Dr. Donald Corenman, Colorado spine specialist, lectures primarily to doctors and therapists about sacroiliac joint dysfunction and different chiropractic treatment techniques. For laymen, visit Dr. Corenman's website (for more information on these clinical terms).
Dr. Corenman begins by discussing the anatomy of the SI joint. Sacroiliac joint dysfunction can be very complex in nature. The sacroiliac joint combines two different types of bone union: one is a diarthrodial joint and the other is a fibrous joint. The sacroiliac joint is stabilized by the symphysis pubis, which limits joint movement. The sacroiliac joint is the most strongly ligated joint in the body.
As the sacroiliac joint ages, it begins to harden. As the joint becomes loose it can create wear on the cartilage. Pregnancy can also loosen the SI joint. Longer lumbar fusions increase arm stress in the sacroiliac joint and hip disorders can also increase stress.
The relative rotation of the sacroiliac joint may have an "upward slip" (posterior rotation) and a "downward slip" (anterior rotation). If one side goes up and the other side goes down, this is called "sacred twist".
There are very few muscles that cross the SI joint and the muscle vector forces are deficient to control the unstable SI joint or to correct the abnormal biomechanics. It is very difficult to strengthen the muscles in that area to stabilize the sacroiliac joint.
Dr. Corenman provides an overview of the history of different chiropractic treatment techniques for the sacroiliac joint. Level 1 involves an active range of movement. Level 2 is mobilization. This is where a chiropractor can move the joint beyond an active range. Level 3 is manipulation, which takes the joint beyond its passive range of motion and opens the joint in an adjustment or manipulation. What an adjustment is a release from the suction of the joint as it breaks the suction releases a gas in the joint, which creates the "explosion" of the joint.
There are different chiropractic treatment techniques for the treatment of sacroiliac joint pain. There is the diversified adjustment, the descent table, the flexion-distraction, the saro-occipital technique, the active release, the activator and the mobilization. Dr. Corenman analyzes each technique in detail.
For more information on sacroiliac joint dysfunction and chiropractic treatment techniques, visit:
Video credits to Donald Corenman, MD, DC YouTube channel