Reason for back pain, ischias, foot pain, ankle pain, stiff back,...

[expatient]

Sacroiliac joint subluxation:
http://www.youtube.com/watch?v=iEUPFNBXTNE

[tonibunny]

You have posted about this quite a few times on these forums, and you give the impression that people shouldn't need bracing or surgery because all cases of idiopathic scoliosis are due to SI Joint dysfunctions. I feel that it is wrong for you to tell people this.

Your video on SI Joint problems is interesting, and it may actually be the cause of some cases of idiopathic scoliosis, but it is NOT responsible for all cases.

I myself was diagnosed with infantile idiopathic scoliosis at the age of 6 months; I had two large curves (62 and 40 degrees) that had developed before I even sat up for the first time. These cannot in any way be said to be due to SI Joint problems!

[structural75]

Expatient,

I have to echo tonibunny's sentiment here... you are providing very misleading and inaccurate information to people on these forums. I see people with dysfunctional SI joint problems all of the time and can tell you that it often has very little to do with the SI joint itself.... it is usually a secondary dysfunction to various other primary conditions.

It is definitely not the cause of most cases of scoliosis. Albeit, you will often find dysfunctional SI joint(s) in those with scoliosis but it is a biomechanical adaptation/consequence of abnormal or compromised spinal and pelvic mechanics, not the cause.

As Tonibunny pointed out, her scoliosis developed during infancy during which time the SI joints are flat and very mobile.

Sacroiliac joint subluxation:The term 'subluxation' is also highly questionable.. there is a big debate as to whether you can actually see them on an x-ray... one chiropractor and researcher claims that he's NEVER seen a subluxation on an x-ray. It's a subjective term... it could mean a variety of things relating to the mechanics of the joint... very misleading to the public. Asking 'Where does your back go when it goes out?' is like asking 'where does your lap go when you stand up?'.???

[expatient]

you are providing very misleading and inaccurate information to people on these forums.
Well that is just your opinion. Doctors gave me misleading information for over 20 years when they told my left foot was shorter and I had scoliosis and nothing can help that. Yet those problems were corrected when I was 35yrs by correcting my SIJD. All my chronic pains vere gone. My posture got better and walking became easier. So all the doctors were wrong. And there were a lot of them...

And since then I have been interviewing patients and found over 100 similar cases during a last year. They all tell the same story. And there are thousands more, I just haven't interviewed them yet...

How can it be misleading information if the source is from medical experts? One of many is well educated PT who has been 10 years in World Congress on Low Back Pain and the Pelvis.

[tonibunny]

Expatient.....it is only misleading in that you appear to claim that ALL cases of idiopathic scoliosis are caused by SI Joint dysfunctions.

Whilst some cases - including yours - may well be caused by them, it is misleading and wrong to claim that everyone's idipathic scoliosis is caused by the same problem.

[expatient]

Expatient.....it is only misleading in that you appear to claim that ALL cases of idiopathic scoliosis are caused by SI Joint dysfunctions.
No I did not say ALL! And there are other factors too, like subluxated/luxated hip joint. Do you know how many cases are not noticed from baby examiantions. More than 50%. And uncorrected hip luxation is one reason for scoliosis that starts developing since a baby starts walking with other leg shorter...

Whilst some cases - including yours - may well be caused by them, it is misleading and wrong to claim that everyone's idipathic scoliosis is caused by the same problem.
I agree. Only most of them.

[tonibunny]

Good :) Maybe you should explain things better in your posts, because you do seem to be arguing that hip/pelvic problems are the sole cause of "idiopathic" scoliosis.

[structural75]

Expatient,

http://dianelee.ca/
This is a Physical Therapist from Canada, member and editor for the Congress for Low Back Pain and expert in the field of pelvic and spinal dysfunction and rehabilitation. She's written several up-to-date books on Pelvic and SI joint dysfunction and conducted research and studies on the matter. You can find many insightful articles on her website.

While I agree that SIJD can be a significant source of problems for people, it's also important to recognize that pain, discomfort, improper mechanics, "subluxations, etc. of the SI joint are reflections of a larger problem/imbalance in the body. Pelvic torsions, spinal curvatures caused by 'other' factors, rotations and/or foot, knee or hip problems will potentially all give rise to SI joint dysfunctions. The SI joint should never be examined and treated in isolation from the rest of these factors because its integrity and function is reliant on all the rest. It happens to be a vulnerable joint(s) because it is the only place where the weight of the entire upper body rests on the lower... those two joints bear the weight of the whole spine, ribcage, head and arms. Tremendous forces are at play here and if there is a discrepancy in function or balance elsewhere in the body these joints will become fixated or hypermobile to accomodate that.

In scoliotic spines it is not uncommon or unreasonable to find SIJD for this reason. Manipulation of the joint often brings relief to people and often is temporary and requires constant attention.

Static imaging is not suffice to analyze SI joint function or dysfunction. Someone can have a perfectly healthy and functional SI joint with pelvic asymmetries or torsions. Movement determines function (or a lack thereof), not static pictures. Although they can provide useful information and give reason for further inquiry, they don't define the condition. Also, what if you were looking at another aspect to those pictures.. couldn't you also suggest that the pelvic asymmetries you're seeing are the result of problems with the pelvic floor, adductor tensional imbalance, pubic symphasis dysfunction, etc.? It all depends on what 'part' you want to isolate.

Do you know how many cases are not noticed from baby examiantions. More than 50%. And uncorrected hip luxation is one reason for scoliosis that starts developing since a baby starts walking with other leg shorter... Also, some infants have neurologic deficits that inhibit the action of the hip flexors which will also result in SIJD.. but SIJD is not the cause of it. There are many factors that pre-exist the rise of SIJD... it is predominantly a consequence rather than the overwhelming cause. And although it may cause scoliosis in some, or may influence and perpetuate its progression in others, it is not the predominant cause if you look critically, comprehensively and deductively at the situation.

How can it be misleading information if the source is from medical experts? One of many is well educated PT who has been 10 years in World Congress on Low Back Pain and the Pelvis.I certainly don't refute your experience with this and I think it provides very useful insight into misdiagnosed cases. For you, this was the answer, and many more I'm sure will/have benefited from these observations and interventions.

But a word on how it can be misleading if information comes from a "medical expert"... not too long ago it was a common belief that the SI joints were fused and did not move. This was common and accepted belief throughout most of the medical community... now we know this is false and has been proven through various tests. So in the realm of SIJD and the body in general, be wary of anyone who claims to have the definitive answers to matters like this. We're all still learning, as advanced as we've become, and you can be certain that we'll continue to be confused... just on a higher level. I don't disagree with what you're offering up, just the fact that it is the predominant cause of ideopathic scoliosis.

[expatient]

Good :) Maybe you should explain things better in your posts, because you do seem to be arguing that hip/pelvic problems are the sole cause of "idiopathic" scoliosis.
Yes that's my fault. They are a cause only perhaps in 99%. And 99 times out of 100 they are misdiagnosed because doctors don't believe they can exist.

[structural75]

I believe they exist, but not 99% of the time.??? I wouldn't choose to go to a doctor to find the 'cause' of an ideopathic scoliosis (unless it would require lab testing for possible genetic influences)... Doctors are mostly concerned with treating the end result of disease and dysfunction... basically what they can see and quantify... prevention and causal approaches are low on the list of likely outcomes for treatment for them because it is extremely difficult and subjective to determine. And doctors don't like subjectivity.. it lays outside the scope of 'pure' science.

I find it interesting that if the numbers you present are correct... ? ...then wouldn't all of those people with IS who are being treated by chiropractors adjusting their SI joints be 'cured' of their scoliosis by now? Why, despite constant manipulation of the SI joint in these people is their curve not being corrected or slowed down? SI joint manipulation is one of the most common HVLA adjustments given to patients see a chiropractor.

[tonibunny]

It sounds to me, from what Structural said, that SI joint problems etc can themselves be caused by scoliosis. So, isn't it all a bit chicken-and-egg?

[structural75]

Tonibunny,

Precisely... many people with congenital and structural forms of scoliosis develop SI joint dysfunctions... with curvatures of the spine as such, it's somewhat inevitable... and some experience pain locally to the joint and some don't.
With these types of scoliosis it is obviously not a result of SIJD... so it goes to show that SIJD can be present but not necessarily the primary cause in ANY form of scoliosis, including ideopathic.

You said it best tonibunny... which came first, the chicken or the egg?

[expatient]

Precisely... many people with congenital and structural forms of scoliosis develop SI joint dysfunctions...
So why can't it be the other way around? What if sijd causes all that? And up there you said many sijd patients have pelvic torsion. Ofcourse they do! SIJD is causing it. Obviously you don't understand what sijd really is. You think it is stiffnes and pain? No it is not. It is that sij has moved and ilium/innominate has rotated and created pelvis torsion. You didn't even bother to watch the video in my first message...

SIJD is not pain or stiffnes. Pain and stiffnes are the symptoms of sijd and usually they are on the side of the healthy sij!

Start learning here:
http://www.healing.org/only-3.html

It is not logical that something comes from nothing like scoliosis. There is always a cause to it. If you don't know it, it doesn't mean it doesn't exist.

And the cause for sijd is taruma: fall, hit to buttock, accident, slipping, etc. Most people get it as a child and the pain comes after years of walking with non-symmtrical functioning pelvis. It stresses spine and deep muscles. Scoliosis is just a compensation curve for that twisted foundation of a spine so that body balance will hold.

[structural75]

Obviously you don't understand what sijd really is. You think it is stiffnes and pain???? ...when did I define SIJD as being pain and stiffness??? I said that pain is often a symptom of SIJD, either locally or distally.

So why can't it be the other way around? What if sijd causes all that? And up there you said many sijd patients have pelvic torsion. Ofcourse they do! Because it is well documented and common knowledge that structural scoliosis develops for a variety of reasons such as: ribs fused together during embryologic development, hemivertabrae (formation of half a vertabrae on one side of the spine), malformation of articular processes, etc... none of these have anything to do with the si joint initially. Invariably the scoliotic curve they create will more than likely lead to SIJD of some kind down the road, but rib fusions that limit one side of the spine from growing symmetrically with the other is not a result of SIJD... that's why.

On torsion... a true torsion is more rare than most think. There is usually an upslip, downslip, inflare or outflare... and you can have SIJD without a true torsion... in other words, with one of the aforementioned situations present and no torsion. In fact, the chiropractor that wrote the article you linked me to describes this quite plainly... the innominate slips UP or DOWN.. that is not the same as a torsion or anterior/posterior rotation and they can occur independantly from one another.

It is not logical that something comes from nothing like scoliosis. There is always a cause to it. If you don't know it, it doesn't mean it doesn't exist.I totally agree with you, things happen for a reason, whether known or unknown to our feeble intellects. But what I really can't agree with and let slide is this notion that SIJD is the cause 99% of the time.??? It's just as irrational to say that ideopathic scoliosis is caused by one thing. I think there are many causes for ideopathic scoliosis. We tend to treat this condition like a disease, as if it is the same thing for each person... scoliosis is a term used to describe a lateral deviation of the spine from its central axis. There are numerous factors that can cause this to happen.

I took the time to read the link you provided, and I find it a bit oversimplified. It's a typical description/premise for dysfunction as a lot of chiropractors would give. Everything revolves around the joint or the bones themselves, but there's never any mention of HOW the bones have moved or fixated into these dysfunctional positions or what is keeping them there. The sacroiliac joint in and of itself cannot create any movement whatsoever. It is the movement of the innominates themselves and the sacrum/spine that create movement at/within that joint. So if there is an upslip or a downslip it is imperative to look beyond the si joint and address the soft-tissue imbalances that are positioning the pelvis in this manner. That is exactly why "adjustments" have to be done repeatedly and the chiropractor you're getting this info from insists that people don't twist or move in certain ways while undergoing treatments... as they might "subluxate" the joint again. How about addressing the tissues responsible for the pelvic torsion, upslip, etc... ? Because the joint surfaces themselves are not moving the pelvis/sacrum.

Just to be clear here, the si joints only have about 4 -5 degrees rotational capacity at best and only a few milimeters if that in translation. (Remember, half of this joint is fibrous meaning that it doesn't slide.

We also utilize a method of muscle goading and relaxation. In this treatment, a lubricant, usually olive oil, is rubbed into the patient's lower spine, and the large muscle groups contiguous with the pelvis are then deeply massaged by the practitioner.You mean massage therapy? That's one of the brilliant components to this solution for SIJD and scoliosis????


And the cause for sijd is taruma: fall, hit to buttock, accident, slipping, etc. Most people get it as a child Not always.. and how does a fetus inccur trauma to its si joints in the womb, as you're suggesting in the cases of congenital/structural forms?

[structural75]

expatient,

I'm not in complete disagreement with you that healthy si joint function and pelvic stability is important and may be contributing in some manner. But the all or nothing stance excludes so many other potential legitimate factors/causes... many of which take precedence over the si joints (organ development, injury, infection or trauma, neurovascular, etc. - anything the body may be curving around to accommodate, protect or compensate for.).

Why wouldn't sijd cause scoliosis in everyone who has it... according to the article you posted, it's very common?

[structural75]

Expatient,

I'm sorry to have to say this, but I just finished reading some of your past posts on other topics and it's become shockingly apparent that you're sources of information are questionable at best. I don't know where you get this stuff from or who your chiropractor is, but you've been severely misled along the way.

In one post you claim carpel tunnel syndrome is caused by nerve impingment in/around the cervicals... that's more accurately related to thoracic outlet syndrome. In another you state that 'tennis elbow' is caused by nerve impingement as well... tennis elbow is the lay term for lateral epicondylitis (inflamation of the tissues at the lateral epicondyle... not nerve impingement.

It sounds as though you're getting a lot of your 'theories' from a chiropractor with questionable intentions and knowledge. Everything revolves around pinched nerves in the spine, subluxations, the atlas, the si joints, etc... .

Again, it's not to diminish the benefit you've received from these approaches.. but you stated earlier that your "scoliosis" was "mild" and "never measured". So it doesn't sound as though you fully understand the severity of some of these peoples cases... Adjusting the si joint, the hip or changing a pelvic tilt is not going to offer much more than symptomatic pain relief for most folks. Chiropractic has value, but in the case of scoliosis if you don't address the connective tissue restrictions that have developed over time to support and conform to the curvature, adjustments will be futile at best. (with the exception of a few).

It sounds as though you have a desire to learn about your body... I would recommend finding some new sources though. It's probably not a good idea to learn from a home video someone posted on the internet. :eek:

[expatient]

Expatient,

I'm sorry to have to say this, but I just finished reading some of your past posts on other topics and it's become shockingly apparent that you're sources of information are questionable at best. I don't know where you get this stuff from or who your chiropractor is, but you've been severely misled along the way.
No I don't have a chiropractor. I have seen few but they didn't know how to help me. I got my help from a doctor. And after that I started to look for more information and for more others like me. I have found hundreds of them..

In one post you claim carpel tunnel syndrome is caused by nerve impingment in/around the cervicals... that's more accurately related to thoracic outlet syndrome.
Yes I had diagnosed TOS a while ago. Its gone now.
So what is your theory for carpal tunnel syndrome? It is well known that if nerve is pinched it swallows... And when it swallows the tunnel it goes through gets tight.

In another you state that 'tennis elbow' is caused by nerve impingement as well... tennis elbow is the lay term for lateral epicondylitis (inflamation of the tissues at the lateral epicondyle... not nerve impingement.
Again that is your theory. I have seen and met many who have had tennis elbow and after one proper manipulative treatment the pain was gone. Treatment included sijd correction, opening thorax facet locks and some mobilisation for shoulder.

It sounds as though you're getting a lot of your 'theories' from a chiropractor with questionable intentions and knowledge. Everything revolves around pinched nerves in the spine, subluxations, the atlas, the si joints, etc... .
No chiropractor have helped me. They claim to know something but they can't do much...

Again, it's not to diminish the benefit you've received from these approaches.. but you stated earlier that your "scoliosis" was "mild" and "never measured". So it doesn't sound as though you fully understand the severity of some of these peoples cases...
My scoliosis was mild, but I have met many who were suppose to go to a surgery for their scoliosis. They chose not to go and are very thankful now to did so...

Adjusting the si joint, the hip or changing a pelvic tilt is not going to offer much more than symptomatic pain relief for most folks.
That is true. Many people tried to manipulate my pelvis but it did't help me. So many adjusments are done wrong. That is why many people won't get help. It's because they are adjusted by a poor expert. Only so few really can do the adjustment. Many claim they can... Not every hockey player is a good player even how well they have been trained.

[expatient]

On torsion... a true torsion is more rare than most think. There is usually an upslip, downslip, inflare or outflare... and you can have SIJD without a true torsion... in other words, with one of the aforementioned situations present and no torsion. In fact, the chiropractor that wrote the article you linked me to describes this quite plainly... the innominate slips UP or DOWN.. that is not the same as a torsion or anterior/posterior rotation and they can occur independantly from one another.
Yes they slip up but no, they don't slip down. They also rotate and cause functional LLI/LLD that is causing more torsion. If one ilium is rotated and one is not, the pelvis gets torsion. But it can happen that both iliums are upsipped and no torsion exists but extended lordosis and many times later a spondylolisthesis.

It's just as irrational to say that ideopathic scoliosis is caused by one thing. I think there are many causes for ideopathic scoliosis.
Yes, SIJD is just one thing. Others are hip joint subluxations that are very common and often misdiagnosed even from babies.

Just to be clear here, the si joints only have about 4 -5 degrees rotational capacity at best and only a few milimeters if that in translation. (Remember, half of this joint is fibrous meaning that it doesn't slide.
In normal situation things are as you said. But when it is not at it's place (subluxated) it can be hypermobile or opposite way as stuck.

You mean massage therapy? That's one of the brilliant components to this solution for SIJD and scoliosis????
Yes, to treat symptoms but not the cause...

[expatient]

Why wouldn't sijd cause scoliosis in everyone who has it... according to the article you posted, it's very common?
Almost everyone has scoliosis as an adult. In a study of one university in Finland they said 80% of young (17-20years) had some asymmetry in pelvis and spine and 30% of them had chronic pains and over 60% had had back pains sometimes...

One study said almost all league basket ball players had spinal scoliosis of small degrees indicating pelvis misalignments.

[tonibunny]

If most people have these hip/pelvic misalignments, may I ask why just a few people develop large scoliotic curves, whilst others simply have slight curves that are within "normal" range?

[expatient]

If most people have these hip/pelvic misalignments, may I ask why just a few people develop large scoliotic curves, whilst others simply have slight curves that are within "normal" range?
Because some people have worse sijd than others. It is a joint surface that can subluxate any amount from 1mm to tens of mms. And when your pelvis is badly misaligned and rotated you get more scoliosis. You can have S or C curve depending on how much it is subluxated and rotated or perhaps both are subluxated and rotated, but one is more than other.

And because it effects to your feet too, you can have leveled pelvis when standing. But when you lie down you can have pelvis in torsion.

[structural75]

It is a joint surface that can subluxate any amount from 1mm to tens of mms.In all of my clinical practice, lab disections and reading alike I have never seen this to be anatomically possible. Half the joint is fibrous.. in other words it is held together very, very strongly on the surface of the joint with dense connective tissue. It also contains surface irregularities that inhibit motion beyond a certain point (form closure). To "subluxate" as far as your suggesting would be absolutely debilitating and extraordinarily painful.

You can have S or C curve depending on how much it is subluxated and rotated or perhaps both are subluxated and rotated, but one is more than other. The jury remains out on the reasoning why some have c curves and some s. But it's safe to say that one influencing factor is the persons autonomic capacity to compensate or overcompensate (which would lead to an s curve). Because there are a lot of people out there with sacropelvic asymmetries and many don't have moderate or severe scoliosis, or any at all.

I do agree that most everyone has some degree of pelvic asymmetry, I don't necessarily believe this is a dysfunctional pattern in and of itself. SIJD usually occurs when one of the two joints becomes more or less mobile than the other, which in turn creates uneven forces and strain in one or both of the joints. Our bodies are inherently ASYMMETRICAL contrary to what we would initially think. This is evident when you look inside at the organs... they are not symmetrical in their development and placement (stomach on one side, liver on the other, one lung larger than the other, heart slightly off center and suspended on a diagonal, etc.). We all develop tendencies from the beginning for right or left handedness, one leg is predominantly postural and one more gestural (you'll see this in dancers who use one leg as their base for support while the other is used for articulate and graceful movements, etc). Asymmetry is not bad if it is countered throughout the body in a functional manner. It is only harmful if dysfunctional countering arises or the system incurs so much asymmetry that it can no longer adapt efficiently.

I think tonibunny's question on why some develop into scoliosis and some don't points directly to the fact that etiology of ideopathic scoliosis is numerous... there is more than one factor at play so with such a wide spectrum of variables as its cause you get a wide spectrum of effects.

Yes they slip up but no, they don't slip down.Yes, they do slip down.

So what is your theory for carpal tunnel syndrome? It is well known that if nerve is pinched it swallows... And when it swallows the tunnel it goes through gets tight.It's not my theory, it's just a fact. CTS is entrapment/irritation of the median nerve within the carpel tunnel of the wrist. As the tunnel narrows for a variety of reasons or the tendons passing through undergo repetitive strain they can irritate the nerve causing inflammation and further impingement. This happens at the carpel tunnel though, not in the neck. Yes, other problems up the arm, shoulder and neck can and often do contribute to the problem, but CTS happens specifically in the wrist. Nerve irritation in the neck will not cause the nerve to swell in the wrist.


Quote:
Originally Posted by structural75
In another you state that 'tennis elbow' is caused by nerve impingement as well... tennis elbow is the lay term for lateral epicondylitis (inflamation of the tissues at the lateral epicondyle... not nerve impingement.

Again that is your theory. I have seen and met many who have had tennis elbow and after one proper manipulative treatment the pain was gone. Treatment included sijd correction, opening thorax facet locks and some mobilisation for shoulder. No, that again is medical fact, as described in many, many medical orthopedic texts.I just gave you the medical terminology for 'tennis elbow'. It can be treated successfully... it's also quite possible that these cases you're referring to were misdiagnosed as tennis elbow when in fact they were nerve impingements at the elbow which would respond immediately to that type of intervention. Treatment of an SIJD will do nothing for tennis elbow... .???

And I agree, no two practitioners are alike.. even though they receive the same reputable training/education. Manual/manipulative therapies of the body are part science and part art. Not everyone has the skill required in their hands to be highly effective in successful treatment. That's the human variable meeting the scientific method. Logic and understanding may be sound but execution of it will vary greatly.

Scoliosis, or any condition for that matter, can't be reduced to one etiology such as SIJD. We see SIJD in structural and congenital cases where the cause is very apparent, so it's very safe to assume that it is also not causing the majority of other cases, but a secondary biomechanical effect. I'm not sure what else to say, ... ?

[expatient]

Yes, they do slip down.

I want to know how do you decide this: For example if you have left ilium higher than right when patient is lying, so how can you tell is the left lifted up or is the right slipped down? How can you tell? Do you follow the pain and diagnose that painful side is the one that has moved?

[structural75]

I don't want to take up other peoples time getting too descript about diagnostics, nor do I feel this is the appropriate place for it... but I can say this.

Down-slips are more rare than up-slips and often walking will correct it on its own. But in those cases where it doesn't self correct, you need to perform a standing stork test and/or forward bend, depending on other factors involved. Also worthy to perform a forward bend in the seated position as this will isolate the pelvis from influence in the legs to a degree. You're testing for si mobility in these test and looking for the restricted/fixated side. Using that info you gather from the standing test, the patient may then lay on the table and you can proceed with further analysis.

For instance, if a standing test reveals an si fixation on the right, then when laying down you determine the right innominate is lower than the left (checking the ischial tuberosities) then you have probably found a down-slip of the right. This is misleading sometimes if the lumbars have a type I curvature in them... one innominate will be drawn higher than the other, but not necessarily due to a fixation at the sij. Also need to consider and rule out any in-flares/out-flares/ and anterior/posterior shears, etc..

Torsions are possible as well but the above situations should be checked first as they are more likely than a torsion.

Hope that helps.

[expatient]

you need to perform a standing stork test and/or forward bend, depending on other factors involved. Also worthy to perform a forward bend in the seated position as this will isolate the pelvis from influence in the legs to a degree. You're testing for si mobility in these test and looking for the restricted/fixated side. Using that info you gather from the standing test, the patient may then lay on the table and you can proceed with further analysis.
If you are are doing flexion tests to someone and you can see left SIPS/PSIS moving more than right. Does it mean right sij is restricted and left side is ok? Or left side is subluxated and right side is ok?

For instance, if a standing test reveals an si fixation on the right, then when laying down you determine the right innominate is lower than the left (checking the ischial tuberosities) then you have probably found a down-slip of the right.
When many "experts" performed on me that fexion test they diagnosed stiffnes and restriction on right side. On lying my right side was lower. Then they tried to manipulate on my right sij. I was manipulated over 30 times during few years. Not much help. That's why I tried many different experts: PTs, chiropractors, osteopaths, naprapats,... Then I found a doctor of PT who did those same tests and said my left sij was subluxated and moved too much. And that was the reason for right side stiffnes and pain because on that side was longer leg side so that side carried most of the body weigth. Then he pushed my left sij (that was higher) down and all my symptoms were gone: no more back pain, leg weaknes, muscle stiffnes and even my breathing got easier and headache released. All that within few minutes. And all the others were trying to dislocate my right sij???

It's been 2 years now and I am still in perfect shape. And my legs have equal lenths. So the sijd is most often on the short leg side and the pain, stiffnes and restrictions are on longer leg side, that is the healthy side. The cause is not there where the stiffnes and pain is...

What do you think about that? And no, I was not a special case! I have interviewed (during last and this year) over 100 patients who have the same experience. Other side stiff and restricted but the cause was on the other side! They too have been manipulated on wrong side! After correcting the cause (one time was enough for most) from other side they have been without pains! Pains from buttock, groins, low back, upper back, ischias, achilles, knee, hip, legs feet,..

So, for my experience and for many others: down slip is actually an upslip on other side. And most "experts" make the same mistake and treat the same patient over and over again without much help.

Any comments on that?

[zuma]

Publish your findings then dude

[structural75]

Understanding ones individual case on the internet is near impossible... I can't make any claims about what your situation entailed without analyzing it in person... so this is all speculation.

If you are are doing flexion tests to someone and you can see left SIPS/PSIS moving more than right. Does it mean right sij is restricted and left side is ok? Or left side is subluxated and right side is ok?I don't know what SIPS is? In any case, when the person forward bends your thumbs are placed on the inferior slope of one PSIS and the other thumb is on the midline of the sacrum roughly. If the PSIS thumb moves superior relative to the other thumb on the sacrum during the forward bend then that is the side that is restricted... so if your left PSIS moved superiorly (rides up) during the test, that was the side that is actually restricted. They must be evaluated relative to the sacrum, not each other. It sounds as though the interpretation of the findings was inaccurate.

Down-slips do occur as I mentioned before but they are very rare relative to up-slips. If your left moved up during the test it didn't mean that it was more mobile, it meant it was fixated and being carried along with the movement of the sacrum during the bend rather then allowing the sacrum to articulate smoothly with the ilium.

"Subluxations" is a term I don't care for or believe much in... joints aren't generally 'in place' or 'out of place'. They have a dynamic range of motion unique to each of them... when this motion is inhibited or the joint is fixated in a certain position within that range then you get the problems that we call "subluxations". If a joint is "moving too much" relative to it's neighbors/counterparts it is not a "subluxation", but it's certainly a recipe for problems.

And your right, the sight of pain is not always the cause of the problem... pain should never dictate where you work in that manner. I don't treat people according to where their pain is... that is symptomatic work, not a causal approach.

[expatient]

I don't know what SIPS is?
Let me help you...
PSIS Posterior Superior Iliac Spine
SIPS Spina Iliaca Postero Superiore

In any case, when the person forward bends your thumbs are placed on the inferior slope of one PSIS and the other thumb is on the midline of the sacrum roughly. If the PSIS thumb moves superior relative to the other thumb on the sacrum during the forward bend then that is the side that is restricted... so if your left PSIS moved superiorly (rides up) during the test, that was the side that is actually restricted. They must be evaluated relative to the sacrum, not each other. It sounds as though the interpretation of the findings was inaccurate.
Sounds good. So why that one that moves more is called restricted?

Down-slips do occur as I mentioned before but they are very rare relative to up-slips. If your left moved up during the test it didn't mean that it was more mobile, it meant it was fixated and being carried along with the movement of the sacrum during the bend rather then allowing the sacrum to articulate smoothly with the ilium.
I believe you. Sounds logical.

"Subluxations" is a term I don't care for or believe much in... joints aren't generally 'in place' or 'out of place'. They have a dynamic range of motion unique to each of them... when this motion is inhibited or the joint is fixated in a certain position within that range then you get the problems that we call "subluxations". If a joint is "moving too much" relative to it's neighbors/counterparts it is not a "subluxation", but it's certainly a recipe for problems.
Well, terms are difficult to define. Let the name be whatever, upslip or subluxation. Let's say the system is in wrong position or something... Same thing can happen to shoulders. They are too much forward, mut is there a subluxation that cause it? Perhaps not, but the whole shoulder system has moved forward...

And your right, the sight of pain is not always the cause of the problem... pain should never dictate where you work in that manner. I don't treat people according to where their pain is... that is symptomatic work, not a causal approach.
Thank you. So many other experts follow always and only the pain...

Here is one procedure that is totally wrong:

Physical Therapy. Volume 82. Number 8. August 2002: Evaluation of the Presence of Sacroiliac Joint Region Dysfunction Using a Combination of Tests:
http://www.ptjournal.org/cgi/reprint/82/8/772
According to Table 3
(Description of the Interpretation of the Possible Findings for Each Diagnostic Test):
1. Standing flexion test: "Left PSIS moves cranially more than right PSIS (left SIJ hypomobile)"
-My left SIJ lifted, so it was hypermobile! (hypermobile = dislocated = SIJD)
This test alone should have given enough evidence that it was left SIJ dysfunction/dislocation!

2. Prone knee flexion test: "Symptoms are on the right side, the right leg appears shorter than the left leg in the prone knee extended position, and the right leg appears to be about equal to or longer than the left leg in the prone knee flexed position"
-I had the pain on right side and right leg was longer, so this test gives the wrong diagnosis to me: posteriorly rotated right innominate. Wrong diagnosis!

3. Supine long sitting test:< "Symptoms are on the right side, the right leg appears shorter than the left leg in supine position, and the right leg appears to be about equal to or longer than the left leg in long sitting position"
-Again I had the pain on right side and right leg was longer, so this test gives the wrong diagnosis to me: posteriorly rotated right iliac. Wrong diagnosis!

4. Sitting PSIS test: "Right PSIS lower than left PSIS (left anteriorly rotated innominate if pain on left side; right posteriorly rotated innominate if pain on right side)"
-This is the worst! I had pain on right side and left PSIS was higher. According to this test I had posteriorly rotated right iliac. Totally wrong result!

Many experts follow that procedure. Do you think it is correct? After all that is the procedure most "experts" follw as far as I understand...

[structural75]

Let me help you...
PSIS Posterior Superior Iliac Spine
SIPS Spina Iliaca Postero SuperioreYes, I'm very familiar with PSIS,PIIS,ASIS,AIIS... but I've never heard anyone use the Latin form SIPS... thanks though.

I think you misread this...

According to Table 3
(Description of the Interpretation of the Possible Findings for Each Diagnostic Test):
1. Standing flexion test: "Left PSIS moves cranially more than right PSIS (left SIJ hypomobile)"
-My left SIJ lifted, so it was hypermobile! (hypermobile = dislocated = SIJD)
This test alone should have given enough evidence that it was left SIJ dysfunction/dislocation! It says the left PSIS that moved cranially (superior) was hypomobile, not hypermobile as you then concluded. If your left PSIS lifted, it was hypomobile as stated above, congruent with what I had described in the previous post.

"HypOmobile means restricted motion... HypO = less, HypER = more... that's how a HYPOmobile joint can be labeled as restricted.

Hypermobility describes the relationship of something moving through a larger range of motion relative to its counterpart or the 'normal' expected range. It doesn't mean something is dislocated... although it might be more likely to happen to a hyper rather than hypomobile joint.

Tests 2 and 3 show that when the knee is flexed the tibias reveal roughly equal length... the bent knee aspect of the test is to isolate and reveal and length discrepancies in the tibias. Leg length discrepancies with the knee/leg straight will show either a functionally shorter leg as a result of innominate rotation/torsion, up/down-slip or a lateral tilt of the pelvis or sidebend in the lumbar spine. They don't necessarily have to involve dysfunction of the si joints. The other possibility is a structurally short leg or femur. But only an x-ray can accurately confirm this.

All in all, this procedure is led predominately by the presence of symptoms... which are always important to consider and acknowledge but does NOT provide for accurate diagnosis in any way. It just tells you where it hurts... plain and simple. The pain itself in one side or the other has nothing to do with the direction of tilt in the innominates. There can be pain present in either si or both in any position of the pelvic innominates.

It's sad to think 'professionals' are actually using this method for diagnosis... it's no wonder people have little faith and result from manual approaches by certain practitioners.

[structural75]

Maybe this topic of discussion should be happening on another forum??

[expatient]

Maybe this topic of discussion should be happening on another forum??
Where then?

[harmoniesdj]

Where to post indeed??? Right here, right now. I do not want to get into a debate on the subject. The info is needed. I am just grateful this topic was introduced.

HOWEVER about 7 yrs ago I bought a Si-Loc belt http://www.orthobionics.com/sn/back/siloclumbar.htm unknowingly thinking it would help me w/ pain in hips. It did and I wear it when doing housework & gardening. Showed doctor & he didn't acknowlege the problem.

Then got into MAT therapy 4yrs ago http://www.muscleactivation.com/main.html and completely got rid of all pain in hips & lower back. She did most of her work on the feet and hips. Never did I think SIJD was a problem for me but my MAT therapist always told me not to sit cross-legged. Every time I did the pain came back. After reading this post thread I see now I have a SIJD problem.

And it is more common than I thought. At a NSF Chapter mtg last month I wore the belt & had several scoli patients ask me about it for they had the same problem.

If it were not for the experimental custom prototype brace I wore in the late 50s/early 60s, modern bracing treatments of scolosis would not exist. Perhaps new ideas should be listened to instead of debated. I for one find it disheartening to be attacked on this forum for postings about new ideas. As scoliosis patients, we have this forum to help each other - not to be dissuaded by non-scoliosis people who have opinions. Walk a mile in a scoli's shoes (if you have the courage) and then talk.

[structural75]

harmoniesdj,

Perhaps new ideas should be listened to instead of debated.

Wow... I have been in support of that idea since I arrived on this forum. I wasn't trying to 'silence' this topic, I just didn't see anyone else participating in the 'anatomy' lecture so I thought I'd discontinue my ramblings. ...?

In any case, I suggested ending the discussion as it was getting somewhat technical and I didn't think that most folks here would see a use for it... apparently I was mistaken.. sorry harmoniesdj...

I for one find it disheartening to be attacked on this forum for postings about new ideas. Again, I couldn't agree with you more...

I do think SIJD is a relevant factor for some people and many folks with scoliosis may suffer from an SI joint dysfunction... But keep in mind it's not the joint itself that is usually the cause of dysfunction... it is the alteration in pelvic and spinal mechanics that creates SI joint dysfunctions.

I work with musculoskeletal dysfunctions on a daily basis and experience has shown that sijd is more often a byproduct of structural imbalances, not the cause. And the proof is in the fact that when you address the cause (which is numerous, if not infinite in origin) the sijd resolves. If you're wearing a belt for sijd you are providing support to the dysfunctional sij, but it's not doing much to address the actual cause of the sijd... does that make sense... ?? I may not be articulating that very clearly. It's not unlike wearing a brace.. it doesn't speak to the cause of the scoliosis, it simply provides support for it, regardless of the cause.

I think the initial preposition put forth on sijd was that it was the cause of all ideopathic (and possibly congenital) scoliosis... and this is simply not true... no debate required. There is plenty of evidence to prove otherwise in many conventional and non-conventional clinical instances.

Healthy function of the si joints is almost entirely dependent on proper mechanics and relationships of the pelvis and the spine (sacrum, L5, L4, etc.) which in turn is dictated by the soft tissue balance coming up from the legs, into the pelvis and so forth... as well as neurologic functioning and visceral mobility. Scoliosis creates a discrepancy in these mechanics and therefore often leads to sijd. Keep in mind that the weight of the entire upper body (spine, ribs, head and arms) is bearing down and supported by just those two points... the si joints. The sacrum is wedged in between the two pelvic innominates and held together with ligaments. So you can begin to iagine how the function of these two joints would become compromised and problematic if the pelvis and/or spine were to lateral deviate from center, putting tremendous torque into this area in addition to the pre-existing weight.

In any case, hope that clears things up a little... I'm glad the belt has been useful... SI belts are pretty common and are used for a variety of causes resulting in sijd.

[structural75]

harmoniesdj,

As scoliosis patients, we have this forum to help each other - not to be dissuaded by non-scoliosis people who have opinions. Walk a mile in a scoli's shoes (if you have the courage) and then talk.No offense, but walking a mile in your shoes wouldn't make someone more educated on the matter (besides there are many folks out there with sijd without scoliosis). I was just offering my 'observations' and 'knowledge' on the matter at hand as a professional... "opinions" have little to do with this situation... the evidence is abundant, you just need to become aware of it. I wasn't "dissuading" anyone, I was legitimately questioning an outrageous proposition that all IS is caused by SIJD... Does that sound like a reasonable claim to you?

[expatient]

I do think SIJD is a relevant factor for some people and many folks with scoliosis may suffer from an SI joint dysfunction... But keep in mind it's not the joint itself that is usually the cause of dysfunction... it is the alteration in pelvic and spinal mechanics that creates SI joint dysfunctions.
Many experts say it is. So two possibiities: You are wrong or the others are wrong. Who decides who is right?

SI-dysfunction comes because other SIJ is not working properly. Reason for that is often malposition of the joint. It creates unlevelled pelvis and torsion. That torsion continues up to spine and to ribs. Perhaps that's why those ribs get stuck and curves come to spine. I believe so. So do many experts.

I work with musculoskeletal dysfunctions on a daily basis and experience has shown that sijd is more often a byproduct of structural imbalances, not the cause.
So what is SIJD? Is it pain and stiffnes on other SIJ? Or is that only a symptom of SIJD? What is the cause of SIJD?

I have been "working" as a patient for many years trying many different treatments of many different experts. Most of them explain things just the opposite comparing to other collegues. So who is wrong and who is right if everybody believes it to be some other way? You are just one of many trying to explane it differently. I am too...

If you're wearing a belt for sijd you are providing support to the dysfunctional sij, but it's not doing much to address the actual cause of the sijd... does that make sense... ?? I may not be articulating that very clearly. It's not unlike wearing a brace.. it doesn't speak to the cause of the scoliosis, it simply provides support for it, regardless of the cause.
Yes. It stabilises the movement. It prevents back muscles from overwork as they try to stabilize asymmetrical movement.

Scoliosis creates a discrepancy in these mechanics and therefore often leads to sijd. Keep in mind that the weight of the entire upper body (spine, ribs, head and arms) is bearing down and supported by just those two points... the si joints. The sacrum is wedged in between the two pelvic innominates and held together with ligaments.
Twisted pelvis creates discrepancy. As well as twisted pelvis creates scoliosis. Like you said: sacrum is the base and if it is not straight the spine can't be either. Scoliosis is a compensation of that malalignment of pelvis and sacrum.

If you see those scoliosis pictures, that are shown in every scoliosis site, they all have (9 out of 10) other ilium higher than other. But it is not because their legs are anatomically different. Otherwise a heel lift would correct it. It is because other ilium has an "upslip" and rotated.

If you see pictures of surgically straightened spine you see that iliums are usually still unleveled even spine is straight...

[structural75]

Many experts say it is. So two possibiities: You are wrong or the others are wrong. Who decides who is right?

SI-dysfunction comes because other SIJ is not working properly. Reason for that is often malposition of the joint. It creates unlevelled pelvis and torsion. That torsion continues up to spine and to ribs. Perhaps that's why those ribs get stuck and curves come to spine. I believe so. So do many experts.Who are these "experts"? Are they chiropractors who move bones without consideration for the soft tissue elements that are responsible for positioning the bones? Of course chiropractors will tell you that everything revolves around the 'static' alignment of the bones and that by moving them via "adjustments" they will somehow magically stay in place... without need to address the soft tissue that creates the torsions.
SI-dysfunction comes because other SIJ is not working properly. Reason for that is often malposition of the joint.Why is the joint not working properly? If it is because of "malpositioning" then what creates that "malpositioning"? The soft tissue creates it! Imbalances tensegrity of the soft tissue network causes dysfunction of the joint they are meant to align and move.... .So it's not the joint itself that is the problem, it's merely a consequential byproduct of the two bones malpositioning themselves and causing stress/strain on the biomechanics of the joint. I guess I fail to see how a joint (the relational point between two bones) can mysteriously move itself out of place.???

If these supposed "experts" are so knowledgeable, then why do they often fail to address this issue.. or propose that by adjusting the joint the soft tissue responsible for moving the bones will no longer be influential?
So what is SIJD? Is it pain and stiffnes on other SIJ? Or is that only a symptom of SIJD? What is the cause of SIJD?The causes are numerous... .
Twisted pelvis creates discrepancy. As well as twisted pelvis creates scoliosis. Like you said: sacrum is the base and if it is not straight the spine can't be either. Scoliosis in a compensation of that malalignment of pelvis and sacrum.What is "twisting" the pelvis??? That's at the heart of what I'm trying to explain here. And I've seen many uneven sacral bases and many don't cause a scoliosis.
If you see those scoliosis pictures, that are shown in every scoliosis site, they all have (9 out of 10) other ilium higher than other. But it is not because their legs are anatomically different. It is because other ilium has an "upslip".

If you see pictures of surgically straightened spine you see that iliums are usually still unleveled even spine is straight...Upslip is a descriptive term for relative positioning... not a disorder or condition. You see the supposed upslips or anterior tilts/torsions because the pelvis is attempting to regulate the imbalances... upslips and anterior tilts (which often resemble and upslip) are the bodies functional means to attempt to level the sacral base at times.

Surgical straightened spines often retain their pelvic torsion because surgery doesn't address that. All of the structural imbalances in the body, pelvis, legs and feet don't disappear just because the spine was surgically straightened. That is where I've proposed adjunctive treatments to be potentially very beneficial to people... even though they've had surgery to fix the spine in place it still often requires management of the rest of the body and its numerous compensatory patterns that arose from the scoliosis.


Who is right? Well, I'm not proposing that my 'opinion' is the gold standard. But I will suggest that the theory you're "experts" propse be re-examined because it leaves a lot of questions unanswered and some of it is implausible and simply neglects very important factors. There are many who agree with me on this and share the same ideas and clinical experience. The fact remains that many people have to go to get their SIJ adjusted on a regular bases in order to maintain comfort.... so if adjusting the SIJ would solve all these problems then why doesn't it frequently hold?

[expatient]

Who are these "experts"? Are they chiropractors who move bones without consideration for the soft tissue elements that are responsible for positioning the bones?
Actually first expert was a doctor of physiatry who corrected it from me. Second was an other doctor of physiatry, who recently published a research about it:
J Manipulative Physiol Ther. 2006 Sep;29(7):561-5. Reversible pelvic asymmetry: an overlooked syndrome manifesting as scoliosis, apparent leg-length difference, and neurologic symptoms.Timgren J, Soinila S.

That doctor Timgren has excellent site where he explanes subluxation as malposition of SIJ. And he explanes with pictures how it can effect to our spine from sacrum to atlas and to legs too. That Soinila is a doctor of neurology...

And the third source I found was a physical therapeutist Richard DonTigny who has a long history in the subject. He has been 10 years as a Member of Advisory board and World Congress on Low Back Pain and the Pelvis. He has written many documents about the subject.

And many other doctors can be found who tell the same. They are not chiropractors! Like doctors Chamberger, Amaral, Spidler, etc.

I guess I fail to see how a joint (the relational point between two bones) can mysteriously move itself out of place.???
It is not a mystery. Only a fall, slip, accident, traumatic force to buttock, etc. We have all had those as a child. But pains come after years of walking with twisted pelvis... Similar subluxation can happen like in Subluxatio capitulum-radii. It is well documented in medical science but most doctors don't know much about it. One medical library tells it is common in children. And it also describes how to correct it with manipulation. One other is TMJ as jaw subluxation/dislocation. TMJ is described in medical world form early years by Hippocrates and he also described how to correct it with manipulation. Still many doctors think it as a symptom of some disease if they see it.

The fact remains that many people have to go to get their SIJ adjusted on a regular bases in order to maintain comfort.... so if adjusting the SIJ would solve all these problems then why doesn't it frequently hold?
I also got tens of times that soft manipulation to correct my twisted pelvis. It didn't hold. But it will hold much better when it is moved back to its place with correct technique. Seems like only very few experts has that skill.

Ofcourse it is not like new anymore when it is once damaged. But I have been ok for over two years now and I haven't been careful at all.

[structural75]

And the third source I found was a physical therapeutist Richard DonTigny who has a long history in the subject. He has been 10 years as a Member of Advisory board and World Congress on Low Back Pain and the Pelvis. He has written many documents about the subject.How about Diane Lee, Physiotherapist and board member for the World Congress of Low Back Pain. Also author of several books on spinal and pelvic dysfunction... known today to be one of the leading experts on the topic due to her clinical experience and scientific research. She would disagree with the theory your Drs are presenting.

Actually first expert was a doctor of physiatry who corrected it from me.What did he "correct"? Do you realize how little movement actually ocurrs in the SIJ?

That doctor Timgren has excellent site where he explanes subluxation as malposition of SIJ. And he explanes with pictures how it can effect to our spine from sacrum to atlas and to legs too. That Soinila is a doctor of neurology...I don't think it's rocket science to have a DR explain what a subluxation is... sorry, but I really don't see the brilliance in that. Joints move and can become misaligned to various degrees... if these DRs want to peer deeply into the joint and try to find what's causing it from within then fine... par for the course. But until these DRs and yourself recognize that the bones are not moving or fixating on their OWN and that the position of them is representative of the inbalanced tensegrity of the larger system.... I'm afraid we're missing each others point.
It is not a mystery. Only a fall, slip, accident, traumatic force to buttock, etc. We have all had those as a child. But pains come after years of walking with twisted pelvis... Similar subluxation can happen like in Subluxatio capitulum-radii. It is well documented in medical science but most doctors don't know much about it. One medical library tells it is common in children. And it also describes how to correct it with manipulationActually "subluxations" are highly debated in science... And it's hard for me to believe that these Drs "don't know much about" why this occurs... A traumatic fall/impact trauma wil have tremendous effect on the soft tissue as well as displacing the bones. In fact it's the stabilizing and bracing response coupled with adaptive and compensatory patterns that follow that cause the chronic "twisting" of the pelvis. If that weren't the case then the two bones would simply slide back into their appropriate place.... (have you seen firsthand the inside surfface of the SI Joint? There's no 'locking' mechanism or such and it's movement is so slight that displacement is a relative term.
I also got tens of times that soft manipulation to correct my twisted pelvis.What exactly did you get? Massage is not going to correct those structural imbalances... I think I recall you talking about this before... one of the "Drs" you refered to was using adjustments along with massage techniques and such... sorry but massaging muscles won't do a bit of good for repositioning bony segments.

I think it would be useful to examine 'why' the adjustments "work"... what is happening physiologically to the entire joint structure and surrounding tissue network.... Joints are not to blame here, there function and relative relationships to the whole are the influential factors. I may not have nearly all the answers, but I am starting with an understanding that the Drs you point out don't seem to be considering.

[expatient]

How about Diane Lee, Physiotherapist and board member for the World Congress of Low Back Pain. Also author of several books on spinal and pelvic dysfunction...
But she seems to explain only how to find SIJ pain? If there is no pain in SIJ or low back then what would she diagnose?

known today to be one of the leading experts on the topic due to her clinical experience and scientific research. She would disagree with the theory your Drs are presenting.
You can always find two experts who disagree, no matter what the subject is.

What did he "correct"? Do you realize how little movement actually ocurrs in the SIJ?
Yes. He corrected the position of that joint. It was "locked". But it was also moved out of its natural place. I gues few millimeters perhaps...


Actually "subluxations" are highly debated in science... And it's hard for me to believe that these Drs "don't know much about" why this occurs...
I have notised that too. And at the same time medical books are using that word on describing disorders..

A traumatic fall/impact trauma wil have tremendous effect on the soft tissue as well as displacing the bones. In fact it's the stabilizing and bracing response coupled with adaptive and compensatory patterns that follow that cause the chronic "twisting" of the pelvis. If that weren't the case then the two bones would simply slide back into their appropriate place.... (have you seen firsthand the inside surfface of the SI Joint? There's no 'locking' mechanism or such and it's movement is so slight that displacement is a relative term.
I have seen pictures. The surface is not slick. Once malpositioned it is not easy to move back. It needs a high force impact from the precise direction to slip and subluxate. And same time muscles must be relaxed. Like when you fall or are in an accident. So when that happens it is not easy to get back.

What exactly did you get? Massage is not going to correct those structural imbalances... I think I recall you talking about this before... one of the "Drs" you refered to was using adjustments along with massage techniques and such... sorry but massaging muscles won't do a bit of good for repositioning bony segments.
You remember wrong. No massage!

It took over one hour for the doc to find out what was wrong with me. He diagnosed scoliosis, TOS and migraines. But when I said my legs were weak and sometimes I got cramps to my toe then he decided to check my pelvis.

He palpated me while I did flexion test. Picture! (http://www.selkasivut.fi/selka/kuvat/testi1.jpg) During flexion my left SIPS lifted more than right. Also he diagnosed that my crista iliaca was leaning left while I was sitting.

The doctor pushed my left ilium down while I was lying on my stomack on his treating table and my legs were hanging outside. He used quite much power doing that but it was fast, only about 3-5 seconds.

After a minute I felt strtength coming to my legs and standing was much easier. Pelvis felt lighter and in flexion I could reach the floor first time in 20 years.

First correction hold 3 weeks. Then one morning I woke up and my legs felt weak and tired. And soon back pain came back to my right side. Also burning pain to right SIJ. So I called and asked a new time to same doctor. I was lucky to get a time to same day because someone had cancelled.

The doc was first angry and said it is not possible to be out of place again. But I asked him to recheck. Then he did same flexion tests and saw the same: left SIPS lifted more. Same correction and it held few days. Then the same symptoms came back: leg weaknes, right SIJ pain, muscle burning on middle of the back left side under shoulder blade and on neck right side.

Then I tried to call the doc again but he had started his summer vacation and next free time was after 3 months. I was unhappy but I understood what was wrong. All I needed was to find someone who knew how to correct it. I already knew local chiropractic, naprapath, osteopath and PTs didn't understand about this because I had been seeing all of them many times before. They all treated my pelvis twisted pelvis, but only by stretching or "moving" it with different techniques.

Then I explained the situation to my collegues at work and one man said his mother had the same problem and he went to one PT in the other city. I looked for his name and called him and went to see him. There I was explaned what was wrong and how it effected me. He also corrected my shoulder problem and migraine. No more TOS. For SIJ he used this technique (http://www.youtube.com/watch?v=BYSjorETvro).

I think it would be useful to examine 'why' the adjustments "work"... what is happening physiologically to the entire joint structure and surrounding tissue network.... Joints are not to blame here, there function and relative relationships to the whole are the influential factors. I may not have nearly all the answers, but I am starting with an understanding that the Drs you point out don't seem to be considering.
No muscle massage was used. After the treatment the new posture was felt clearly. And my legs were even; no more short left leg and pronation problem. My walking changed.

I just wish someone would study this more. That is why I study and write about this. That doctor, who corrected me, is an old man. I hear he have had many visitors since I have started to write about this. Also that PT who did the 3rd correction have had many visitors to follow his work and learning his techique. Even medical experts. But they are very careful to start talking about this. Medical association can throw them out from the union and that would be the end of their carier.

One of my aunt's freind had had 10 years of pain after having a child. She had bad pains but no-one could explain them. She visited that PT and got perfect help. She had both SIJs misplaced. That is over a year ago and still she is 100% pain free. I have spoken to her many times since that and she tells that her husband-doctor is afraid to speak about this. He is just happy to get his wife back to normal. But he could easily see the postural change in his wife.

[structural75]

But she seems to explain only how to find SIJ pain? If there is no pain in SIJ or low back then what would she diagnose?She does a bit more than just that....

Yes. He corrected the position of that joint. It was "locked". But it was also moved out of its natural place. I gues few millimeters perhaps...What is "locking" the joint? Soft tissue fixates joints...

I have notised that too. And at the same time medical books are using that word on describing disorders..A good example of them talking out of both sides of their mouths. For decades the medical community wouldn't accept chiropractics partly due to its subluxation theories. An interview with a chiropractor and researcher who spent countless hours doing radiologic reviews (x-rays) was once asked if he had ever seen a subluxation on an x-ray... his response was "Yes, with my eyes closed".
I have seen pictures. The surface is not slick. Once malpositioned it is not easy to move back. It needs a high force impact from the precise direction to slip and subluxate. And same time muscles must be relaxed. Like when you fall or are in an accident. So when that happens it is not easy to get back.I have done numerous dissections and half the surface of the joint (the mobile portion) is "slick", consisting of hyaline cartiledge as in other joints... a gliding joint. The other half is fibrous meaning it is strongly adhered via dense connective tissue providing a pivot point of sorts for movement of the gliding portion to move around. Its malposition effects many other components of the pelvis including the hip joints, pubic symphasis and coccyx. When you fall in an accident most often the body is in a state of contraction to brace the fall... if not before, certainly upon impact do the tissues contract and prevent excessive movement of the joints. Although it may be too late at that point to prevent the movement, the tissue response remains long after the incident. We see this clearly when people sustain whiplash and feel "fine" immediately after the injury... the next day or two they wake up feeling as though they were hit by a train.

So to unravel all that trauma intelligent soft tissue/connective tissue/fascial work must be done in the right places at the right time with precise skill. This doesn't involve just working where it hurts or working randomly on 'tight' tissues... .

I don't doubt for a minute that you are doing better from this approach and the adjustments.. but you yourself saw your problems return following these adjustments... It's rarely ever that a simple adjustment is going to address all of the components of the problem. I happy that you're doing well and have benefited from the work of these professionals, but I see these sort of things being addressed in that manner all the time by PT's and chiropractors and they almost always return, with or without symptoms, or they return as strain in another area of the body because the torsion in the tissues was not addressed. I just can't buy into the concept that a specific adjustment is going to create miracles in that the rest of the system will just fall into place. There is far too much new evidence these days on the properties of fascia that shows that this segmental type of theory is severely outdated. It's time these Docs catch up with the latest research and re-explore/re-examine their theories on proposed mechanisms.

Just my thoughts on all this. In the end, I respect your success but I just can't buy into the be all, end all nature of your theory on SIJ dysfunction and scoliosis. I hope others can benefit from what you've utilized... at the same time, I hope those Drs./PTs catch up with the times. A new perspective is not only sorely needed, but is already in action by a minority of Drs and health practitioners who can set their egos aside and practice truly objective and evolutionary medicine.

structural

[expatient]

She does a bit more than just that....
Yes her texts look good. But how she checks if the SIJs are in neutral position or not? She writes:
"If there is increased motion when the SIJ is in a neutral position"

What if motion is not increased? Does she compare them to each others? So what if both are off from neutral position?


What is "locking" the joint? Soft tissue fixates joints...
I'm sure they have a meaning in that. When upslip or malposition happens the ligaments hold the SIJ well in that new position. And only ligament or muscular treatment is not enough to move it back, especially if it has been out of place for years, since child. But ofcourse that treatment will release the tightness and pain. But they will come back...

And it may not be locked but still can be out of place. So how do you diagnose that?

What if 8yrs old girl is complaining heel pain and she seems to have bad posture, uneven iliums and other leg short but no pain or stiffnes in back or pelvis and she is very flexible.

I have done numerous dissections and half the surface of the joint (the mobile portion) is "slick", consisting of hyaline cartiledge as in other joints... a gliding joint.
I agree.

The other half is fibrous meaning it is strongly adhered via dense connective tissue providing a pivot point of sorts for movement of the gliding portion to move around. Its malposition effects many other components of the pelvis including the hip joints, pubic symphasis and coccyx.
But ofcourse. Many names for it's symptoms: PGP, piriformis syndrome, etc.

When you fall in an accident most often the body is in a state of contraction to brace the fall... if not before, certainly upon impact do the tissues contract and prevent excessive movement of the joints.
Most people are quite relaxed when they fall...

Although it may be too late at that point to prevent the movement, the tissue response remains long after the incident. We see this clearly when people sustain whiplash and feel "fine" immediately after the injury... the next day or two they wake up feeling as though they were hit by a train.
Yes that is how it goes with SIJ upslip or malposition: Pain and stiffnes can come after many years...

So to unravel all that trauma intelligent soft tissue/connective tissue/fascial work must be done in the right places at the right time with precise skill. This doesn't involve just working where it hurts or working randomly on 'tight' tissues... .
Yes. Don't treat the symptom but the cause. And the cause is not always there where the pain is.

I don't doubt for a minute that you are doing better from this approach and the adjustments.. but you yourself saw your problems return following these adjustments...
Yes, but it held for days. Other adjustments hold only hours. And after few real adjustments I have been pain free for over two years. Befor that I had like 30 times of useless adjustment treatment from few different experts.

It's rarely ever that a simple adjustment is going to address all of the components of the problem. I happy that you're doing well and have benefited from the work of these professionals, but I see these sort of things being addressed in that manner all the time by PT's and chiropractors and they almost always return, with or without symptoms, or they return as strain in another area of the body because the torsion in the tissues was not addressed.
I have interviewed over 200 patients with the same story as I have: chiropractor, PTs, doctors, etc. did not help then. They didn't get good, great or even perfect help before they saw the same specialist that I did. And there are hundreds of more like them but I just don't have the time to interview them all...

I just can't buy into the concept that a specific adjustment is going to create miracles in that the rest of the system will just fall into place.
Usually not all. You have to treat all the problems to get a great result. But even treating SIJ alone gives a good results. Some might need more muscular treatment to make it stay but there are cases where perfect help had been received without any muscular treatment. And they have been fine over a year now.

There is far too much new evidence these days on the properties of fascia that shows that this segmental type of theory is severely outdated. It's time these Docs catch up with the latest research and re-explore/re-examine their theories on proposed mechanisms.
But latest researcers don't know how to do that effectively. Like I sain: If a doctors tries to push ilium and it doesn't help he makes a conclusion that it is impossible make it work by anyone.

Just my thoughts on all this. In the end, I respect your success but I just can't buy into the be all, end all nature of your theory on SIJ dysfunction and scoliosis. I hope others can benefit from what you've utilized... at the same time, I hope those Drs./PTs catch up with the times. A new perspective is not only sorely needed, but is already in action by a minority of Drs and health practitioners who can set their egos aside and practice truly objective and evolutionary medicine.
This doc is talking about new times: Irwin Abraham, MD (http://www.irwinabraham.com/joint.php)