SIJ is the abbreviation for sacroiliac joint. The first problem with the sacroiliac joint is that it is out of reach of both manipulation as well as imaging. “The SIJ is particularly inaccessible due to its depth within the pelvis and the surrounding musculature, making it impossible to palpate the joint externally.” (L. M. Goff, 2008). The second problem is that the sacroiliac joint is subject to very minuscule range of motion. For instance, measurements effectuated on the sagittal plane have found that the range of motion of the SIJ was less than 1°. In fact all the SI damages observed on horses affected with sacroiliac dysfunction are all due to excessive movement and therefore instability of the joint. Stability is the main issue and consequently, all therapies attempting to release muscles, tendons and fascia involved in the stability of the sacroiliac joint are likely to create sacroiliac dysfunction instead of treating the problem. The third problem is that palpations are extremely problematic. The SI joint itself is out of reach and the only palpation that can be made is on the dorsal sacroiliac ligament (DSIL), which is greatly involved in the stability of the SIJ. However, if it might be possible to access the DSIL on a skinny horse, the mass of the gluteal muscles renders any manipulation quite difficult on a horse properly muscled up.
There is a battery of tests and manipulations that have been proposed for horses based on manipulations applied to humans. However, while a human is likely to participate in the manipulation knowing that some pain during manipulation might lead to better reeducation in the future, the horse, which lives in the moment, is more likely to protect himself from any stimulation of pain, resisting the movement that the therapy is suggesting. Therefore, even if some movement might have some therapeutic effect, their application through manual manipulation is unlikely to occur. Instead, therapeutic movements can be created riding the horse or working the horse in hand through the technique proper to the science of motion.
The most important concept relative to SI injury is that the main problem is about lack of stability. Instability is either caused by incorrect work of the muscles and tendons and ligaments associated with the joint or due to pathologic changes within the joint. In fact, pathologic changes are the more advanced level of a problem that started with poor or inappropriate muscular work. The therapy is therefore about recreating stability of the whole system. This is the topic of our Sacroiliac Day which is Friday February 17th, 2012 starting at 10am.
Jean Luc Cornille