Hypermobility<unk>  is an outcome of either extra-articular<unk>  or from intraarticular<unk> . SI<unk><unk>  is sometimes referred to as<unk><unk>  instability" or<unk><unk>  insufficiency" due to the support the once strong and taut ligaments can no longer sustain. When the<unk>  is hypermobile or loose, it is classified as an extra-articular<unk>  because abnormal<unk>  movement and alignment is a consequence of weakened, injured, or sprained ligaments, while the<unk>  itself is structurally normal and healthy. The<unk><unk>  itself often will not show degenerative changes, such as arthritis, until many years of the<unk>  being allowed to continue. Injury to the ligaments that hold the<unk><unk> s in proper support is thought to be caused by a torsion or high impact injury (such as an automobile accident) or a hard fall, resulting in the hypermobility. As many as 58% of people diagnosed with<unk><unk>  pain had some inciting traumatic injury based on clinical examination findings. The<unk>  that was once stabilized by strong ligaments, now overly stretched, sprained, or torn, will move beyond its normal range. This is thought to result in the ilium and sacral surfaces "locking" in an incongruent or asymmetrical fashion (one innominate bone is tilted anteriorly; the other innominate bone is tilted posteriorly) causing pain that can be debilitating. Hormone imbalances, particularly those associated with pregnancy and the hormone relaxin, can also cause a ligamentous laxity resulting in the weakening of the<unk>  structure. During pregnancy, relaxin serves as nature's way of allowing the female pelvis to achieve distention of the birthing canal. Pelvic<unk>  pain in post pregnancy women is thought to be derived from the inability of the stretched out ligaments to return to normal tautness. Women who have delivered large babies or who have had extended labors also are prone to developing chronic<unk><unk>  pain and instability. In some people, the<unk><unk> s reverse the normal concave-convex 'locking' relationship, which can lead to rotational misalignment. The variation in<unk>  configuration results in some<unk><unk> s being inherently weaker or more prone to misalignment. Certain biomechanical or muscle length imbalances may ultimately predispose a person to<unk><unk>  and pain. Likely, this is a result of altered gait patterns and repetitive stress to the SI<unk>  and related structures. These conditions exist in persons with leg-length inequality, scoliosis, a history of polio, poor-quality footwear, and hip osteoarthritis. There is also a notable incidence of lumbar spinal fusion patients that present with<unk>  pain and hypermobility, potentially due to the adjacent lumbar<unk> s being fixed and unable to move. Clinical studies have found up to 75% of post-lumbar fusion patients develop SI<unk>  degeneration within five years of surgery. Hypomobility Pathological hypomobility (too little movement) of the<unk><unk>  is an intra-articular disorder in which the<unk>  locks due to wearing down with age or degenerative<unk>  disease. Hypomobility of this kind can also occur with an inflammatory disease such as ankylosing spondylitis, rheumatoid arthritis, or an infection.
Sacroiliac joint dysfunction
Radicular pain
Pelvic girdle pain
Jaw claudication
Back pain
Tendinopathy
Low back pain
Xiphodynia