SIJ pain treatment plan??

[Mattimmins]

Hi, I have recently seen a patient that is complaining of pain near the left sacro-iliac joint when playing netball. The patient is positive on compression/distraction test of left SI joint pain. Also the thigh thrust test brings on discomfort in the same region.
On the stork test there seems to be very little 'normal' movement compared to the right SIJ.
In addition, the patient has suffered from 'clicky hips' since she was young.
I just wondered if Anyone knew if this could be linked to the clicky hips or are they separate problems?

If so, what treatment plan should I go ahead with? I have thought about kenisio taping over the SIJ, with various stretches, and stability exercises of the hip and lower back. as well as RICE protocol advice for any flare ups.
However I just wondered if there would be other treatment approaches that may be of benefit to this patient.

Many thanks
Matt

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[neurospast]

Idea: you have noticed a discrepancy between left and right SIJ. This you have to sort out 1st with manual therapy otherwise exercise will be not effective. Most of the time SIJ problems do not stand alone but will have compensatory effect at the L-spine (level L-5 and at T11-L1). Also to remember that there are numerous other pelvis dysfunctions you may have to treat. Clicking of hips: How do you know the hips are clicking and not the SIJ or the L-spine? (One might think it is the hip because the patient tells it clicks at the hip but what about the Pubis?)
If an instability is apparent of the L-spine you need to find out if it is in flexion-extension direction or in sideflex-rotation direction because the emphasis is different. In case of a Pelvis dysfunction you need to know if this is due to stability problems alone or also related to a dis-balance of muscles. e.g. high toned (Iliops)Psoas, Rectus femoris and Piriformis, Hamstrings and Quadratus Lumborum, Latissimus Dorsi with low toned Gluteus complex (and all these little muscles around the hip.