Hip Pain, continued

The rather immobile sacroiliac joint is located between a fairly mobile lumbar spine and a very mobile hip joint. The function of the sacroiliac joint is related to both areas. The joint acts like a buffer zone that enables the forces to be transmitted from the femur to the ilium to the lower back, as well as from the lower back to the ilium to the femur. The absorption of forces in the sacroiliac joint reduces the stress on the pelvis. It can easily be seen how the sacroiliac ligaments are injured because they are, in essence, the primary shock absorbers between the hip and lower back vertebrae. Any tackle, body smash, knee contusion, or fall that transmits forces from the back to the lower extremity or vice versa must travel directly through the sacroiliac ligaments.

The often-overlooked Pubic Symphysis plays a role very similar to that of the sacroiliac joint by enhancing overall pelvic mobility. It also is the site of attachment of the powerful adductor muscles, which move the leg inward, and the abdominal muscles whose strength helps keep force off of the lower back and discs.

Ischial Tuberosity Pain: A Pain in the Butt
Pain on the bottom of the buttock, especially when sitting and running, is indicative of ischial tuberosity pain. Unfortunately for the athlete, the orthopedic surgeon or team physician will examine this area, find it to be tender to palpation, and give the diagnosis of ischial bursitis. The RICE treatment will be followed and the latest anti-inflammatory medication prescribed. The cortisone injection will soon follow. A true bursitis is rare. The bursae are fluid-filled sacs that decrease the friction of muscles and tendons moving over bone.

Before an athlete receives a buttock steroid shot, go see a Prolotherapist. Prolotherapists know that the hamstring muscles and sacrotuberus ligaments attach to the ischial tuberosity, and all that is needed is a little Prolotherapy to the area to resolve the buttock pain.

Acute, moderate, or severe hamstring strains are common injuries among sprinters, hurdlers, and long jumpers. They also occur in other sports involving sprinting, especially football and hockey.

Hamstring injuries occur frequently despite the prevalence of stretching programs. Is it possible that these stretching programs are predisposing athletes to these injuries?

Repetitive hamstring strains can occur because of some weakness at the origin of the hamstring muscle onto the ischial tuberosity. (Refer back to Figure 21-6.) If the athlete has pain at the attachment site and in the belly of the muscle, Prolotherapy is given. This will strengthen the hamstring attachment onto the ischial tuberosity and resolve the pain.

The sacrotuberus ligaments go from the sacrum to the ischial tuberosity and, generally, both attachment sites are tender. This is an often-overlooked cause of buttock pain. Prolotherapy to both attachments resolves the buttock pain and often the lower back pain that is associated with it.

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