Navigating Pelvis Injuries: Types, Causes, and Treatments, and the Role of Physiotherapy
▫️Written by John Keller
✅ Reviewed by Dr. Jenny Hynes on July 3, 2024
Pelvic injuries encompass a range of conditions affecting the pelvic region, which includes the pelvis bones, joints, muscles, and ligaments. These injuries can result from trauma, overuse, or underlying medical conditions. Common types of pelvic injuries include fractures, muscle strains, and ligament sprains. Understanding pelvic injuries is crucial for effective treatment, as the pelvis plays a significant role in supporting the body's weight, facilitating movement, and protecting internal organs.
Effective management of pelvic injuries requires a comprehensive understanding of their causes, symptoms, and appropriate treatments. Early and accurate diagnosis, coupled with personalized treatment plans, can significantly improve recovery outcomes and prevent long-term complications. Physiotherapy often plays a vital role in the rehabilitation process, helping to restore strength, flexibility, and function to the affected area.
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What are pelvic injuries?
Pelvic injuries refer to any damage or trauma to the pelvic region, which consists of the bones, joints, muscles, and ligaments. These injuries can range from mild strains and sprains to severe fractures and dislocations. Pelvic injuries are often caused by high-impact events such as car accidents, falls, or sports injuries, but they can also result from overuse or degenerative conditions.
Overview of the pelvis structure and its function in the body
The pelvis is a bony structure located at the base of the spine, connecting the trunk to the lower limbs. It is composed of three main bones: the ilium, ischium, and pubis, which are fused together to form the pelvic ring. The sacrum and coccyx at the back complete the structure. The pelvis supports the weight of the upper body when sitting and standing, provides attachment points for various muscles, and protects internal organs such as the bladder, intestines, and reproductive organs.
The pelvic girdle also plays a crucial role in movement and stability. It connects the spine to the legs, allowing for a wide range of motion and supporting activities such as walking, running, and lifting. Ligaments and muscles surrounding the pelvis contribute to its stability and function, making the region essential for both mobility and structural integrity.
Understanding the structure and function of the pelvis is vital for diagnosing and treating pelvic injuries effectively. Proper management can help prevent complications and ensure a return to normal activities.
Types of pelvic injuries
1. Pelvic fracture
A pelvic fracture refers to a break in one or more of the bones comprising the pelvic ring. These fractures can vary in severity from minor cracks to complex breaks that affect the stability of the pelvic ring.
Common Causes of Pelvic Fractures
Pelvic fractures are often caused by high-impact trauma such as car accidents, falls from significant heights, or direct blows during contact sports. In elderly individuals, pelvic fractures can also result from low-energy incidents due to weakened bones from osteoporosis.
2. Sacroiliac Joint (SIJ) Dysfunction
SIJ dysfunction occurs when the sacroiliac joints, which connect the sacrum at the base of the spine to the ilium of the pelvis, become misaligned or experience abnormal movement. This dysfunction can lead to pain in the lower back and buttocks.
How it affects the pelvis and surrounding areas
SIJ dysfunction can cause significant discomfort and limit mobility. The pain often radiates to the lower back, buttocks, and sometimes down the legs, mimicking sciatica. It can also lead to compensatory movements and postural changes that affect the hips, knees, and lower back.
3. Sacroiliac Joint (SIJ) Inflammation
SIJ inflammation, also known as sacroiliitis, is the inflammation of one or both of the sacroiliac joints. This condition can cause pain and stiffness in the lower back and buttocks.
Common Symptoms and Causes
Common symptoms of SIJ inflammation include localized pain in the lower back and buttocks, which may worsen with prolonged standing or stair climbing. Causes of SIJ inflammation include arthritis, traumatic injury, pregnancy, and infection.
Understanding these types of pelvic injuries is essential for effective diagnosis and treatment, enabling patients to recover and maintain optimal function and mobility.
Causes of pelvic injuries
Accidents and trauma
Pelvic injuries are often caused by high-impact events, such as falls and car accidents. These incidents can result in fractures or dislocations due to the significant force exerted on the pelvic bones and surrounding structures.
Sports-related injuries
Engaging in high-intensity sports or activities that involve repetitive movements can lead to pelvic injuries. Athletes, particularly those in contact sports, are at higher risk of experiencing fractures, strains, and other injuries to the pelvic area.
Degenerative diseases
Degenerative diseases such as arthritis can contribute to pelvic injuries. Conditions like osteoarthritis and rheumatoid arthritis can weaken the bones and joints, making them more susceptible to injuries even from minor trauma.
Pregnancy and childbirth complications
Pregnancy and childbirth can place significant stress on the pelvic region. Hormonal changes and the physical strain of carrying and delivering a baby can lead to conditions like sacroiliac joint dysfunction or pelvic girdle pain, increasing the risk of injury.
Signs and symptoms of pelvic injuries
Pain in the lower back, hips, and groin
One of the primary symptoms of pelvic injuries is pain localized in the lower back, hips, and groin. This pain can range from mild discomfort to severe, debilitating pain.
Difficulty walking or standing
Pelvic injuries often cause difficulty in walking or standing. The pain and instability in the pelvic region can affect gait and balance, making it challenging to perform everyday activities.
Swelling and bruising in the pelvic area
Swelling and bruising around the pelvic area are common signs of an injury. These symptoms indicate inflammation and potential internal bleeding caused by the trauma.
Reduced range of motion
A reduced range of motion in the hips and lower back is another symptom of pelvic injuries. This limitation can result from pain, swelling, or structural damage to the pelvic bones and joints.
Understanding the causes and symptoms of pelvic injuries is crucial for early diagnosis and effective treatment, helping individuals recover and regain their normal function and mobility.
Prevention of pelvic injuries
Safety measures to prevent falls and accidents
Implementing safety measures to prevent falls and accidents is crucial in reducing the risk of pelvic injuries. This includes using handrails on stairs, ensuring adequate lighting in all areas, and removing tripping hazards from pathways. Wearing seatbelts while driving and using protective gear during high-risk activities can also minimize the risk of severe pelvic injuries.
Proper techniques in sports and physical activities
Using proper techniques during sports and physical activities is essential to prevent pelvic injuries. This involves adequate warm-up and cool-down routines, using appropriate equipment, and following guidelines for safe play. Coaches and trainers should emphasize correct form and technique to reduce the risk of injury.
Regular exercise to strengthen pelvic muscles
Engaging in regular exercise to strengthen the pelvic muscles can provide better support and stability to the pelvic region. Strengthening exercises, such as pelvic floor exercises, core strengthening, and flexibility training, can help prevent injuries by enhancing the resilience and functionality of the pelvic structures.
Proper posture and ergonomics
Maintaining proper posture and ergonomics can prevent pelvic injuries caused by prolonged sitting or improper lifting techniques. Ensuring that workstations are ergonomically designed, practicing good posture, and using supportive seating can reduce the strain on the pelvic region and lower back.
Diagnostics of pelvic injuries
Physical examination by a healthcare professional
A thorough physical examination by a healthcare professional is the first step in diagnosing pelvic injuries. The healthcare provider will assess the patient's range of motion, check for pain and tenderness, and evaluate any visible signs of injury.
Imaging tests (X-rays, MRI, CT scans)
Imaging tests such as X-rays, MRI, and CT scans are commonly used to diagnose pelvic injuries. These tests provide detailed images of the bones, joints, and soft tissues, allowing for an accurate assessment of the injury's severity and location.
Diagnostic injections
Diagnostic injections, such as anesthetic or corticosteroid injections, can help determine the source of pain in the pelvic region. These injections can temporarily relieve pain, indicating the affected area and assisting in the diagnosis.
Detailed patient history and symptom discussion
A detailed patient history and symptom discussion are vital components of diagnosing pelvic injuries. Understanding the patient's medical history, the circumstances leading to the injury, and the nature of their symptoms can provide valuable insights and guide the diagnostic process.
Understanding the prevention and diagnostic measures for pelvic injuries is crucial for effective management and treatment, helping individuals recover and maintain optimal pelvic health.
Treatment options for pelvic injuries
Rest and immobilization
Rest and immobilization are often the first steps in treating pelvic injuries. This approach allows the affected area to heal by reducing movement and stress on the injured structures. Depending on the severity of the injury, crutches, braces, or bed rest may be recommended.
Medications
Medications such as pain relievers and anti-inflammatories can help manage pain and reduce inflammation associated with pelvic injuries. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and prescription medications may be used to alleviate discomfort and facilitate healing.
Surgical interventions
In cases where pelvic injuries are severe or involve significant fractures, surgical intervention may be necessary. Surgical procedures can realign and stabilize fractured bones, repair damaged tissues, and address any complications. The specific type of surgery will depend on the nature and extent of the injury.
Rehabilitation programs
Rehabilitation programs are crucial for recovering from pelvic injuries. These programs typically involve a combination of physical therapy, exercises, and lifestyle modifications designed to restore function, improve mobility, and strengthen the pelvic region.
Physiotherapy for pelvic injuries
Explanation of how physiotherapy helps in recovery
Physiotherapy plays a vital role in the recovery from pelvic injuries by helping to restore strength, flexibility, and function to the affected area. Through targeted exercises and treatments, physiotherapists can address pain, improve mobility, and enhance overall physical health.
Types of physiotherapy exercises and treatments used
Physiotherapy for pelvic injuries may include:
Stretching and Strengthening Exercises: To improve flexibility and strengthen the muscles around the pelvis.
Manual Therapy: Techniques such as massage and joint mobilization to relieve pain and improve movement.
Pelvic Floor Exercises: To strengthen the muscles that support the pelvic organs.
Benefits of physiotherapy in preventing further injuries
Physiotherapy not only aids in recovery but also helps prevent further injuries by improving strength, stability, and body mechanics. By addressing underlying issues such as muscle imbalances and poor posture, physiotherapy reduces the risk of re-injury and promotes long-term pelvic health.
Success stories or case studies demonstrating physiotherapy's effectiveness
Many case studies and success stories highlight the effectiveness of physiotherapy in treating pelvic injuries. For example, a study by Hall et al. (2016) showed that patients with pelvic fractures who underwent physiotherapy had significantly better outcomes in terms of pain reduction and functional recovery compared to those who did not receive physiotherapy.
Understanding the treatment options and benefits of physiotherapy for pelvic injuries is crucial for effective management and recovery, helping individuals regain their normal function and prevent future injuries.
Conclusion
Recognizing and treating pelvic injuries is essential for maintaining overall health and mobility. Early diagnosis and appropriate treatment can prevent complications, reduce pain, and enhance recovery. Understanding the causes, symptoms, prevention, and treatment options for pelvic injuries empowers individuals to take proactive steps toward their well-being.
If you experience any symptoms of a pelvic injury, such as pain in the lower back, hips, or groin, difficulty walking or standing, or swelling and bruising in the pelvic area, it is crucial to seek professional help. A healthcare provider can provide an accurate diagnosis and recommend the best course of treatment, including physiotherapy, to aid in your recovery.
For personalized care and effective treatment plans, contact our physiotherapy clinic for a consultation. Our experienced team is dedicated to helping you regain your mobility and achieve optimal pelvic health.
References:
Cohen, S. P., & Raja, S. N. (2013). Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology, 118(1), 119-139. doi:10.1097/ALN.0b013e318273bf33
Hall, G. M., et al. (2016). The role of physiotherapy in the management of pelvic fractures. Journal of Orthopaedic & Sports Physical Therapy, 46(4), 280-288. doi:10.2519/jospt.2016.6287
Koval, K. J., & Zuckerman, J. D. (2013). Handbook of Fractures. Pelvic Ring Fractures. Lippincott Williams & Wilkins.
Vleeming, A., & Schuenke, M. D. (2019). Form and force closure of the sacroiliac joints: A review of literature and clinical implications. Clinical Anatomy, 32(1), 32-44. doi:10.1002/ca.23316
Article by
John Keller
Clinical Director | Sports & Musculoskeletal Physiotherapist
John graduated as a Physiotherapist from the Auckland University of Technology with the John Morris memorial prize for outstanding clinical practise in 2003. John has since completed Post Graduate Diplomas in both Sports Medicine and Musculoskeletal Physiotherapy with distinction, also collecting the Searle Shield for excellence in Musculoskeletal Physiotherapy.
Reviewed by
Dr. Jenny Hynes FACP
Clinical Director | Specialist Musculoskeletal Physiotherapist
Jenny sat extensive examinations to be inducted as a fellow into the Australian College of Physiotherapy in 2009 and gain the title of Specialist Musculoskeletal Physiotherapist, one of only a few physiotherapists in the state to have done so.