Biomechanics is particularly important to release the blockage. A forward rotation of the pelvic blades is combined with a flare of the pelvic blades (outflare) and an IR (internal rotation) of the hip joints. A backward rotation of the pelvic scoop is combined with an inward migration of the pelvic scoop and an outward rotation of the hip. These malpositions are detected in physiotherapy by means of certain findings and can then be mobilized or manipulated. If ISG complaints occur more frequently, there is poor muscular tension, which should be built up through specific training.
Physiotherapy/treatment
One possibility to solve an ISG blockade by yourself is the option via movement. It is important that there is no relieving posture and accordingly choppy movements. Even if pain is present, the patient should be moved in a final step.
Sometimes the blockage is released by a sudden movement (sneezing, coughing) by itself. In the case of more severe ISG complaints, a physiotherapist can be consulted, who can find the exact direction of the blockage by means of specific examinations, and can release it by mobilizing the pelvis. This can be done directly at the pelvis while the patient lies on his side and the pelvic shovel can be mobilized backwards or forwards depending on the position of the blockage.
An indirect technique using the lever of the leg can mobilize the pelvis further in the prone or supine position by rotating the hip. This technique is very comfortable, since it is not necessary to grip directly at the blocked point. If no improvement can be achieved by the mobilization, the ISG is manipulated in the supine or lateral position, depending on the blockage.
In most cases, pain remains along the pelvic shovel, gluteal muscles and radiations into the leg after the blockage is released. These musculature should be treated in the therapy. Direct techniques, such as massages, trigger point therapy or transverse friction at muscle tendon transitions are suitable, as are indirect techniques such as stretching.
If the musculature is not treated, it can come to a blockage again more quickly due to the high tonus, since an incorrect load is associated due to the gentle posture. Muscular stabilization is extremely important for frequently occurring ISG blockages. Especially the deep abdominal and back muscles should be trained.
The following exercises are especially suitable: Forearm support (Variations with feet alternately lift, or change from forearm support to hand support) Side support (Variation with leg lift and/or pelvis lift) Quadruped stand and knees lift from the floor (keep abdominal tension) and move forward (bear walk) Prone position, lift upper body (Variation; arms stretch and swing, rowing, lift upper body and rotate to the right and left) Supine position: Bridging (alternately pull your legs up to your body, slowly lift your pelvis up and down) Supine position: alternately stretch your legs (cycling) Further exercises to prevent another ISG blockade can be found here: Physiotherapy for hip pain
- Forearm support (alternately lift variations with feet, or change from forearm support to hand support)
- Lateral support (variation with lifting the leg and/or lifting the pelvis)
- Lift the quadruped and knees from the ground (keep abdominal tension) and walk forward (bear walk)
- Prone position, lift upper body (variation; stretch and swing arms, row, lift upper body and rotate to the right and left)
- Supine position: Bridging (alternate legs to the body, slowly lift pelvis up and down)
- Supine position: Stretch your legs alternately (riding a bicycle)
- Half seat: tilt upper body backwards and hold position (isometric tension)
In addition to mobilization, strengthening exercises and massages, the patient of an ISG syndrome can alleviate his or her complaints through heat. The heat stimulates the metabolism, increases the removal of waste products and thus reduces the tension in the tissue. Heat patches, grain cushions or hot air radiators can be used for this purpose.
A sauna session or a warm bath can also have a supportive effect. Tape plasters can be applied to the affected muscles so that the blood circulation is increased throughout the day. In addition, swimming or moving around in the water can have a positive influence on the complaints, as the body weight is lost for a certain period of time.The loosening of adhesions of the fasciae with the fascia roll is now also a frequently used method, which is also very effective. Yoga, Pilates or other gentle exercise classes are recommended for mobilization and gentle, thorough strengthening.
