Mobilization Versus Myofascial Release in Sacroiliac Joint Dysfunction

Summary

Sacroiliac joint dysfunction (SIJD) is a musculoskeletal condition associated with low back and pelvic pain, functional limitations, impaired postural control, and reduced spinal mobility. Although manual therapy techniques are commonly used in the conservative management of SIJD, evidence directly comparing joint-focused and fascial-focused approaches remains limited.

This assessor-blinded, parallel-group randomized controlled trial compared sacroiliac joint mobilization and posterior chain-focused myofascial release, each applied in addition to a standardized conventional physiotherapy program, in adults aged 18-65 years with SIJD. Participants were randomly allocated in a 1:1 ratio to the mobilization group or the myofascial release group. Both groups received three supervised treatment sessions per week for six weeks.

The primary outcomes were postural control assessed using the Biodex Balance System and spinal posture, mobility, postural endurance, and total Spine Check performance assessed using the Spinal Mouse system. Secondary outcomes were resting, activity-related, and night pain assessed using the Visual Analog Scale and functional disability assessed using the Oswestry Disability Index. Assessments were performed at baseline and immediately after the six-week intervention.

Conditions

• Sacroiliac Joint Dysfunction

Interventions

OTHER

Traditional treatment program

Both groups received a standardized conventional physiotherapy program consisting of therapeutic exercise and therapeutic ultrasound. The exercises included bridging, trunk extension, and abdominal curl exercises and were performed in three sets of 15 repetitions. The exercises were progressed from initial to intermediate and advanced levels at two-week intervals when participants completed the prescribed sets with appropriate technique and without increased pain. Therapeutic ultrasound was applied over the right and left sacroiliac joint regions with the participant in the prone position. Continuous ultrasound was delivered at a frequency of 1 MHz and an intensity of 1.5 W/cm² using a 4-cm-diameter probe for a total duration of 6 minutes. Treatment was delivered three times per week for six weeks, for a total of 18 supervised sessions.

OTHER

myofascial relaxation

The myofascial release time for each muscle was 90 to 120 seconds, applied twice per session. 1. Myofascial release of the erector spinae muscles: the patient assumed a prone position; and the therapist stood at the patient's pelvis level on the treatment side, applying the cross-hand technique. 2. To increase muscle tension, the patient's lower extremity was placed in hip flexion and adduction at the highest point. The therapist stood behind the patient, at the level of the patient's pelvis, and applied the transverse tapping technique using the knuckles. 4. Myofascial release of the gluteus medius muscle: The patient assumed a lateral recumbent position on the untreated side. The therapist stood behind the patient, at the level of the patient's pelvis, and applied the vertical tapping technique using the knuckles.

OTHER

Mobilization

Patients lay on their side with the sacroiliac joint restricted at the top, and sacroiliac manipulation was performed. Then, the physiotherapist flexed the lumbar spine by moving toward the upper part of the thigh, applying an impulse using the intermittent stretching technique in the direction of the major thoracanthus from the iliac crest. In the prone position, caudal traction, traction of the sacrum relative to the ilium, and traction stretches from the iliac crests will be applied.

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi

  lead OTHER

Principal Investigators

• Şafak KUZU · Kirsehir Ahi Evran Universitesi

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-19

Primary Completion

2026-03-20

Completion

2026-04-20

Countries

• Turkey (Türkiye)

Study Locations