Physical therapeutic options for residual sacrotuberous ligament pain after treatment of sacroiliac joint dysfunction.
Takeshi Sasaki, Daisuke Kurosawa, Eiichi Murakami and 1 others
PMID 34539068WHAT IT FOUND
In 57 people with residual buttock pain after sacroiliac injections, 33 had sacrotuberous ligament pain.
Injection relieved 11 alone; 22 needed physical therapy. In this small record review, ligament relaxation, plus biceps femoris relaxation or gluteus maximus contraction, was chosen using first exam findings.
Key findings
01Among 57 patients with persisting lower-buttock pain after sacroiliac injections, 33 had confirmed sacrotuberous ligament pain.
02Of the 33 patients with sacrotuberous ligament pain, 11 had sustained relief after sacrotuberous ligament injection alone, and 22 needed physical therapy in addition to injections.
03Of the 22 patients who needed physical therapy, 8 improved with sacrotuberous ligament relaxation alone and did not show straight-leg raise difference, biceps femoris tenderness, or gluteus maximus weakness; 8 improved with biceps femoris and sacrotuberous ligament relaxation and had greater straight-leg raise difference and biceps femoris tenderness; and 6 improved with gluteus maximus contraction and sacrotuberous ligament relaxation and had lower gluteus maximus strength.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was retrospective and used medical records, so treatments were not randomly assigned and there was no control group. Each treatment group was small, with 8, 8, and 6 patients, and the authors describe the flowchart as preliminary. Sacrotuberous ligament relaxation was performed before biceps femoris relaxation or gluteus maximus contraction exercises were added, so the contribution of any single component cannot be separated. The authors could not identify why biceps femoris contracture or gluteus maximus weakness occurred. The authors state that prospective studies are required to confirm the usefulness of the treatment flowchart.
Declared interests
The authors report no funding and no conflicts of interest.
The easy way to misread this
Do not conclude that sacrotuberous ligament relaxation, biceps femoris relaxation, or gluteus maximus contraction caused pain relief. This was a small retrospective record review, and sacrotuberous ligament relaxation was included before the other techniques were added, so the effect of any single component cannot be separated.