{"id":5696,"date":"2023-06-04T11:05:29","date_gmt":"2023-06-04T09:05:29","guid":{"rendered":"https:\/\/martinkonvicka.cz\/?p=5696"},"modified":"2023-06-04T11:08:31","modified_gmt":"2023-06-04T09:08:31","slug":"sakra-sakra-aneb-co-delat-kdyz-zlobi-si-sakroiliakalni-skloubeni","status":"publish","type":"post","link":"https:\/\/martinkonvicka.cz\/en\/sakra-sakra-aneb-co-delat-kdyz-zlobi-si-sakroiliakalni-skloubeni\/","title":{"rendered":"Sakra, Sakra, aneb co d\u011blat, kdy\u017e zlob\u00ed SI (sakroiliak\u00e1ln\u00ed) sklouben\u00ed"},"content":{"rendered":"
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Co je SI sklouben\u00ed ?
\nJak se projevuje dysfunkce SI sklouben\u00ed?
\nDiagnostika
\nJak\u00e9 jsou p\u0159\u00ed\u010diny?
\nAkutn\u00ed pomoc a l\u00e9\u010dba
\n\n\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Obr. 1 SI sklouben\u00ed<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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<\/p>

Bol\u00ed V\u00e1s doln\u00ed \u010d\u00e1st zad a oblast h\u00fd\u017ed\u00ed? Jsou bolesti tak velk\u00e9, \u017ee se nem\u016f\u017eete t\u00e9m\u011b\u0159 pohnout a svaly v\u00a0t\u00e9to oblasti jsou napjat\u00e9? Bolest se projevuje po del\u0161\u00ed dob\u011b ne\u010dinnosti, p\u0159i vst\u00e1v\u00e1n\u00ed z\u00a0auta nebo z postele?<\/strong><\/p>

P\u0159\u00ed\u010dinou m\u016f\u017ee b\u00fdt dysfunkce SI (sacroiliak\u00e1ln\u00edho) sklouben\u00ed.<\/p>

\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Co je SI sklouben\u00ed \u201cd\u00e1le jen SI\u201c?<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Tvo\u0159\u00ed ho dva klouby nach\u00e1zej\u00edc\u00ed se mezi p\u00e1nv\u00ed a kost\u00ed k\u0159\u00ed\u017eovou (viz. obr\u00e1zek). Jsou to jedin\u00e9 klouby, kter\u00e9 spojuj\u00ed vrchn\u00ed a spodn\u00ed \u010d\u00e1st\u00ed t\u011bla. Jsou neohebn\u00e9 a tuh\u00e9. Pohybuj\u00ed se jen o n\u011bkolik stup\u0148\u016f. Jejich hlavn\u00edm \u00fakolem je p\u0159en\u00e1\u0161en\u00ed s\u00edly mezi doln\u00ed a horn\u00ed polovinou t\u011bla, tlumen\u00ed n\u00e1raz\u016f, pom\u00e1h\u00e1n\u00ed p\u0159i ch\u016fzi a udr\u017eov\u00e1n\u00ed rovnov\u00e1hy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Jak zjist\u00edm, \u017ee se jedn\u00e1 o dysfunkci SI sklouben\u00ed?\n\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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V\u011bd\u011bli jste, \u017ee 16-30% bolest\u00ed doln\u00ed \u010d\u00e1sti zad je zp\u016fsobeno dysfunkc\u00ed SI sklouben\u00ed<\/strong> (1). Zde nast\u00e1v\u00e1 probl\u00e9m se spr\u00e1vnou diagnostikou, proto\u017ee \u010dastokr\u00e1t je za p\u0159\u00ed\u010dinu ozna\u010dena pr\u00e1v\u011b bedern\u00ed p\u00e1te\u0159. Ke spr\u00e1vn\u00e9 diagnostice slou\u017e\u00ed baterie test\u016f, kter\u00e9 maj\u00ed za c\u00edl provokovat bolest v oblasti SI sklouben\u00ed. Je nutn\u00e9, aby je prov\u00e1d\u011bl vy\u0161kolen\u00fd terapeut, aby nedo\u0161lo k chybn\u00e9 diagnostice nebo k je\u0161t\u011b v\u011bt\u0161\u00edmu zran\u011bn\u00ed a bolesti. Jeden z\u00a0 test\u016f je zobrazen na obr.2.\u00a0<\/p>

K\u00a0diagnostice slou\u017e\u00ed i injekce s\u00a0analgetiky aplikovan\u00e1 do kloubu. Pokud bolest po aplikaci odezn\u00ed, je velk\u00e1 pravd\u011bpodobnost, \u017ee se probl\u00e9m nach\u00e1z\u00ed pr\u00e1v\u011b v\u00a0SI sklouben\u00ed.<\/p>

Obr.2 Test dysfunkce SI (6). Terapeut aplikuje tlak na levou a pravou stranu kosti k\u0159\u00ed\u017eov\u00e9. Test je pozitivn\u00ed, pokud se objev\u00ed bolest v\u00a0oblasti SI.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Co dysfunkci SI zp\u016fsobuje?\n\n\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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P\u0159ev\u00e1\u017en\u011b se jedn\u00e1 o naru\u0161en\u00ed sou\u010dinnosti mezi b\u0159i\u0161n\u00edmi, bedern\u00edmi a z\u00e1dov\u00fdmi svaly. Pokud je \u010d\u00e1st t\u011bchto sval\u016f slab\u00e1, nedok\u00e1\u017ee jistit obratle a p\u00e1nev. T\u00edm m\u016f\u017ee doj\u00edt k pooto\u010den\u00ed v mal\u00fdch kloubech p\u00e1te\u0159e nebo v SI sklouben\u00ed (7).<\/p>

P\u0159\u00ed\u010dinou m\u016f\u017ee b\u00fdt tak\u00e9 nadm\u011brn\u00e1 lord\u00f3za, ploch\u00e1 z\u00e1da, z\u00e1n\u011bt, volnost vaz\u016f, po\u0161kozen\u00ed kloubn\u00edho pouzdra, zlomeniny kost\u00ed a poran\u011bn\u00ed nerv\u016f v\u00a0oblasti SI kloubu, ostoartr\u00f3za, spondylartitida a krat\u0161\u00ed doln\u00ed kon\u010detina (1,6).<\/p>

N\u00e1chyln\u011bj\u0161\u00ed ke zran\u011bn\u00ed SI kloubu jsou t\u011bhotn\u00e9 \u017eeny, proto\u017ee d\u00edky hormon\u00e1ln\u00edm zm\u011bn\u00e1m je kloub \u201erozvoln\u011bn\u00fd\u201c. Dal\u0161\u00edm rizikov\u00fdm faktorem je v\u011bk od 40-ti let. Zde doch\u00e1z\u00ed ke sni\u017eov\u00e1n\u00ed volnosti kloubu. Ten se pak st\u00e1v\u00e1 v\u00edce tuh\u00fdm. V\u00fdsledkem m\u016f\u017ee b\u00fdt jeho zv\u00fd\u0161en\u00e1 bolestivost (1).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Akutn\u00ed pomoc a l\u00e9\u010dba \n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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V\u00a0akutn\u00ed f\u00e1zi<\/strong> je doporu\u010den klid (nedr\u00e1\u017ed\u011bn\u00ed bolesti), ledov\u00e1n\u00ed, protiz\u00e1n\u011btliv\u00e9 l\u00e9ky pop\u0159. l\u00e9ky pro svalovou relaxaci. M\u011bli bychom si hledat polohy, p\u0159i kter\u00fdch se bolest neobjevuje. Velice vhodn\u00e9 jsou polohy na boku s\u00a0ohnut\u00fdmi doln\u00edmi kon\u010detinami nebo vle\u017ee na z\u00e1dech se zvednut\u00fdmi doln\u00edmi kon\u010detinami op\u0159en\u00fdmi o ze\u010f \u010di \u017eidli.<\/p>

Po odezn\u011bn\u00ed akutn\u00ed f\u00e1ze<\/strong> je vhodn\u00e9 zapojit bezbolestn\u00fd pohyb (ch\u016fze), cvi\u010den\u00ed, mobiliza\u010dn\u00ed techniky prov\u00e1d\u011bn\u00e9 vy\u0161kolen\u00fdm profesion\u00e1lem, teplo a kineziotaping. Dle (2) mobiliza\u010dn\u00ed cvi\u010den\u00ed a dom\u00e1c\u00ed cvi\u010den\u00ed, stejn\u011b jako d\u00e1vka trp\u011blivosti vy\u0159e\u0161\u00ed v\u011bt\u0161inu p\u0159\u00edpad\u016f bolesti SI sklouben\u00ed.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Pohyb a cvi\u010den\u00ed<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Fyzicky aktivn\u00ed lid\u00e9 maj\u00ed mnohem lep\u0161\u00ed p\u0159edpoklady pro zvl\u00e1dnut\u00ed dysfunkce SI ne\u017e lid\u00e9 \u017eij\u00edc\u00ed sedav\u00fdm \u017eivotn\u00edm stylem.<\/p>

Cvi\u010den\u00ed pro sn\u00ed\u017een\u00ed bolestivosti a odstran\u011bn\u00ed dysfunkce SI je podobn\u00e9 tomu, kter\u00e9 je zam\u011b\u0159eno na odstran\u011bn\u00ed bolesti doln\u00ed \u010d\u00e1sti zad. Zam\u011b\u0159ujeme se na zv\u00fd\u0161en\u00ed stability p\u00e1te\u0159e (posilov\u00e1n\u00ed b\u0159i\u0161n\u00edch sval\u016f s\u00a0d\u016frazem na p\u0159\u00ed\u010dn\u00fd sval b\u0159i\u0161n\u00ed (1) a \u0161ikm\u00e9 b\u0159i\u0161n\u00ed svaly (obr.3.), posilov\u00e1n\u00ed p\u00e1nevn\u00edho dna, vzp\u0159imova\u010d\u016f p\u00e1te\u0159e (obr.4), \u010dty\u0159hrann\u00e9ho svalu bedern\u00edho a h\u00fd\u017e\u010fov\u00fdch sval\u016f). Ve studii (6) bylo zji\u0161t\u011bno, \u017ee posilov\u00e1n\u00edm h\u00fd\u017e\u010fov\u00fdch sval\u016f a zv\u00fd\u0161en\u00edm jejich s\u00edly do\u0161lo ke sn\u00ed\u017een\u00ed bolestivosti SI sklouben\u00ed. \u00da\u010dastn\u00edci v\u00fdzkumu posilovali h\u00fd\u017ed\u011b 2x t\u00fddn\u011b po dobu 5 t\u00fddn\u016f.<\/p>

P\u0159id\u00e1v\u00e1me tak\u00e9 cvi\u010den\u00ed na prota\u017een\u00ed a mobilitu SI (obr.5).<\/p>

Nem\u011bli bychom zapomenout na zv\u00fd\u0161en\u00ed pohyblivosti ky\u010deln\u00edho kloubu. To doc\u00edl\u00edme protahov\u00e1n\u00edm a mobilitou h\u00fd\u017e\u010fov\u00fdch sval\u016f a hru\u0161kovit\u00e9ho svalu, \u010dty\u0159hlav\u00e9ho svalu stehenn\u00edho a hamstring\u016f.<\/p>

Obr.3 Bo\u010dn\u00ed prkno<\/p>

Obr. 4 Ptakopes<\/p>

Obr.5 Prota\u017een\u00ed SI<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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z\u00e1v\u011br\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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P\u0159i bolestivosti SI sklouben\u00ed je d\u016fle\u017eit\u00e9 se po odezn\u011bn\u00ed akutn\u00ed f\u00e1ze zam\u011b\u0159it na bezbolestn\u00fd pohyb, kter\u00fd by m\u011bl obsahovat stabiliza\u010dn\u00ed cvi\u010den\u00ed, rotace p\u00e1te\u0159e, protahov\u00e1n\u00ed sval\u016f v\u00a0oblasti ky\u010deln\u00edho kloubu a posilov\u00e1n\u00ed h\u00fd\u017e\u010fov\u00fdch sval\u016f. <\/strong>Ka\u017ed\u00fd doporu\u010den\u00fd cvik by m\u011bl b\u00fdt prov\u00e1d\u011bn minim\u00e1ln\u011b 10x alespo\u0148 3x t\u00fddn\u011b. V\u00fdborn\u00e9 v\u00fdsledky maj\u00ed tak\u00e9 mobiliza\u010dn\u00ed techniky zam\u011b\u0159en\u00e9 na SI prov\u00e1d\u011bn\u00e9 vy\u0161kolen\u00fdm profesion\u00e1lem.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Reference:<\/b>\u00a0<\/p>

  1. Dydyk, A. M., Forro, S. D., & Hanna, A. (2023). Sacroiliac Joint Injury. In StatPearls<\/em>. StatPearls Publishing.<\/li>
  2. van Mechelen W, Hlobil H, Kemper HC, Voorn WJ, de Jongh HR. Prevention of running injuries by warm-up, cool-down, and stretching exercises. Am J Sports Med. 1993 Sep-Oct;21(5):711-9.<\/li>
  3. Added, M. A. N., de Freitas, D. G., Kasawara, K. T., Martin, R. L., & Fukuda, T. Y. (2018). STRENGTHENING THE GLUTEUS MAXIMUS IN SUBJECTS WITH SACROILIAC DYSFUNCTION. International journal of sports physical therapy<\/em>, 13<\/em>(1), 114\u2013120.<\/li>
  4. Nejati, P., Safarcherati, A., & Karimi, F. (2019). Effectiveness of Exercise Therapy and Manipulation on Sacroiliac Joint Dysfunction: A Randomized Controlled Trial. Pain physician<\/em>, 22<\/em>(1), 53\u201361.<\/li>
  5. Javadov, A., Ketenci, A., & Aksoy, C. (2021). The Efficiency of Manual Therapy and Sacroiliac and Lumbar Exercises in Patients with Sacroiliac Joint Dysfunction Syndrome. Pain physician<\/em>, 24<\/em>(3), 223\u2013233.<\/li>
  6. Laslett M. (2008). Evidence-based diagnosis and treatment of the painful sacroiliac joint. The Journal of manual & manipulative therapy<\/em>, 16<\/em>(3), 142\u2013152.<\/li>
  7. Adlerov\u00e1, K., Fengler, A., 2019. Psoas tr\u00e9nink, posilov\u00e1n\u00ed a zlep\u0161ov\u00e1n\u00ed pohyblivosti bedroky\u010deln\u00edho svalu p\u0159i sedav\u00e9m \u017eivotn\u00edm stylu.<\/em> Pozn\u00e1n\u00ed<\/li><\/ol>

    <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

    Co je SI sklouben\u00ed ? Jak se projevuje dysfunkce SI sklouben\u00ed? Diagnostika Jak\u00e9 jsou p\u0159\u00ed\u010diny? Akutn\u00ed pomoc a l\u00e9\u010dba Obr. 1 SI sklouben\u00ed Bol\u00ed V\u00e1s doln\u00ed \u010d\u00e1st zad a oblast h\u00fd\u017ed\u00ed? Jsou bolesti tak velk\u00e9, \u017ee se nem\u016f\u017eete t\u00e9m\u011b\u0159 pohnout a svaly v\u00a0t\u00e9to oblasti jsou napjat\u00e9? Bolest se projevuje po del\u0161\u00ed dob\u011b ne\u010dinnosti, p\u0159i vst\u00e1v\u00e1n\u00ed […]<\/p>","protected":false},"author":6,"featured_media":5697,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"plain-container","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"disabled","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5696","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"\nSakra, Sakra, aneb co d\u011blat, kdy\u017e zlob\u00ed SI (sakroiliak\u00e1ln\u00ed) sklouben\u00ed - Martin Konvi\u010dka<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/martinkonvicka.cz\/en\/sakra-sakra-aneb-co-delat-kdyz-zlobi-si-sakroiliakalni-skloubeni\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sakra, Sakra, aneb co d\u011blat, kdy\u017e zlob\u00ed SI (sakroiliak\u00e1ln\u00ed) sklouben\u00ed - Martin Konvi\u010dka\" \/>\n<meta property=\"og:description\" content=\"Co je SI sklouben\u00ed ? 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