Sacroiliac Joint Physical Therapy

About the Sacroiliac Joint

The sacroiliac joint (SIJ) is a synovial joint located in the pelvis. The SIJ forms the juncture of the sacrum and the ilium, where both bones are covered with smooth cartilage that serves as a shock absorber between the spine and pelvis. The space between the bones is filled with synovial fluid to reduce friction and allow for smooth movement.

The SIJ serves to mediate load transfers between the upper and lower body during physical activity, and plays a central role in maintaining spinal and pelvic stability during walking, running and other physical activities. SIJ dysfunction is most prevalent in young and middle-aged females. The SIJ is an integral component of the entire lumbopelvic-hip complex, and cannot be treated as a stand-alone structure.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About SI Joint Physical Therapist Dr. Lev Kalika

Dr. Kalika, clinical director at NYDNRehab, has participated in multiple interdisciplinary conferences on pelvic pain. He has studied with pelvic and SIJ health specialist Diane Lee, a renowned leader and researcher in the diagnosis and treatment of SIJ pain, and author of the most up-to-date book on SIJ treatment.

Physical therapy for pelvic pain and dysfunction requires specialized training. Dr. Kalika is a certified practitioner of the ISM (Integrated Systems Model) approach, a comprehensive and evidence-based methodology for diagnosing and treating pelvic pain. He is certified in multiple evidence-based therapy approaches for treating SIJ pain and dysfunction.

The NYDNRehab clinic features the most advanced technologies available for diagnosis and treatment of musculoskeletal injuries, pain syndromes and movement disorders.

SIJ Physical Therapy at NYDNRehab

Sacroiliac joint pain can be debilitating, keeping you from meeting your responsibilities and enjoying your favorite activities. Misdiagnosis and inappropriate treatment can prolong your pain and suffering, putting your life on hold while you seek a long-term solution.

The specialists at NYDNRehab understand how important it is for patients to get fast and effective treatment. We work with athletes, competitive runners and ballet dancers whose careers hang in the balance after an injury. Accurate diagnosis lays the foundation for a personalized treatment plan that gets you back to pain-free function in the shortest time possible.

We never use one-size-fits-all treatment protocols that deliver mediocre results. Our unique one-on-one personalized approach to patient care ensures that you get the exact therapy you need for a quick return to your normal daily activities.

Our extensive toolbox of high-tech equipment is rarely found in run-of-the-mill physical therapy clinics. Our dedication to providing exemplary patient care using state-of-the-art equipment makes NYDNRehab the premier clinic for SIJ physical therapy in NYC.

SIJ Physical Therapy at NYDNRehab

Symptoms and Causes of SIJ Pain
and Dysfunction

Symptoms

  • Low back pain below the L5 vertebra

  • Sensations of pain, numbness, tingling, and weakness in the lower extremities

  • Pain in the pelvis and buttocks

  • Hip and groin pain

  • Leg instability

  • Pain that disrupts sleep

  • Pain while sitting

  • Pain when getting up from sitting

Causes

  • Muscle imbalances that alter SIJ position

  • Poor lumbopelvic motor control

  • Pelvic misalignment

  • SIJ uncoupling

  • Ligament laxity

  • Trauma

  • Weakened core muscles

  • Pelvic floor dysfunction

Risk Factors

  • Young to middle aged female

  • Pregnancy and childbirth

  • Obesity

  • Being out of shape

Accurate Diagnosis of SIJ Dysfunction is Key to Successful Treatment

Because symptoms of SIJ dysfunction include pain in the low back, buttocks and legs, SIJ pain is often misdiagnosed as sciatica. An incorrect diagnosis can cost a patient time and money while prolonging or even exacerbating your pain.

Other conditions that present with the same symptoms asf SIJ dysfunction include:

  • Piriformis syndrome

  • Hip osteoarthritis

  • Hip femoroacetabular impingement (FAI)

  • Discogenic low back pain

  • Lumbar facet joint pain

At NYDNRehab, we use the highest resolution diagnostic ultrasound to view the structures of the pelvic region in real time, with the patient in motion. Visualizing the pelvis helps us differentiate SIJ symptoms from other conditions.

Dr. Kalika is a world-renowned expert in diagnostic musculoskeletal ultrasonography, with numerous peer-reviewed articles on the topic to his credit.

Accurate Diagnosis of SIJ Dysfunction is Key to Successful Treatment
Treatment Options for SIJ Pain and Dysfunction

Treatment Options for SIJ Pain and Dysfunction

Once we accurately diagnose your SIJ condition, we have a variety of treatment options available, depending on your specific needs.

Your treatment plan may include some or all of the following:

  • Ultrasound guided dry needling to release deep tissue trigger points that can cause pain and impair SIJ function

  • Manual SI joint mobilization and chiropractic care, to restore pain-free SIJ range of motion

  • SI joint reeducation, to restore optimal muscle firing patterns and stabilize the SIJ

  • Focused shockwave therapy to alleviate pain and promote healing

  • Extracorporeal magneto transduction therapy (EMTT), to reduce inflammation, soothe pain and accelerate tissue repair

Cutting-Edge HEIT Therapy in NYC

If you suffer from chronic pain and want fast and effective results, you need a clinic that leverages the latest technologies and therapies that really work. Run-of-the-mill physical therapy clinics often use a cookie-cutter approach to patient care that gets mediocre results.

The personalized one-on-one approach at NYDNRehab ensures that every patient is accurately diagnosed and appropriately treated. Our goal is to restore pain-free function in the least time possible, so you can get back to doing the things you love.

Shockwave Therapy is a Game-Changer for Non-Surgical Lymphedema Treatment

HIGH
ENERGY INDUCTIVE
THERAPY (HEIT)

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Our Regenerative Therapies are Game-Changers for SIJ Patients

Regenerative therapies are new technologies making a big splash in the fields of physical therapy and chiropractic care. They work by mobilizing your body’s innate healing mechanisms, to stimulate tissue repair and encourage the progenesis of healthy new cells.

Focused Shockwave Therapy

Focused Shockwave Therapy

Focused Shockwave Therapy

Extracorporeal shockwave therapy (ESWT) is a highly effective treatment approach that delivers low-energy acoustic waves to the patient’s skin via a hand-held transducer under ultrasound guidance. ESWT is completely non-invasive and does not require anesthesia or pain medication. Focused shockwaves trigger the body’s innate healing mechanisms to stimulate tissue repair and reduce pain. Many patients report significant pain reduction after a single ESWT session.


Electromagnetic Transduction Therapy (EMTT)

Extracorporeal magnetic transduction therapy (EMTT) is a non-invasive technology that uses electromagnetic fields to reduce pain and stimulate cellular progenesis in targeted tissues. This groundbreaking new technology is an effective treatment choice for a variety of conditions, including joint pain, muscle disorders, bone fractures, athletic injuries and chronic pain conditions. As a new technology, NYDNRehab is one of the few private clinics where SIJ patients can leverage EMTT’s healing benefits.

Electromagnetic Transduction Therapy (EMTT)

Electromagnetic Transduction Therapy (EMTT)

Get Sacroiliac Joint Physical Therapy in NYC that
Really Works

The pelvic, hip and low back region share a network of nerves, muscles, bones and connective tissues that act interdependently, and conditions involving the SI joint cannot be treated in isolation. Diagnosing and resolving SIJ issues requires expertise and experience in pelvic health.

The pelvic pain specialists at NYDNRehab are experts at SI joint physical therapy and SI joint mobilization. Our knowledge and expertise, coupled with our toolbox of advanced technologies, make NYDNRehab the number one clinic for SI joint rehab in NYC. Make your appointment with an SI joint physical therapist today, and get rid of SIJ pain and dysfunction for good.

Range of Available Unique Physical Therapy
Treatments at Nydnrehab

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    Sacroilliac Joint Pain Treatment NYC
    The sacroiliac joint (SIJ) is a synovial planar joint located in the pelvis. It plays an important role in load transfer during physical activity, and helps Anatomy and Function of the SIJ

    The SIJ forms the juncture of the sacrum and the ilium. Both bones have rough surfaces that interlock to stabilize the pelvis.

    Upper body force loads are transferred from the spine through the SIJ tor. The SIJ’s articular cartilage serves as a shock absorber between the spine and the pelvis, and SIJ movement facilitates hip joint range of motion.

    Incidence of SIJ Dysfunction

    SIJ dysfunction is most prevalent in young and middle-aged females. Pregnant women or those who have recently given birth are more likely to SIJ dysfunction.

    Symptoms of SIJ Dysfunction

    Symptoms include:

    • Low back pain ranging from mild to severe
    • Pain spreading
    • Pain in the upper back and along the side of the thigh

    Causes of SIJ Dysfunction

    Pain from SIJ dysfunction stems from either too little movement (hypomobility).

    Causes of SIJ dysfunction include:

    • Muscle imbalances that alter SIJ position
    • Poor lumbopelvic motor control
    • Pelvic misalignment
    • SIJ uncoupling
    • Ligament laxity
    • Trauma
    • Weakened core muscles
    • Pelvic floor dysfunction

    Diagnosis of SIJ Dysfunction

    SIJ pain may mimic herniated disc pain, sciatica, piriformis syndrome, or gluteal myofascial syndrome, making accurate diagnosis a key facto confirm diagnosis.

    Treatment for SIJ Dysfunction

    The SIJ plays a central role in maintaining spinal and pelvic stability during walking, running and other physical activities. Two components of SIJ stability include structural stability which relies on the two joint surfaces being tightly linked and held in place by ligaments; and functional stability, which relies on motor control. Both aspects must be considered when devising a treatment plan.

    The SIJ is an integral component of the entire lumbopelvic-hip complex, and cannot be treated as a stand-alone structure. In addition to the foot.

    Normal gait and hip function are pivotal to SIJ function. Over time, a dysfunctional SIJ may become a weak link in the kinetic chain, causing pain and dysfunction elsewhere in the body.

    Treatment options at NYDNR include:

    • Gait retraining
    • Specialized physical therapy
    • Chiropractic treatment
    • DNS (Dynamic Muscular Stabilization)
    • Other innovative treatment methods

    Dr. Kalika has participated in multiple interdisciplinary conferences on pelvic pain. He has had the privilege of meeting Diane Lee, a foremost leader and evidence based researcher on the diagnosis and treatment of SIJ pain. Dr. Kalika is a certified practitioner of ISM (integrated systems model approach), a comprehensive and evidence based method for diagnosis and treatment of pelvic pain.

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    In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

    Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

    The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

    Dynamic ultrasonography examination demonstrating
    the full thickness tear and already occurring muscle atrophy
    due to misdiagnosis and not referring the patient
    to proper diagnostic workup

    Demonstration of how very small muscle defect is made and revealed
    to be a complete tear with muscle contraction
    under diagnostic sonography (not possible with MRI)

    image

    Complete tear of rectus femoris
    with large hematoma (blood)

    image

    Separation of muscle ends due to tear elicited
    on dynamic sonography examination

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