:Yoo H; Shin D; Song C (2015).
935:"Sacroiliac Joint Dysfunction"
460:medicine can also be helpful.
138:within five years of surgery.
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437:herniated intervertebral disc
432:had not yet been discovered.
215:posterior sacroiliac ligament
2181:10.1097/PHM.0000000000001389
1922:The Clinical Journal of Pain
1723:. Economist. 4 December 2003
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63:sacroiliac joint dysfunction
33:Sacroiliac joint dysfunction
1707:10.1056/nejm193408022110506
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289:free nerve endings and the
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45:
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500:Pelvic floor dysfunction
472:) is more common than a
311:iliotibial band syndrome
2665:Achilles tendon rupture
2660:Patellar tendon rupture
1227:"The Sacroiliac Joint"
740:Managing Low Back Pain
291:posterior primary rami
241:Affected muscle groups
227:sacrotuberous ligament
151:ankylosing spondylitis
2258:10.1089/acm.2010.0031
2040:10.1093/ptj/72.12.903
1561:10.1007/s005860050083
1467:Arch Phys Med Rehabil
1436:Hesch, Jerry (2011).
1195:Clin Orthop Relat Res
1160:Am J Phys Med Rehabil
941:. Saunders/Elsevier.
806:Clin Orthop Relat Res
2539:Patellar dislocation
1721:"MRI's inside story"
1680:J Bone Joint Surg Am
1225:Richard Don Tigney.
1006:Dynamic Chiropractic
480:Platelet-rich plasma
275:thoracolumbar fascia
155:rheumatoid arthritis
18:SI joint dysfunction
2427:Dislocated shoulder
1401:(3). LWW: 364–368.
1311:10.1589/jpts.27.279
426:piriformis syndrome
251:piriformis syndrome
211:iliolumbar ligament
157:, or an infection.
121:, can also cause a
2480:Gamekeeper's thumb
2437:Separated shoulder
2396:Dislocation of jaw
2134:10.3233/BMR-160734
2079:10.1111/papr.12526
358:physical therapist
123:ligamentous laxity
73:Signs and symptoms
2682:
2681:
2678:
2677:
2616:Rotator cuff tear
2584:
2583:
2570:High ankle sprain
2252:(12): 1285–1290.
1991:(10): 1124–1128.
1793:(18): 2073–2082.
1637:J Ortoped Science
1600:(16): 1889–1892.
1447:978-0-615-27939-8
1258:(14): 1593–1600.
1085:(11): 1192–1198.
948:978-1-4160-4007-1
628:978-0-9760347-0-4
458:anti-inflammatory
422:piriformis muscle
221:, posterior, and
198:hyaline cartilage
110:changes, such as
59:
58:
27:Medical condition
16:(Redirected from
2712:
2638:Pulled hamstring
2600:
2544:Knee dislocation
2524:Tear of meniscus
2380:
2343:
2336:
2329:
2320:
2313:
2312:
2284:
2278:
2277:
2240:
2234:
2233:
2231:
2230:
2215:
2209:
2208:
2160:
2154:
2153:
2113:
2107:
2106:
2058:
2052:
2051:
2028:Physical Therapy
2023:
2017:
2016:
1980:
1974:
1973:
1960:
1954:
1953:
1917:
1911:
1910:
1900:
1889:10.14740/jmc3816
1868:
1862:
1861:
1825:
1819:
1818:
1782:
1776:
1775:
1750:(9): 1047–1054.
1739:
1733:
1732:
1730:
1728:
1717:
1711:
1710:
1690:
1684:
1683:
1675:
1669:
1668:
1632:
1626:
1625:
1589:
1583:
1582:
1572:
1540:
1534:
1533:
1497:
1491:
1490:
1461:
1452:
1451:
1433:
1427:
1426:
1390:
1384:
1383:
1339:
1333:
1332:
1322:
1290:
1284:
1283:
1247:
1238:
1237:
1235:
1233:
1222:
1203:
1202:
1190:
1184:
1183:
1166:(12): 997–1006.
1155:
1146:
1145:
1117:
1111:
1110:
1074:
1068:
1067:
1049:
1025:
1014:
1013:
1001:
988:
987:
959:
953:
952:
930:
924:
923:
921:
919:
909:
876:
875:
867:
830:
829:
812:(217): 266–280.
801:
790:
789:
753:
744:
743:
735:
726:
725:
723:
721:
710:
699:
698:
662:
647:
646:
640:
632:
614:
579:
578:
576:
574:
563:
317:, including the
307:iliotibial tract
271:latissimus dorsi
179:innominate bones
67:sacroiliac joint
50:
30:
21:
2720:
2719:
2715:
2714:
2713:
2711:
2710:
2709:
2685:
2684:
2683:
2674:
2642:
2620:
2593:
2580:
2548:
2506:
2502:Hip dislocation
2484:
2457:
2405:
2373:
2364:
2347:
2317:
2316:
2286:
2285:
2281:
2242:
2241:
2237:
2228:
2226:
2217:
2216:
2212:
2162:
2161:
2157:
2115:
2114:
2110:
2060:
2059:
2055:
2034:(12): 903–916.
2025:
2024:
2020:
1982:
1981:
1977:
1962:
1961:
1957:
1919:
1918:
1914:
1870:
1869:
1865:
1827:
1826:
1822:
1784:
1783:
1779:
1741:
1740:
1736:
1726:
1724:
1719:
1718:
1714:
1692:
1691:
1687:
1677:
1676:
1672:
1634:
1633:
1629:
1591:
1590:
1586:
1542:
1541:
1537:
1499:
1498:
1494:
1473:(11): 2048–56.
1463:
1462:
1455:
1448:
1435:
1434:
1430:
1392:
1391:
1387:
1341:
1340:
1336:
1299:J Phys Ther Sci
1292:
1291:
1287:
1249:
1248:
1241:
1231:
1229:
1224:
1223:
1206:
1192:
1191:
1187:
1157:
1156:
1149:
1119:
1118:
1114:
1076:
1075:
1071:
1027:
1026:
1017:
1003:
1002:
991:
961:
960:
956:
949:
932:
931:
927:
917:
915:
911:
910:
879:
869:
868:
833:
803:
802:
793:
755:
754:
747:
737:
736:
729:
719:
717:
712:
711:
702:
664:
663:
650:
633:
629:
616:
615:
582:
572:
570:
565:
564:
523:
518:
496:
453:
417:
354:sports medicine
331:
259:gluteus maximus
243:
196:In this joint,
183:pubic symphysis
163:
161:Pathophysiology
144:
96:
91:
75:
28:
23:
22:
15:
12:
11:
5:
2718:
2716:
2708:
2707:
2702:
2697:
2687:
2686:
2680:
2679:
2676:
2675:
2673:
2672:
2667:
2662:
2656:
2654:
2644:
2643:
2641:
2640:
2634:
2632:
2622:
2621:
2619:
2618:
2612:
2610:
2597:
2586:
2585:
2582:
2581:
2579:
2578:
2573:
2566:Sprained ankle
2562:
2560:
2550:
2549:
2547:
2546:
2541:
2536:
2531:
2526:
2520:
2518:
2508:
2507:
2505:
2504:
2498:
2496:
2486:
2485:
2483:
2482:
2477:
2471:
2469:
2459:
2458:
2456:
2455:
2453:Bankart lesion
2450:
2445:
2440:
2430:
2419:
2417:
2407:
2406:
2404:
2403:
2398:
2392:
2390:
2377:
2366:
2365:
2348:
2346:
2345:
2338:
2331:
2323:
2315:
2314:
2279:
2235:
2224:www.mmj.eg.net
2210:
2175:(8): 689–693.
2155:
2128:(2): 363–370.
2108:
2073:(6): 782–791.
2053:
2018:
1975:
1972:on 2012-04-26.
1955:
1928:(5): 446–455.
1912:
1863:
1836:(3): 364–368.
1820:
1777:
1734:
1712:
1685:
1670:
1643:(3): 274–280.
1627:
1584:
1555:(4): 328–331.
1535:
1492:
1453:
1446:
1428:
1385:
1350:(2): 162–165.
1334:
1285:
1239:
1204:
1185:
1147:
1112:
1069:
1040:(8): 760–764.
1015:
989:
954:
947:
925:
877:
831:
791:
764:(1): E27–E32.
745:
727:
700:
648:
627:
580:
520:
519:
517:
514:
513:
512:
507:
502:
495:
492:
452:
449:
416:
413:
404:
403:
399:
392:
385:
382:
330:
327:
323:deconditioning
267:erector spinae
255:rectus femoris
242:
239:
233:(e.g., during
202:fibrocartilage
162:
159:
143:
140:
95:
92:
90:
87:
74:
71:
57:
56:
52:
51:
43:
42:
39:
35:
34:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
2717:
2706:
2703:
2701:
2698:
2696:
2693:
2692:
2690:
2671:
2668:
2666:
2663:
2661:
2658:
2657:
2655:
2653:
2649:
2645:
2639:
2636:
2635:
2633:
2631:
2627:
2623:
2617:
2614:
2613:
2611:
2609:
2605:
2601:
2598:
2596:
2591:
2587:
2577:
2574:
2571:
2567:
2564:
2563:
2561:
2559:
2555:
2551:
2545:
2542:
2540:
2537:
2535:
2534:Unhappy triad
2532:
2530:
2527:
2525:
2522:
2521:
2519:
2517:
2513:
2509:
2503:
2500:
2499:
2497:
2495:
2491:
2487:
2481:
2478:
2476:
2473:
2472:
2470:
2468:
2464:
2460:
2454:
2451:
2449:
2446:
2444:
2441:
2438:
2434:
2431:
2428:
2424:
2421:
2420:
2418:
2416:
2412:
2408:
2402:
2399:
2397:
2394:
2393:
2391:
2389:
2385:
2381:
2378:
2376:
2371:
2367:
2363:
2359:
2355:
2351:
2344:
2339:
2337:
2332:
2330:
2325:
2324:
2321:
2310:
2306:
2302:
2298:
2294:
2290:
2283:
2280:
2275:
2271:
2267:
2263:
2259:
2255:
2251:
2247:
2239:
2236:
2225:
2221:
2214:
2211:
2206:
2202:
2198:
2194:
2190:
2186:
2182:
2178:
2174:
2170:
2166:
2159:
2156:
2151:
2147:
2143:
2139:
2135:
2131:
2127:
2123:
2119:
2112:
2109:
2104:
2100:
2096:
2092:
2088:
2084:
2080:
2076:
2072:
2068:
2067:Pain Practice
2064:
2057:
2054:
2049:
2045:
2041:
2037:
2033:
2029:
2022:
2019:
2014:
2010:
2006:
2002:
1998:
1994:
1990:
1986:
1979:
1976:
1971:
1967:
1966:
1959:
1956:
1951:
1947:
1943:
1939:
1935:
1931:
1927:
1923:
1916:
1913:
1908:
1904:
1899:
1894:
1890:
1886:
1882:
1878:
1874:
1867:
1864:
1859:
1855:
1851:
1847:
1843:
1839:
1835:
1831:
1824:
1821:
1816:
1812:
1808:
1804:
1800:
1796:
1792:
1788:
1781:
1778:
1773:
1769:
1765:
1761:
1757:
1753:
1749:
1745:
1738:
1735:
1722:
1716:
1713:
1708:
1704:
1700:
1696:
1689:
1686:
1681:
1674:
1671:
1666:
1662:
1658:
1654:
1650:
1646:
1642:
1638:
1631:
1628:
1623:
1619:
1615:
1611:
1607:
1603:
1599:
1595:
1588:
1585:
1580:
1576:
1571:
1566:
1562:
1558:
1554:
1550:
1546:
1539:
1536:
1531:
1527:
1523:
1519:
1515:
1511:
1507:
1503:
1496:
1493:
1488:
1484:
1480:
1476:
1472:
1468:
1460:
1458:
1454:
1449:
1443:
1439:
1432:
1429:
1424:
1420:
1416:
1412:
1408:
1404:
1400:
1396:
1389:
1386:
1381:
1377:
1373:
1369:
1365:
1361:
1357:
1353:
1349:
1345:
1338:
1335:
1330:
1326:
1321:
1316:
1312:
1308:
1305:(1): 279–84.
1304:
1300:
1296:
1289:
1286:
1281:
1277:
1273:
1269:
1265:
1261:
1257:
1253:
1246:
1244:
1240:
1228:
1221:
1219:
1217:
1215:
1213:
1211:
1209:
1205:
1201:(16): 126–34.
1200:
1196:
1189:
1186:
1181:
1177:
1173:
1169:
1165:
1161:
1154:
1152:
1148:
1143:
1139:
1135:
1131:
1127:
1123:
1116:
1113:
1108:
1104:
1100:
1096:
1092:
1088:
1084:
1080:
1073:
1070:
1065:
1061:
1057:
1053:
1048:
1043:
1039:
1035:
1031:
1024:
1022:
1020:
1016:
1011:
1007:
1000:
998:
996:
994:
990:
985:
981:
977:
973:
970:(6): 436–43.
969:
965:
958:
955:
950:
944:
940:
936:
929:
926:
914:
908:
906:
904:
902:
900:
898:
896:
894:
892:
890:
888:
886:
884:
882:
878:
873:
866:
864:
862:
860:
858:
856:
854:
852:
850:
848:
846:
844:
842:
840:
838:
836:
832:
827:
823:
819:
815:
811:
807:
800:
798:
796:
792:
787:
783:
779:
775:
771:
767:
763:
759:
752:
750:
746:
741:
734:
732:
728:
716:
709:
707:
705:
701:
696:
692:
688:
684:
680:
676:
672:
668:
661:
659:
657:
655:
653:
649:
644:
638:
630:
624:
620:
613:
611:
609:
607:
605:
603:
601:
599:
597:
595:
593:
591:
589:
587:
585:
581:
569:
562:
560:
558:
556:
554:
552:
550:
548:
546:
544:
542:
540:
538:
536:
534:
532:
530:
528:
526:
522:
515:
511:
508:
506:
503:
501:
498:
497:
493:
491:
488:
483:
481:
477:
475:
474:spinal fusion
471:
470:bone grafting
467:
461:
459:
450:
448:
444:
442:
438:
433:
431:
430:sciatic nerve
427:
423:
414:
412:
408:
400:
397:
393:
390:
386:
383:
379:
378:
377:
375:
371:
367:
363:
359:
355:
350:
348:
344:
340:
336:
328:
326:
324:
320:
316:
312:
308:
304:
300:
296:
295:referred pain
292:
288:
284:
280:
276:
272:
268:
264:
260:
256:
252:
248:
240:
238:
236:
232:
228:
224:
220:
216:
212:
206:
203:
199:
194:
192:
188:
184:
180:
176:
172:
168:
160:
158:
156:
152:
147:
141:
139:
135:
131:
127:
124:
120:
115:
113:
109:
105:
99:
94:Hypermobility
93:
88:
86:
84:
80:
79:referred pain
72:
70:
68:
64:
53:
49:
44:
40:
36:
31:
19:
2670:Shin splints
2475:Pulled elbow
2443:ALPSA lesion
2354:subluxations
2350:Dislocations
2292:
2288:
2282:
2249:
2245:
2238:
2227:. Retrieved
2223:
2213:
2172:
2168:
2158:
2125:
2121:
2111:
2070:
2066:
2056:
2031:
2027:
2021:
1988:
1984:
1978:
1970:the original
1964:
1958:
1925:
1921:
1915:
1883:(1): 31–35.
1880:
1876:
1866:
1833:
1829:
1823:
1790:
1786:
1780:
1747:
1743:
1737:
1725:. Retrieved
1715:
1701:(5): 210–5.
1698:
1695:N Engl J Med
1694:
1688:
1679:
1673:
1640:
1636:
1630:
1597:
1593:
1587:
1552:
1548:
1538:
1508:(1): 31–37.
1505:
1501:
1495:
1470:
1466:
1437:
1431:
1398:
1394:
1388:
1347:
1343:
1337:
1302:
1298:
1288:
1255:
1251:
1230:. Retrieved
1198:
1194:
1188:
1163:
1159:
1125:
1121:
1115:
1082:
1078:
1072:
1037:
1033:
1009:
1005:
967:
963:
957:
938:
928:
916:. Retrieved
871:
809:
805:
761:
757:
739:
718:. Retrieved
673:(1): 31–37.
670:
666:
618:
571:. Retrieved
510:Sacroiliitis
487:prolotherapy
484:
478:
462:
454:
445:
434:
428:"), and the
418:
415:Misdiagnosis
409:
405:
370:chiropractor
351:
335:radiological
332:
319:psoas muscle
287:unmyelinated
244:
223:interosseous
207:
195:
167:diarthrodial
164:
148:
145:
142:Hypomobility
136:
132:
128:
116:
108:degenerative
100:
97:
76:
62:
60:
1549:Eur Spine J
1232:January 18,
918:January 18,
505:Pelvic pain
389:iliac crest
362:physiatrist
315:hip flexors
38:Other names
2689:Categories
2229:2021-12-17
720:18 January
573:18 January
516:References
303:quadriceps
247:piriformis
2608:upper arm
2448:SLAP tear
2415:upper arm
2375:ligaments
2295:: 64–68.
2266:1075-5535
2218:Soliman.
2205:210880853
2189:1537-7385
2142:1878-6324
2087:1533-2500
1682:(7): 109.
1364:0362-2436
1272:0362-2436
1107:205509576
637:cite book
485:Dextrose
451:Treatment
396:abduction
374:palpating
366:osteopath
329:Diagnosis
299:hamstring
235:pregnancy
112:arthritis
61:The term
2604:Shoulder
2576:Turf toe
2411:Shoulder
2401:Whiplash
2309:29609940
2274:21138388
2197:31972616
2150:27392848
2095:27677100
2013:36480639
1950:19672727
1942:16093751
1907:35211233
1858:33228238
1850:10703111
1815:39907332
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