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Understanding Symptoms 

Problem in Disguise

Structures of the body have the ability to refer pain (an individual feels pain in a structure away from the source). The low back and the pelvis commonly refer pain, to:

  • The buttock
  • The back of the thigh or the back of the calf

These patterns of pain are often referred to as Sciatica.

Low back and pelvis problems can also cause pain that refers to the, outer hip, groin, the front of the thigh, the shin and even the foot. This is due to the multiple nerves that come from the low back and the varied supply to the pelvis, it even varies from one individual to another.

skeleton running manConditions that often accompany low back stability issues and mechanical pelvic girdle dysfunctions that are helped by its resolution include:

  • Ilio-tibial band syndrome
  • Low back pain
  • Sciatica
  • Runners knee
  • Shin splints
  • Plantar fasciitis

and in some cases neck and shoulder pain.

The Sacroiliac joint

The Sacroiliac joint is a major player in Pelvic girdle dysfunction. Many of the problems we see are either due to a malfunction of the joint itself.

Or they are attributable to structures that cross the joint and under normal circumstances would support it during movement. (muscles, ligaments and other soft tissues)

Some problems are connected with trauma, while some simply develop; it is possible that the problem that just develops is troubled by a condition or conditions that are not obviously connected, examples include:

  • poor function / stability of the foot
  • poor core stability and problems that cause habitual one sided activity, for example limping due to an injury of the lower limb.

Good quality therapy includes restoration of stability and control as well as restoring movement.

What is stability?

Core stability as it is often called is "the ability to control movement of one part of your body without adversely disturbing the position of central or core stuctures (the spine and pelvis)". It is not being rigid like a plank and is not simply about strength alone.

An individual with poor stability walks or runs with a rocking from side to side motion, whereas an individual with good stability moves with a grace that appears to keep the head moving as if on rails. 

One of the simple tests for stability of the pelvic girdle is to stand on one leg keeping your pelvis level (use your waist band as a guide) then dip the standing knee by approx 5 to 8cm, you should be capable of maintaining your balance as well of maintaining a level waistband.
If you cannot? Then you at least need help with improving stability and if you are also experiencing pain on walking and or running you should consider seeking help from a health care professional with an interest in pelvic / spinal movement and stability.

We could say we need pelvic and spinal ability; we should all have the ability to move and control our movement.

Pain at the site of a soft tissue injury

Sometimes the pain, swelling and bruising are simply at the site of a soft tissue injury.

Injuries can be simple, requiring some very simple remedies.

You are advised if injured to apply;

                                                   Rest 

                                                     Ice

                                                      Compression

                                                        Elevation

RICE (for short) is important during the first 48hours, this should be followed by relative rest, ice, compression, elevation and gentle exercise / movement (rricee) for approximately 5 days. 

Further progress depends upon the injury, severity and site, but at some stage over the next 2 to 3 weeks a gradual return to activity should be commenced, eventually the movement becoming a loaded exercise with some stretching.

Soft tissue injuries do not progress if they are kept still for extended periods, they need movement to become pain free, and that movement needs to be controlled. You will make poor progress by resting for two weeks then in one day returning to normal activity, your return to activity needs to be graded. 

If there is uncertainty at any stage you should consult a health professional.

I will be happpy to advise people by phone or in person who are uncertain if they need help or not, as will many other Chartered and Health Professions Council registered Physiotherapists.

 

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