骨盤安定化

仙腸関節障害・骨盤機能不全

仙骨と腸骨をつなぐ仙腸関節の炎症や剪断ストレスにより、片側のお尻の窪み付近に鋭い局所痛が生じます。

臨床的所見

主な症状

片脚立ちでの体重負荷や階段昇降時に走る片側骨盤の鋭い痛み

重要注意点

避けるべき動作

✗ 過度な開脚や非対称な無理な骨盤ねじり動作

💡 理学療法士のアドバイス

クラムシェルやグルートブリッジで中臀筋を強化し、骨盤帯をしっかりとロック・安定させましょう。

段階別シークエンス

推奨処方プロトコル

7 EXERCISES

Clinical back pain images demonstration - PIRIFORMIS / SCIATIC RELEASE

PIRIFORMIS / SCIATIC RELEASE

🎯 Deep Gluteal Tension

Nerve Glide 3 mins • 30s

4の字（フィギュアフォー）梨状筋ストレッチ

Releases the deep piriformis muscle to relieve sciatic nerve impingement and glute ache.

L4-L5 L5-S1 Piriformis Gluteus Medius +1

Clinical back pain images demonstration - GLUTE & PELVIC STABILITY

GLUTE & PELVIC STABILITY

🎯 Posterior Chain

筋力強化 3 mins • 3s

グルートブリッジ（腰部・骨盤安定化運動）

Activates inhibited gluteals and posterior chain to remove excessive load from lumbar extensors.

L3-L4 L4-L5 Gluteus Maximus Hamstrings

Clinical back pain images demonstration - MCGILL CORE STABILIZER

MCGILL CORE STABILIZER

🎯 Rotational Control

筋力強化 3 mins • 5s

バードドッグ（マギル式体幹安定化運動）

One of the "McGill Big 3" exercises that strengthens the lumbar stabilizers with minimal spinal load.

T6-T7 T7-T8 Multifidus Erector Spinae +2

Clinical back pain images demonstration - ANTI-EXTENSION CORE

ANTI-EXTENSION CORE

🎯 Deep Transverse Core

筋力強化 3 mins • 3s

デッドバグ（腰椎過伸展防止コア運動）

Re-trains the deep transverse abdominis to protect the lumbar spine during extremity movement.

L1-L2 L2-L3 Transverse Abdominis Internal Obliques +1

Clinical back pain images demonstration - PSOAS & HIP DECOMPRESSION

PSOAS & HIP DECOMPRESSION

🎯 Anterior Hip Flexors

Desk Relief 3 mins • 30s

片膝立ち腸腰筋（股関節屈筋群）ストレッチ

Decompresses the lumbar spine by releasing chronically shortened iliopsoas muscles caused by prolonged sitting.

L1-L2 L2-L3 Iliopsoas Rectus Femoris +1

Clinical back pain images demonstration - GLUTEUS MEDIUS STABILITY

GLUTEUS MEDIUS STABILITY

🎯 Pelvic Symmetry

筋力強化 3 mins • 2s

クラムシェル（中臀筋＆骨盤スタビライザー強化）

Isolates the gluteus medius to stabilize the sacroiliac joint and prevent pelvic drop during walking.

L4-L5 L5-S1 Gluteus Medius Gluteus Minimus +1

Clinical back pain images demonstration - LATERAL QL STRETCH

LATERAL QL STRETCH

🎯 Quadratus Lumborum

Desk Relief 2 mins • 25s

立位体側伸ばし（腰方形筋ストレッチ）

Decompresses the Quadratus Lumborum and side waist to relieve asymmetrical pelvic and lower back tightness.

T11-T12 T12-L1 Quadratus Lumborum Latissimus Dorsi +1

CLINICAL QUESTIONS & ANSWERS

よくある臨床の質問: 仙腸関節炎

Q How do I know if my pain is SI joint or lumbar spine?

SI joint pain typically concentrates right over the posterior superior iliac spine (the dimple on one side of your lower back) and does not usually radiate below the knee, unlike classic lumbar sciatica.

Q Can glute bridges fix SI joint instability?

Yes. Bilateral symmetrical glute bridges engage both gluteus maximus heads and create pelvic force-closure across the sacrum without putting asymmetrical rotational torque on the pelvis.

医学文献・論文

査読済み論文およびガイドライン

•
"Force-Closure and Pelvic Stability in Sacroiliac Joint Rehabilitation" — Manual Therapy & Postural Rehabilitation (2023).