Pelvis Strain, Ischium

Injury to the muscles or tendons of the lower pelvis (ischium), or injury at places
where muscles attach to pelvic bones. Tendons, muscles and bones comprise units. These units stabilize the pelvis and allow its motion. A strain occurs at the weakest part of a unit. Strains are of 3 types:

• Mild (Grade I)- Slightly pulled muscle without tearing of muscle or tendon fibers. There is no loss of strength.
• Moderate (Grade II)- Tearing of fibers In a muscle, tendon or at the attachment to bone. Strength is diminished.
• Severe (Grade III)- Rupture of the muscle-tendon-bone attachment with separation of, fibers. Severe strain requires surgical repair. Chronic strains are caused by overuse. Acute strains are caused by direct injury or overstress.

Body Parts Involved

• Tendons and muscles of the lower pelvic region, including thigh, abdominal and back muscles.
• Bones of the pelvis, thigh and lower spine.
• Soft tissue surrounding the strain, including nerves, periosteum (covering to bone), blood vessels and lymph vessels.

Causes

• Prolonged overuse of muscle-tendon unite in the pelvis.
• Single violent injury or force applied to the muscle-tendon units in the lower pelvis. Strains of pelvic muscles are common in sports in which the hip is bent and the knee is straight, as with a hurdler's leading leg. Forceful straight leg-raising exercises also lead to pelvic strain.

Signs & Symptoms

• Pain when moving or stretching the thigh.
• Spasm in muscles that attach to the pelvis.
• Swelling in the lower pelvic area.
• Loss of strength (moderate or severe strain).
• Crepitation ("crackling")feeling and sound when the injured area is pressed with finger.
• Calcification of the muscle or tendon (visible with X-rays).                                   .
• Inflammation of the tendon sheath.

Treatment

Note:- Follow your doctor's instructions. These instructions are supplemental.

First Aid

Use instructions for R.I.C.E., the first letters of rest, ice, compression and elevation (If possible).

Continuing Care

• Use ice massage 3 or 4 times a day for 15 minutes at a time. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
• After the first 24 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
• Take whirlpool treatments, if available.
• Wrap the injured pelvic muscles loosely with an elasticized bandage or wear a corset between treatments.
• Massage gently and often to provide comfort and decrease swelling.

Medication

• For minor discomfort, you may use:

Aspirin, acetaminophen or ibuprofen.

Topical liniments and ointments.

• Your doctor may prescribe:

Stronger pain relievers.

Injection of a long-acting local anesthetic to reduce pain.

Injections of corticosteroids, such astriamcinolone, to reduce inflammation(rare).

Home Diet

Diagnostic Measures

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• X-rays of pelvis bones to rule out fractures.

Prevention Tips

• Participate in a strengthening and conditioning program appropriate for your sport.
• Warm up before practice or competition.