The Serola Inflatable Pelvic Blocks
Within the weight-bearing portion of the SIJ is the interosseous ligament, which contains blood vessels, connective and fatty tissue. This ligament is not a single continuous band. Rather, it is composed of many individual bands that go between the sacrum and ilium. When sprained, these interosseous ligament bands do not tear. Instead, they pull away from their insertion into either the sacrum or ilium; this allows the joint to separate slightly. Fluid from the surrounding tissues, as well as from blood vessels within the joint, infiltrates the space between the sacrum and ilium and creates swelling, inflammation, and pain. Here is the key point: the fluid within the space keeps the joint surfaces apart, preventing the re-integration of the ligament into the bone.
It is reasonable to assume that the internal pressure caused by the swelling pushes out on the joint surfaces, stretching the ligaments. Nerves within the ligaments respond by activating the ligamento-muscular reflex which, in turn, causes protective muscular contraction or inhibition. The internal pressure of the swelling, pushing out, is countered by the external muscular compression, pushing in, resulting in the body's best attempt at stability.
Chiropractic, although very effective in aligning the joint and removing stress, a quick short thrust, is not effective enough to remove all the fluid from the SI joint space. However, it will usually give considerable relief because it can take a lot of stress off the injured ligaments.
Muscle strengthening programs, as done by physical therapists and rehab specialists, are also highly regarded as a treatment for SIJ instability. When done properly, muscle strengthening and stretching can realign the body structure to remove stress on the joint. However, the muscles cannot provide enough power to compress the SIJ sufficiently to push out the excess fluid, so the lesion remains.
Injection therapy, such as prolotherapy, is use of an irritant injected into the joint space, or surrounding ligaments. This is done in an attempt to create additional scar tissue which will help the ligaments hold the SI joint together. But, without removing the excess fluid, the best it can do is hold the SIJ in a separated position.
The only method available to provide the correct amount of pressure, direction, and time to effectively compress the weight bearing portion of the SIJ to eventually result in permanent removal of excess fluid, re-establishment of ligamentous integrity by re-integration of the ligament into the joint surface, restoration of muscular balance, and normalization of joint function is Category 2 blocking. When done properly, muscle strength will be increased immediately after the procedure
Due to the delicate nature of the tissues, adjustment, manipulation, or mobilization of the SIJ should be avoided until the SIJ has stabilized and the ligaments have healed. To help ensure this, it is strongly recommended that these actions should be avoided for a period of 6-8 weeks after pelvic blocking has no longer been needed.