Sacroiliac

[msk101]

HI All,

I would like to ask the pelvic specialists amongst you about the merits of pelvic/trochanteric belts.

I have been interested to read the posts on this issue and know that pelvic girdle examination and treatment is not my strongest point. I have definitely found that troch belts can be really useful with SIJ pain in pregnancy and was wondering if something along these lines would be useful to provide some external stability to the pelvis thereby allowing strengthening exercises to be done more effectively if the pelvis is just too "unstable" to allow them otherwise??? but not as a long term solution as such.

Looking forward to your input.

Thanks
msk101

[sijproblems]

Hi sarah … sorry I was so self absorbed I forgot to look at what you wrote …

I think I know what your problem might be … you’re describing what happened to me which BH alluded me to. I can suggest that “perhaps” you might have your sacrum in anterior fixation on the left, which is accompanied by an upslip and a posterior rotation on the left. Or at least, at the very least, it sounds like you might have an upslip on the left which is causing all these muscles on the left leg to tighten up. Do you have knee pain on the left? Another question that I have is, no matter what you do, can you get your left SIJ to pop or not?

The symptoms you describe, shoulder pain on the right etc and all those tight muscles on the left leg is what I had … is it your left leg that feels shorter?

Regarding the right side, she told me that if the left is dysfunctional, the right side tends to “overactive” to compensate. But for me, this is all old news since now both sides of my pelvis are a bit of a dogs breakfast.

Anyways, hope this helps.

[sijproblems]

hi alophysio

firstly, sorry for my spelling. i'm an engineer so hopefully can be forgiven :-)

well, my history is long. but now, so much has happened ... i think i'd exceed my character limit on this website if i explained it all. originally it was a snowboarding accident in switzerland where i studied for two years. original pain was thoracic , left knee and left foot pain although i had no impact to the knee or foot in teh accident. i just realised that after the accident, i couldn't run at all without terrible knee pain. i realise now it was due to a biomechanical change in my gait as a result of a pelvic misalignment. initally i saw a few orthopedic surgeons and sports doctors, and chiros and physios in switzerland ... most of them associated with the swiss olympic ski team ... poor ski team. they'd do an MRI on my knee and couldn't find anything ... and and sports doctor and knee doctor finally refused to see me, they thought i was crackers. also i had this terrible shoulder pain and clicking of my ribs into my sternum and spine .. it was hell. then one of the doctors gave me a terribly lame diagnosis of arthritis and suggested a course of pain killers for like 3 months....funny hey.

finally i came back to australia out of dispair and desperation. went to see some chiros and physios again. until that time, i could still walk long distances with the misalignment (at this stage me nor anybody i saw knew all my problems was a result of a pelvic misalignment). anyways, in switzerlnad i was still able to hike for 7 hours in the mountains but i could no longer ski or run without knee pain.

anyways, back in oz, a few chiros, massage therpists, physios and exercise physiologist later, i saw a chiro who did an adjustment and created a very ugly situation in my left leg... i started to get symptoms like sarah was describing. then i went back to see him adn he did something which created an ugly situation in my right side of my pelvis. after that i could no longer walk for long distances... it was hell. that's when i started doing my own research ... three months later, i figured out that the problem originated in my pelvis. then i went to see some physios in my local area who had done a course ... but i think the problem was that htey failed to take into consideration teh orientation of my sacrum. what they did do subsequently created excessive posterior rotation of my left innominate and excessive anterior rotation of my right innominate. then i went to see well, MC and BH and then a few other physios and an osteopath and now i run on my own steam... since i got pain i never had before and i walk like ... really a bit funny... although, like it said, it's improved alot since i do my own diagnosis and adjustments.. the right anterior hip pain has practically gone.

my background is engineering ... i'm currently doing a masters ... but alot of my spare time and not so spare time is trying to get my hands on literature pertaining to lumbo-pelvic dysfunction ... so it's useful being at uni, having access to all libraries in australia and many on-line journals.

i plan to do a phd in the biomechanics of the pelvis starting next year. but obviously my supervisor has already suggested me doing many physio courses, which i will embrace with gusto. i have some understanding of how cells respond to load and tissue repair from my time studying biotechnology in switzerland.

thanx a mil

[sijproblems]

hi

sorry i was a bit mad yesterday ... as you can see. i went on a bit, can get like that sometimes ... where i put my focus upon the failings i've experienced so far. but that doesn't help me - blaming the shortcomings of others. i also know i'm not perfect and my impatience/desperation has probably gotten me in this worse situation... being persistant with physios etc. so i wanted to outline the problems now.

the original accident was january 1st 2005. i think that having my right ilium in excessive anterior rotation and possibly forward shear for about 8 months from nov 2007-june 2008 has created some soft tissue or muscle thing that's causing me to walk funny on the right (originally i felt no problems on the right for almost 3 years until i saw the chiro and physios towards the end of last year). walk funny ... well it's not so bad now but there's still something weird going on with the gait and i have pain in my right leg which seems to extend from hip to knee ... seems like a combination of ITB and lateral side of hamstrings type area. also i have SIJ pain on the right but that occurred after too much manipulation on the right to try to get these shear/rotation out of hte right side. there are some schools of thought that say that anterior shear of the ilium is not possible but i know what adjustment caused that sensation in teh first place so i don't know ...

my left leg feels short and my right leg long. despite the fact that i think now that my right side might be slightly posteriorly rotated and/or outflared (again ... i know some schools of thought who say on outflare is not possible ... but that's what i see). but i don't move it from that position at the moment.

lying down, also, no matter what, my right ILA is inferior (no matter how much i try to push it superiorly), and well, if i can trust what my friend says, anterior ... but there have been periods where it's been stuck posterior no matter what. i understand that this could be a piriformus thing and also i was wondering, since the multifidis attaches there ... if it could be keeping the ILA posterior at that location ...

i know BH also can attribute tightness in the coccygeus muscle to some things witnessed by some in the orientation of a sacrum. but i have't had enough experience to know.

my sacral suclus is deep on the right, no matter what i do. the ichial tuberosity on the right is inferior (so this combination of inferior right ILA and ichial tuberosity could be what's causing the right leg to feel long, despite it's slight/possible posterior rotation). so that leads met to think that there could be some ligament stuff going on at L5/S1 which is allowing the right side to be inferior.... but my QL is tight on the right ... which in theory lifts the back of the iliac crest superior, which could keep my right side in an anterior position despite when i see it posterior when lying down.

thoracic pain is excessive ... but BH corrected a right superior first rib and posteriorly fixated 3rd and 4th ribs. not sure if it worked, still feel a bit of pain there, which she attributed to overactivation of the upper abdominal muscles ... i know that i do overactive the upper abdominal muscles.

i am also hypermobile in some muscles and not in others. abductors are sore but hypermobile, hamstrings are tight, tight, tight on both sides. piriformis ... the stretch indicates left is tighter but the physio told me the right is tighter. ITB is tighter on the left, despite this right leg pain from hip to knee.

so for the moment i don't adjust more my SI joints. (oops, pubic symphis is ok). now i focus on pilates to strengthen core and lengthen and strengthen limb muscles. also i get some massage to help me identify tight and weak muscle patterns to see if i can explain from this what i see in my orientation of pubic bones. i also conciously concentrate on my gait patterns to override modified motor control... i notice if i go off guard, muscle compensation patterns kick in more .. hence a more funny walk :-)

thanx a mil