Sports Massage for Sacroiliac Joint Inflammation

What equipment is required?

• A lubricant is needed to allow the hands to glide smoothly. A number of massage oils are available to buy. A cheap but effective alternative is simple baby oil. Do not use too much oil. Enough to allow for smooth, controlled movement is required but too much will mean a lack of control.
• A firm, flat surface to lie on in order to apply pressure.

How can sports massage benefit the rehabilitation of this injury?

• Sports massage can help relieve some of the stress on the sacroiliac joint from the surrounding muscles.
• In particular work on the Piriformis muscle can be beneficial.
• Click for more details on the benefits of sports massage.

Piriformis techniques

• The piriformis is located on the underside of the sacrum and travels underneath the gluteal muscles and attaches to the top of the femur. It is responsible for outer rotation of the thigh.
• The piriformis can often become shortened through a variety of causes. A common problem is found with the right thigh being externally rotated and can often be seen when standing or lying on your back. The right foot will externally rotate more than the left if you compare the two.
• Often this is due to adaptive shortening of the right piriformis from long periods of driving. Your foot is externally rotated to be placed on the accelerator, especially on long journeys on a motorway.
• A shortened piriformis can have a sidewards pull on the sacrum and affect its function and also be the cause of Sciatic nerve impingement as it is located adjacent to this nerve where it exits from the ilia.

Quick diagnostic test for piriformis shortening

• (See photo image) Lying on your front face down with both knees bent at 90 degrees.
• Allow both ankles to move away from each other to their maximum range and compare. They should be equal and the less distance apart they travel indicates how much rotation of the thighs are evident.
  

Treatment with sports massage

• The piriformis is also a common site for trigger points in this muscle which are very tender to the patient if you palpate them.
• Place patient in recovery position with affected side up and hip flexed towards you (see image)
• Place reinforced hands over edge of sacrum and steadily apply pressure with fingers towards insertion of piriformis at the hip joint.(see image)
• The hip is flexed in order to tighten up the gluteals and the gluteals should be warmed up and relaxed with massage before deep stretching to piriformis takes place.
• It is common for the area to bruise following treatment so patients should be forewarned that this is likely. This can avoid complaints of overuse of pressure at a later date.
• This is not a green light to put the patient through torture and you should try and work to acceptable levels of pain tolerance by constantly asking for patient feedback.

Image 1 - Quick diagnostic test for piriformis shortening Image 2 - Piriformis massage