Résumé
On pense rarement au dysfonctionnement de l'articulation sacro-iliaque comme cause possible de “lombalgie”. Cela est dû au fait que l'on a recours bien souvent à des modèles anatomiques incomplets. D'un point de vue cinématique, les modèles habituels d'anatomie topographique sont généralement insuffisants car ils individualisent le pelvis, la colonne lombaire inférieure et les membres inférieurs comme des entités distinctes. Cette étude anatomo-fonctionnelle centre son intérêt sur la question de savoir si les relations anatomiques entre le muscle biceps fémoral et le ligament sacro-tubéral sont cinématiquement utiles. Les forces appliquées au tendon du muscle biceps fémoral, semblent influencer la tension du ligament sacro-tubéral. Comme la tension du ligament sacro-tubéral influence la cinématique de l'articulation sacro-iliaque, l'entraînement des ischio-jambiers pourrait influencer l'articulation sacro-iliaque et ainsi la cinématique du rachis lombaire. Les applications cliniques concernant la rétraction des ischio-jambiers, l'instabilité pelvienne et la marche sont discutées.
Summary
Sacroiliac joint dysfunction is often overlooked as a possible cause of low back pain. This is due to the use of reductionistic anatomical models. From a kinematic point of view, topographic anatomical models are generally inadequate, since they categorize pelvis, lower vertebral column and legs as distinct entities. This functional-anatomical study focuses on the question whether anatomical connections between the biceps femoris muscle and the sacrotuberous ligament are kinematically useful. Forces applied to the tendon of the biceps femoris muscle, simulating biceps femoris muscle force, were shown to influence sacrotuberous ligament tension. Since sacrotuberous ligament tension influences sacroiliac joint kinematics, hamstring training could influence the sacroiliac joint and thus low back kinematics. The clinical implications with respect to ‘short’ hamstrings, pelvic instability and walking are discussed.
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van Wingerden, J.P., Vleeming, A., Snijders, C.J. et al. A functional-anatomical approach to the spine-pelvis mechanism: interaction between the biceps femoris muscle and the sacrotuberous ligament. Eur Spine J 2, 140–144 (1993). https://doi.org/10.1007/BF00301411
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DOI: https://doi.org/10.1007/BF00301411