Myofascial force transmission in sacroiliac joint dysfunction increases anterior translation of humeral head in contralateral glenohumeral joint
More details
Hide details
Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Thailand
Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
Department of Orthopaedics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
Submission date: 2014-02-12
Acceptance date: 2014-07-17
Online publication date: 2014-08-15
Publication date: 2020-04-06
Corresponding author
Aatit Paungmali   

110 Intawaroros Road, Neuro-Musculoskeletal and Pain Research Unit, Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand. Tel.: +66 53949246; fax: +66 53946042.
Pol. Ann. Med. 2014;21(2):103-108
Posterior and anterior oblique muscle slings contribute to the force closure mechanisms that provide stability to sacroiliac joint. These global muscle slings consist of myofascial network of fascia, muscles and tendons from global muscles. It links the lumbopelvic region to other joints of musculoskeletal system especially the contralateral glenohumeral joint (GHJ). Any sacroiliac joint dysfunction (SJD) may likely disrupt the force transmission across the oblique slings and it can affect the contralateral GHJ.

The current study aims to investigate the effects of SJD on the contralateral GHJ.

Material and methods:
An experimental study is designed recruiting 20 participants with SJD and 20 healthy participants as matched controls to test the hypothesis that SJD may cause excessive anterior translation of humeral head (ATHH) in contralateral GHJ. Using real time ultrasonography, resting position of humeral head (RPHH), ATHH and posttranslation distance of humeral head (PDHH) are compared between the GHJs among participants with SJD and the matched controls. Paired sample t-test and independent sample t-test are used to analyze the data.

Results and discussion:
The paired sample t-test result showed statistically significant increase in ATHH (P = 0.03) and PDHH (P = 0.01) in contralateral GHJs among participants with SJD. The independent sample t-test showed a significant increase in RPHH (P = 0.01) and PDHH (P = 0.01) in SJD participants when compared to matched controls.

SJD contributes to excessive ATHH in the contralateral GHJ. This may occur due to altered myofascial force transmission across oblique sling muscles.

None declared.
Chaitow L. Chronic pelvic pain: pelvic floor problems sacroiliac dysfunction the trigger point connection. J Bodywork Mov Ther. 2007;11(4):327–339.
Cibulka MT. Understanding sacroiliac joint movement as a guide to the management of a patient with unilateral low back pain. Man Ther. 2002;7(4):215–221.
Slipman CW, Jackson HB, Lipetz JS, Chan KT, Lenrow D, Vresilovic EH. Sacroiliac joint pain referral zones. Arch Phys Med Rehabil. 2000;81(3):334–338.
Buchowski JM, Kebaish KM, Sinkov V, Cohen DB, Sieber AN, Kostuik JP. Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint. Spine J. 2005;5(5):520–528.
Hossain M, Nokes LDM. A model of dynamic sacroiliac joint instability from malrecruitment of gluteus maximus and biceps femoris muscles resulting in low back pain. Med Hypotheses. 2005;65(2):278–281.
Bolt PM, Wahl MM, Schofferman J. The roles of the hip, spine, sacroiliac joint, and other structures in patients with persistent pain after back surgery. Semin Spine Surg. 2008;20(1):14–19.
McGrath MC. Clinical considerations of sacroiliac joint anatomy: a review of function, motion and pain. J Osteop Med. 2004;7(1):16–24.
Adamczewski T, Grabowska A, Kujawa J. Is there any coexistence of sacroiliac joints dysfunction with dysfunctions of occipito-atlanto-axial complex? Part II: the biomechanical aspect. Pol Ann Med. 2012;19(1):38–42.
Cusi MF. Paradigm for assessment and treatment of SIJ mechanical dysfunction. J Bodywork Mov Ther. 2010;14(2):152–161.
Masi AT, Benjamin M, Vleeming A. Anatomical, biomechanical, and clinical perspectives on sacroiliac joints: an integrative synthesis of biodynamic mechanisms related to ankylosing spondylitis. In: Movement, Stability & Lumbopelvic Pain. 2nd ed. London: Churchill Livingstone; 2004:205–227.
Pool-Goudzwaard AL, Vleeming A, Stoeckart R, Snijders CJ, Mens JM. Insufficient lumbopelvic stability: a clinical, anatomical and biomechanical approach to 'a-specific' low back pain. Man Ther. 1998;3(1):12–20.
Adamczewski T, Grabowska A, Kujawa J. Is there any coexistence of sacroiliac joints dysfunction with dysfunctions of the occipito-atlanto-axial complex? Part I: the sensorimotor function. Pol Ann Med. 2012;19(1):32–37.
Grassi Dd., de Souza MZ, Ferrareto SB, Montebelo MI, Guirro EC. Immediate and lasting improvements in weight distribution seen in baropodometry following a highvelocity, low-amplitude thrust manipulation of the sacroiliac joint. Man Ther. 2011;16(5):495–500.
Joseph L, Puangmali A, Pirunsan U, Das S. Sacroiliac joint and weight distribution to feet: an opinion towards clinical and research practice. Man Ther. 2012;17(4):e7.
Snijders CJ, Vleeming A, Stoeckart R. Transfer of lumbosacral load to iliac bones and legs. Part I: biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. Clin Biomech (Bristol Avon). 1993;8(6):285–294.
Fox M. Effect on hamstring flexibility of hamstring stretching compared to hamstring stretching and sacroiliac joint manipulation. Clin Chiropr. 2006;9(1):21–32.
Massoud Arab A, Reza Nourbakhsh M, Mohammadifar A. The relationship between hamstring length and gluteal muscle strength in individuals with sacroiliac joint dysfunction. J Man Manip Ther. 2011;19(1):5–10.
Carvalhais VO, Ocarino Jd., Araújo VL, Souza TR, Silva PL, Fonseca ST. Myofascial force transmission between the latissimus dorsi and gluteus maximus muscles: an in vivo experiment. J Biomech. 2013;46(5):1003–1007.
Kim JW, Kang MH, Oh JS. Patients with low back pain demonstrate increased activity of the posterior oblique sling muscle during prone hip extension. PMR. 2014.
DeRosa C, Porterfield J. Anatomical linkages and muscle slings of the lumbopelvic region. In: Movement, Stability and Lumbopelvic Pain. 2nd ed. Edinburgh: Churchill Livingstone; 2007:47–62.
Liebenson C. The relationship of the sacroiliac joint, stabilization musculature, and lumbo-pelvic instability. J Bodywork Mov Ther. 2004;8(1):43–45.
Myers TW. The 'anatomy trains': part 2. J Bodywork Mov Ther. 1997;1(3):135–145.
Rijkelijkhuizen JM, Meijer HJ, Baan GC, Huijing PA. Myofascial force transmission also occurs between antagonistic muscles located within opposite compartments of the rat lower hind limb. J Electromyogr Kinesiol. 2007;17(6):690–697.
Tong HC, Heyman OG, Lado DA, Isser MM. Interexaminer reliability of three methods of combining test results to determine side of sacral restriction, sacral base position, and innominate bone position. J Am Osteopath Assoc. 2006;106(8):464–468.
Huijing PA. Epimuscular myofascial force transmission between antagonistic and synergistic muscles can explain movement limitation in spastic paresis. J Electromyogr Kinesiol. 2007;17(6):708–724.
Arab AM, Abdollahi I, Joghataei MT, Golafshani Z, Kazemnejad A. Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint. Man Ther. 2009;14(2):213–221.
Cibulka MT, Kodehoff R. Clinical usefulness of a cluster of sacroiliac joint tests in patients with and without low back pain. J Orthop Myofascial Force Transm Sports Phys Ther. 1999;29(2):83–92.
Court-Payen M, Krarup AL, Skjoldbye B, Lausten GS. Realtime sonography of anterior translation of the shoulder: an anterior approach. Eur J Ultrasound. 1995;2(4):283–287.
Joseph LH, Hussain RI, Naicker AS, Htwe O, Pirunsan U, Paungmali A. Anterior translation of humeral head in glenohumeral joint: comparison between limb dominance and gender using ultrasonography. Pol Ann Med. 2013;20(2):89–94.
Krarup AL, Court-Payen M, Skjoldbye B, Lautsen GS. UItrasonic measurement of the anterior translation in the shoulder joint. J Shoulder Elbow Surg. 1999;8(2):136–141.
Yeap JS, McGregor AH, Humphries K, Wallace AL. Ultrasonic evaluation of anterior shoulder translation in normal shoulders. JMR. 2003;7(2):125–134.
Schleip R, Klingler W, Lehmann-Horn F. Active fascial contractility: fascia may be able to contract in a smooth muscle-like manner and thereby influence musculoskeletal dynamics. Med Hypotheses. 2005;65(2):273–277.
Vleeming A, Stoeckart R, Volkers AC, Snijders CJ. Relation between form and function in the sacroiliac joint Part I: clinical anatomical aspects. Spine (Phila Pa 1976). 1990;15(2):130–132.
Vleeming A, Volkers AC, Snijders CJ, Stoeckart R. Relation between form and function in the sacroiliac joint Part II: biomechanical aspects. Spine (Phila Pa 1976). 1990;15(2):133–136.
Dalstra M, Huiskes R, Odgaard A, van Erning L. Mechanical and textural properties of pelvic trabecular bone. J Biomech. 1993;26(4–5):523–535.
Levin SM. A suspensory system for the sacrum in pelvic biomechanics: biotensegrity. In: Vleeming A, Mooney V, Stoeckart R, eds. In: Movement, Stability and Lumbosacral Pain: Integration of Research and Therapy 2nd ed. Edinburgh, London/NY: Churchill Livingstone/Elsevier; 2007:229–231.
Solomonow M, Zhou BH, Baratta RV, Lu Y, Harris M. Biomechanics of increased exposure to lumbar injury caused by cyclic loading Part 1: loss of reflexive muscular stabilization. Spine. 1999;24(23):2426–2434.
Preuss R, Fung J. Can acute low back pain result from segmental spinal buckling during sub-maximal activities? A review of the current literature. Man Ther. 2005;10(1):14–20.
Solomonow M, Baratta RV, Zhou BH, Burger E, Zieske A, Gedalia A. Muscular dysfunction elicited by creep of lumbar viscoelastic tissue. J Electromyogr Kinesiol. 2003;13(4):381–396.
van Wingerden JP, Vleeming A, Buyruk HM, Raissadat K. Stabilization of the sacroiliac joint in vivo: verification of muscular contribution to force closure of the pelvis. Eur Spine J. 2004;13(3):199–205.
Leonard J. Importance of considering myofascial force contributions in musculoskeletal surgeries. J Surg Acad. 2013;3(2):1–3.
Yucesoy CA, Koopman BH, Baan GC, Grootenboer HJ, Huijing PA. Effects of inter- and extramuscular myofascial force transmission on adjacent synergistic muscles: assessment by experiments and finite-element modeling. J Biomech. 2003;36(12):1797–1811.
Souza TR, Fonseca ST, Gonçalves GG, Ocarino JM, Mancini MC. Prestress revealed by passive co-tension at the ankle joint. J Biomech. 2009;42(14):2374–2380.
Journals System - logo
Scroll to top