Sacroiliac

Hi Bikegirl, yep its indicative for hyperventilation syndrome. the pass/fail is 23 so as an indicative marker, so you scored below the diagnostic indicator.. However, with a score like yours I would probably look at stuff around you breathing pattern. The basic idea is that diaphragm function is not just important for the gas exchange stuff, but it is very important in maintaining core stability (sorry alophysio!). for example your breathing pattern should change when you are going to lift something, this relies on normal diaphragm movement. The diaphram, pelvic floor muscles et al. should work in an almost orchestra type way to maintain spinal stiffness my maintaing intraabdominal pressure. If you have a stiff thoracic spine/ribs if you use the neck and shoulder muscles for quiet breathing, i.e. they are dominant it cannot do this. have a look at "Hyperventilation and the body" c gilbert in A & E nursing 1999 vol 7 130 to 140 and "understanding breathing" by leon chaitow in massage and bodywork june/july 2007 28 - 40. It might not give you the answer as to what is going wrong with your SIJ, but it might give you a why. Other thing to look for with breathing pattern disorders are frequent sighs, yawns holding your breath, the need to speak quickly inbetween deep audible breaths, inability to breath nasally.

pleasant reding
gwynn

Hi,

Thanks for your post.

I will take a look at the book you suggested even though I believe the breathing problem is a symptom of my Sijoint condition. I don't hold too much importance for my score of 22 and that test as it is very general. Symptoms described on there can apply to many different conditions, I do not think they are very specific. As you said: its indicative for hyperventilation syndrome, to me a syndrome is not a cause but a side effect of something else.

I understand the relation of the diaphragm with muscle balance. It is easy to understand that any muscle working improperly will create all kinds of imbalances in the rest of the body. The hardest part is finding why it creates that and where it is coming from. Most people stop at one symptom and treat that specific area instead of making correlation of it all and understand the full pattern in order to correct the root of it. An Si joint injury creates all kinds of tightness and pain around the body and mimics many other different condition.

Have a good day.
Bikegirl

Try the test for APAS in my area.

It will tell you if you truly have an SI joint problem.

I do not find any test of the supposed stuck or fixated SI joint that hold up to this test.

Best regards,

Neuromuscular

Bikegirl, what happened with the physio you were going to see? I am most interested in what he had to say.

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Originally Posted by sheri

Bikegirl, what happened with the physio you were going to see? I am most interested in what he had to say.

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Hi Sheri,

The Physio I am seeing first saw:

1- Atrophied multifidus and transverse abdominus
2- atrophied glute med (right side)
3- right foot supination (my big toe wasn't touching the floor)
4- torso rotation due to internal oblique
5- inter-vertabral muscle tension from L5/S1 to cervical vertebrae
6- anterior rotation of pelvis
and more I can't remember exactly

after about 7 months of physio treatment twice a week a lot had improved

I am now seeing him once a week and I have still some stuff to be worked on. We kept finding new things as we were moving along.

Humans are not perfectly symmetrical - the more you look for faults the more you will find and the more money you will be spend trying to fix the unfixable (and most likely not broken anyway).

Thats a long and quite "inflammatory" list of "problems" and a hell of a lot of treatment sessions - I would only hope that the last say 5 months has been focused on using your own body and movements to address them and not thru manual therapy techniques. Best of luck into the future.

What a wise reply that means absolutely nothing!

Your opinion isn't worth much when you give it without knowing the patient history and without having seen the patient.

But anyway!

My comments were not meant to disrespect - and I wholeheartedly apologize if they did. I just get concerned when I see the use of body asymmetries as a justification or rationale for long term manual treatment. There is no evidence to support such an approach.

Regarding "without seeing the patient" comment - this forum, as you can appreciate, does not afford for such luxuries and so many of the comments posted can appear negative and taken out of context but I think most members intentions are in the right place, as were mine. I'll make sure to check my step before getting up on the soap box next time.

I do tend to agree with physiodace. you have a really long history and you likely would gain just as much if not more benefit with say a pilates program for your aforementioned problems (perhaps an orthotic would help with the supinated foot althought that might come right with correct pelvic function) as you would with hands on treatment. you are at a stage where you need to retrain your nervous system to work correctly. hopefully you can manage one supervised pilates session a week or fortnight with unsupervised sessions between, saving either you or your health fund a whole heap of cash!

keep us posted. if you are involved in a pilates program could you please send me some exercises you are doing as i am very interested in pilates for pelvic dysfunction. somewhat of a novice in the area :)

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Originally Posted by Physio Dace

My comments were not meant to disrespect - and I wholeheartedly apologize if they did. I just get concerned when I see the use of body asymmetries as a justification or rationale for long term manual treatment. There is no evidence to support such an approach.

Regarding "without seeing the patient" comment - this forum, as you can appreciate, does not afford for such luxuries and so many of the comments posted can appear negative and taken out of context but I think most members intentions are in the right place, as were mine. I'll make sure to check my step before getting up on the soap box next time.

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Thanks for this.

You are allowed to be concerned, but I do no think you are right in this case. I don't know in which book it is written that there is no evidence for long term manual therapy, but I can pledge that textbook stories are being written and lived everyday,as I am one.

You are allowed to your own opinion and you are right when you say that you should check your step before getting on the soap box. Your opinion is just wrong in my case, I need the manual therapy.

Quote:

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Originally Posted by sheri

I do tend to agree with physiodace. you have a really long history and you likely would gain just as much if not more benefit with say a pilates program for your aforementioned problems (perhaps an orthotic would help with the supinated foot althought that might come right with correct pelvic function) as you would with hands on treatment. you are at a stage where you need to retrain your nervous system to work correctly. hopefully you can manage one supervised pilates session a week or fortnight with unsupervised sessions between, saving either you or your health fund a whole heap of cash!

keep us posted. if you are involved in a pilates program could you please send me some exercises you are doing as i am very interested in pilates for pelvic dysfunction. somewhat of a novice in the area :)

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You have the right to agree with physiodace, but are wrong too. The pilates is not helping at all, in fact, it is doing more damage ( I've been through it many times! I tried yoga, pilates name it I have tried it). I am not at the point of retraining my nervous system to work properly yet, I am still in too much pain and I still need a lot of manual therapy.

Everyone I met prior to meeting my current physiotherapist advise me just the way you did and it just caused a lot more damage and pain. A LOT of pain and damage. Perhaps, it is question of perception or just understanding what manual therapy is as opposed to all other types of physiotherapy...

Anyway, at this point I do believe that some people just don't get it or will only get it no other way but theirs....and that's why it took so long to find a good pt to help me out of this. It just happens that I found the best PT in the province, that's why I am getting results. Results I was expecting from all the others I've seen before, but they just didn't have the experience needed and the knowledge needed to work with me. They got stuck in their way of seeing things instead of evaluating, observing, trying things and getting results.

(...)

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Originally Posted by Bikegirl

Thanks for this.
Your opinion is just wrong in my case, I need the manual therapy.

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Opinions are just that - they are neither wrong nor right in any case. I did not say that what you or your physio were doing was wrong - it sounds like your are improving and thats all that counts; I was merely showing my concern regarding long term hands on and thus passive management of persistent pain states and that in most people (not all) this approach tends not to work in the long term. However I hope you prove us all wrong. Best of luck and sorry for any offense.

Dear Bike girl and all:

I do not agree with the SIJ being a big causing factor in the majority. Conditioning of viewpoint has lead to most looking for this in patients.

To use one example, the book Movement, Stability and Low Back Pain has over three pages on SIJ and nothing on the adductors.

In a recent issue of a Helath magazine, it was reported to me that there is new research other than my own that indicates that the adductors may be the larger cause in low back pain than previously considered.

There are numerous factors.

I just gave a presentation on the test that I have been using in assessing the pelvis to a group of physiotherapists in Seattles. Washington, USA, who had Masters and Docturate degrees. The reaction is very positive and they are incorporating the test in their routine.

You might consider having a physio check you for asymmetry of pelvic angles or differring of innominate bone positions as you do hip ABD.

My idea is forget SIJ and look elsewhere. It has been my experience that SIJ problems are the effect and not the cause of the problem.

Best regards,

Neuromuscular.

Dear all..... we all (physios/chiros etc) all have our own pet theories as to which bit is dysfunctional, and consequently our favourite techniques are directed towards them. However, there is more then one way the crack a nut (or treat and sij! - if you believe in them). The key point for us as therapists is to be open to new ideas and others perspectives, as may not be wrong, they just have a different view.

Dear Gwynwallace:

Well said.

Ths person bikegirl seems frustrated that she is sent back to the same idea over and over again.

I might suggest that the newer test for innominate bone position be tried. By the physio mapping the bone position as the patient does hip ABD another approach might result. Maybe something has been missed.

Best regards,

Neuormuscular

Dear Bikegirl,

I want to, in my heart, suggest that such long manual therapy is not necessary but i have seen too much in my professional career to be able to suggest it.

The reason why most people tell you things like that is because there are plenty of studies to support that position. However, in NONE of those studies did they suggest that NO ONE gets better.

Therefore as far as i am concerned, if you feel better, then great!

As for my on ego - i would love to think that i could "do a better job" but the reality is that i can't fix everyone and sometimes people have to see someone else with a different approach. That is ok because my main aim is to a commitment to lifelong learning... as you have no doubt learnt a lot from your experience.

Good luck to you and i hope and pray you get better soon.

Cheers