A Finite Element Analysis of Sacroiliac Joint Displacements and Ligament Strains in Response to Three Manipulations
Abstract BackgroundClinical studies have found that manipulations have a good clinical effect on sacroiliac joint (SIJ) pain without specific causes. However, the specific mechanisms underlying the effect of manipulations are still unclear. The purpose of this study was to investigate the effects of three common manipulations on the stresses and displacements of the SIJ and the strains of the surrounding ligaments.MethodsA three-dimensional finite element model of the pelvis-femur was developed. The manipulations of hip and knee flexion (MHKF), oblique pulling (MOP), and lower limb hyperextension (MLLH) were simulated. The stresses and displacements of the SIJ and the strains of the surrounding ligaments were analyzed during the three manipulations.ResultsMOP produced the highest stress on the left SIJ, at 6.6 MPa, while MHKF produced the lowest stress on the right SIJ, at 1.5 MPa. The displacements of the SIJ were all less than 1 mm during the three manipulations. The three manipulations caused different degrees of ligament strain around the SIJ, and MOP produced the greatest straining of the ligaments.ConclusionThe three manipulations all produced small displacements of the SIJ and different degrees of ligament strains, which might be the mechanism through which they relieve SIJ pain. MOP may be the most effective of these manual therapies.