Abstract
CASE HISTORY: A 21-year-old male baseball catcher presented with left lower back pain radiating to the glute and occasionally hamstrings, worsening throughout the day. Symptoms initially occurred during batting and later progressed to weightlifting and forward flexion. Unable to sit or stand for long periods or participate in baseball. Lidocaine shot and patches provided minimal relief. Physician suspected sacroiliac joint (SIJ) dysfunction with a myofascial component. PHYSICAL EXAM: Negative FABERs, positive FADIRs. Pain during lumbar active range of motion (AROM) in flexion, bilateral side bend, and rotation. Pain with L5 central posterior-anterior global assessment (CPA). Referred pain at left SI with unilateral posterior- anterior assessment (UPA) at all facets on L1-L5. Hypomobile thoracic during CPA. Decrease left hip external rotation (ER) ROM. Tenderness to palpation of the left PSIS, SIJ, and gluteal region. Sahrmann progression score 4/5. DIFFERENTIAL DIAGNOSES: Piriformis syndrome, pars interarticularis defect, Lumbar zygapophyseal syndrome. TESTS & RESULTS: Lumbar spine x-ray showed a mild grade 1 anterolisthesis and mild disc space narrowing at L5-S1.SIJ injection was administered and provided temporary pain relief. FINAL DIAGNOSIS: SIJ Dysfunction DISCUSSION: The SIJ is a bilateral synovial joint enclosed within a fibrous capsule. It connects the sacrum to the ilia and is stabilized by the sacral ligaments and pelvic musculature. Prevalence of SIJ dysfunction in LBP patients is 15-30%, yet difficult to diagnose. The etiology remains unclear; however, pain is exacerbated by activity-related loading. Repetitive deep squatting, rotation, and loading during baseball catching may contribute to lumbopelvic stress and provoke symptoms, particularly when weak gluteal muscles fail to stabilize the lower back, potentially leading to hip impingement. OUTCOME OF THE CASE: Patient was prescribed six weeks of physical therapy and barred from baseball. Treatment included kinetic-chain soft-tissue mobilization and exercises for hip mobility and deep ER. At 11-week follow-up, pain decreased from 7/10 to 2/10, and left hip ER increased by 10˚. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: The athlete returned to play baseball and continued to improve with stretching and was prescribed a home program.
Recommended Citation
Battula, Sri; Arbel, Vered; Verma, Ankur; and Amasay, Tal
(2026)
"Sacroiliac Joint Dysfunction in a Baseball Catcher,"
International Journal of Exercise Science: Conference Proceedings: Vol. 15:
Iss.
9, Article 14.
Available at:
https://digitalcommons.wku.edu/ijesab/vol15/iss9/14