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Manipulation of the Connective Tissue of the Sacrum Iliac: a New Look At Coalesce Research Group Modern Journal of Medicine and Biology Review Article 2020: Volume 1, Issue 1 Manipulation of the Connective Tissue of the Sacrum Iliac: A New Look at Sacroiliac Pain Camilo Cândido da Silva Santos1, Thalita de Jesus Salgado2, Renato Carvalho Vilella3 3 and Luciana Crepaldi Lunkes 1Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Brazil 2Department of Physical Therapy, Centro Universitário de Belo Horizonte (UNIBH), Brazil 3Department of Physical Therapy, Centro Universitário de Lavras (UNILAVRAS), Brazil Received Date: 30-07-2020 Published Date: 26-09-2020 Abstract to local anatomical alteration by muscle, bone, articulation such as compression of the intervertebral disc, peripheral Different therapeutic approaches for treating low back pain fascial, ligament tension, segmental deviation of the Low back pain has a multifactorial origin and each individual apophysealnerve root, andjoint nervous surface, system sacroiliac attachments and lumbosacral (dura mater), joints and sacroiliac pain are available in the scientific literature. acts conservatively in the treatment of acute and chronic lowpresent’s back lowpain back promoting pain in improvement different ways. in jointPhysiotherapy mobility, [7], in addition to the sociodemographic relationship (such as age, sex, education, and income) and lifestyle (such as smoking, alcoholism, physical inactivity) [8]. therapeuticstrength gain, concept central of stability, approaching specific sacroiliac muscle andtraining, low back and painfunctional by manipulating training. Thus, the connectivethis study aimsand ligamentto present tissue a new of This condition affects an average of 65% of people each year and approximately 84% of people will experience ofsome people episodes who have of low low back back painpain dothroughout not seek healththeir lives services [9]. Introductionthe posterior pelvis. However, these values may not be correct, since about 60% Different therapeutic approaches for treating low back [5]. is given by the integration of three systems that act in a The stability and dynamic and static functions of the spine corticosteroidspain and sacroiliac and musclepain are relaxants) available andin theconservative scientific joints, capsules, ligaments and the intervertebral disc itself), literature. They include drug treatment (anti-inflammatories, combined manner: passive system (vertebral bodies, facet lowertreatment trunk (throughand pelvis, suchphysical as biomechanical, exercises and pathological, medical active (axial muscles and tendons) and neuro-modulator infiltration) [1,2]. Several factors are related to pain in the (central and peripheral nervous system) guaranteeing biomechanicalChanges resulting conditions from favorableone of these to function systems [10,11]. can cause emotional, and labor alterations [2]. The result of these changes is pain [3]. joint and/or segmental dysfunction, a deficit in muscle experienceAccording associated to the IASP with - International or related to Associationactual or potential for the recruitment, and reproduce local or irradiated pain [12]. study of pain, pain is defined as “a sensitive and emotional Corresponding author: Renato Carvalho Vilella, totissue disability, damage. absence Each individualfrom work, learns and overloadto use thisof health term Center of Research in Physiotherapy, UNILAVRAS, Brazil through his previous experiences” [4]. Pain is closely related E-mail: [email protected] services [5,6]. Citation:Low back pain has a multifactorial origin. It can occur due Santos CCS, Salgado TJ, Vilella RC. Manipulation of the Connective Tissue of the Sacrum Iliac: A New Look at Sacroiliac Pain. J Mod J Med Biol. 2020; 1: 1-5. 01 Physiotherapy acts conservatively in the treatment of Pelvis acute and chronic low back pain. Promoting improvement in ileum, pubis, and ischia and which connect anteriorly through joint mobility, strength gain, central stability, specific muscle The pelvis is formed by the union of innominate bones training, functional training [13]. of approaching sacroiliac and low back pain by manipulating resistantthe pubic anteriorsymphysis and and posterior posteriorly ligament with theimplement sacrum (oddthat Thus, this study aims to present a new therapeutic concept bone). The pelvis, as it is also known, has a thicker and more network of mechanical and kinesiological functions such as the connective and ligament tissue of the posterior pelvis. Capsule Ligament Manipulation transmittingform an osteoligamentous the weight of ringthe head,(pelvic trunk, ring). and The upper pelvis limbshas a to the sitting bones and the lower limbs with the person tionsCapsule of passive Ligament connective Manipulation, tissue involving developed the bylumbopelvic Prof. Msc andCamilo posterior Cândido sacroiliac is a technique joints basedand ligaments on 6 posture to promote manipula the- standing or walking, running and/or jumping (locomotion). improvement of low and sacroiliac low back pain, function AnotherThe pelvis functional needs torole be of solid the andpelvis stable is to as house it supports part ofa ality, mobility and force transmission through the pelvic cin range of mechanical stresses during locomotion activities. - the digestive, urinary, and sexual ducts, that is, it allows - defecation, urination, and expulsion of the fetus, in the case gulate. tomical, kinesiological, and biomechanical importance of capsulesThe technique and ligaments takes intoin the account stability, the the histological, transmission ana of- of placental mammals. of the male and female pelvis, which allows an expert when analyzing As for the a bone,shape, by there the are characteristics specific differences of the inpelvis the shapeto be energyCapsule and ligament strength, manipulation and the functionality seeks to assistof the physiothersegments. apists in the search for the resolution of the lumbopelvic, sacroiliac, and hip pain discomfort and complementing the- isoscelesable to determine type), presenting whether it ais smaller,a male or more a female. closed The upper male therapeutic techniques already established for these dys pelvis is narrow, assuming a more triangular profile (of the On the other hand, the female pelvis is broader, presenting - narrower, since the man does not have a parturition role. functionsAnatomical in the scientificReview literature. a larger upper narrow, assuming a triangular profile (of the The hip anatomy equilateral type). opening of the eyelids causes an increase in the angle of the This characteristic of the female pelvis of having a greater The hip is a ball-socket joint and is formed by the head of of the pelvis and formed by the fusion of the pubis, ischium, femur to the hip (obliquity), favoring an increase in the more andthe femuriliac) and thecovered acetabulum by hyaline (located articular in the cartilage lateral regionin the thepronounced actions of knee hormones valgus. andThese cytokines characteristics that act may on collagenbecome (Figuremore evident 2). during the final months of delivery due to acetabularshape of a lipcell. (Figure It has 1).a fibrocartilage ring with the role of increasing the depth of the acetabulum (socket) called the The head of the femur is the most proximal portion of the femur, has a hemispherical (convex) shape, and is connected to the neck of the femur (between the greater and lesser trochanters). The neck of the femur guides the head of the femur at an inclination of approximately 125º in the medial, superior, and anterior direction. Figure 2: They present the differences between the shape of the pelvis of (A) man - narrower pelvis - and (B) woman - wider pelvis. feature in the analysis of the functional role of the pelvis and The distribution of loads through the pelvis is an important these characteristics of the pelvis is to support the weight of its association with the role of the pelvic ligaments. One of the trunkloads incoming the fit frombetween the L5trunk and towardsS1, dampened the sacrum by the L5-are dividedS1 intervertebral equally on disc. each In anside individual of the pelvis with bybipedal the sacroiliac support, Figure 1: joints and transmitted in the direction of the acetabulum, Lateral view of the decoapted hip joint. Highlights the head of the femur and acetabulum (with the acetabular lip in evidence). Citation: Santos CCS, Salgado TJ, Vilella RC. Manipulation of the Connective Tissue of the Sacrum Iliac: A New Look at Sacroiliac Pain. J Mod J Med Biol. 2020; 1: 1-5. 02 where the head of the femur rests, thus allowing these loads The joints to be transmitted to the limbs inferior to the ground (Figure 3). The pelvis has three joints, two sacroiliacs, and the pubic symphysis. The sacroiliac joint is a diarthrodial joint formed by the auricular face (for the sacrum) present in the ilium andSacroiliac the auricular joints face have (for thetwo ilium) types present of articulation, in the sacrum. one synovial (inferior, vascularized and innervated basement, and produces synovial fluid) and another syndesmosis Ligaments(upper, fibrous portion). ligaments that join the sacrum to the ilium and the last two lumbarThe sacroiliac vertebrae joint to theis surrounded ilium (Figure by 2) powerful and thick Sacroiliac ligament: divided into anterior and posterior Figure 3: . Are they: (A) Shows the transmission of loads from the spine through the Spinal sacrum: extends from the ischial spine of the ilium sacrum (via the sacroiliac joint), iliac, acetabulum,
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