Sacroiliac

[alophysio]

Hi sijproblems.

wow - that's lots of good info.

i will use point form as i find it easier...

1. I am hoping to challenge the idea that the problem is solely in the SIJ/pelvis area. Your history SCREAMS thoracic spine involvement. However, i take your point about the soft tissue changes after all these years but let me relate a story i have told before elsewhere on this forum...(sorry if you have read it before)...

This lady had something like 12 years of chronic back pain. Had great physios treating her. Had difficult standing up straight for 5 mins after rising every day. For over 12 years! She got assaulted by a patient who threw an outdoor setting bench onto her (pysch ward patient). Anyway, her FF was to the knees only with pain limitation - again for 12 years.

Literally 1 treatment restored her ROM to touching her toes. That one case had made me rethink the whole adaptive change concept which you outline above - real changes are possible quickly. Literally mins. I had 2 physios who were witnesses to the assessment and treatment (i was being assessed at the time).

2. You are spot on with the whole biomechanical change thing. A torsion in the pelvis (or thorax) will create lots of strain on those cartilage joints.

3. scoliosis and short leg feeling etc...tough to judge on that one. I certainly don't believe pushing around on the spinous processes will change that. You are an engineer, do the maths! We might be able to put ?kg of force through a short lever arm (maybe 3cm) - would that counteract the torque of your whole body weight and the tension developed in the tissues?? i doubt it.

I would prefer to work out if your scoliosis is structural (due to the bones) or postural (due to the muscles). Most people have a scoliosis without any problems. It is usually postural and responds well to exercise.

4. twisting the body - the main rotation of the spine comes from the T/S. You only get 3deg from each lumbar vertebrae and maybe 5deg from the pelvis if you add the 2deg each way. Another reason why i was thinking T/S.

5. muscle imbalance and remodelling and response to stress. The body is an amazing machine. Like the story above, i have seen things that theoretically shouldn't happen. I like to find the areas of stress and fix them because then the muscles and other tissues will settle down.

6. Feeling the right leg long and seeing no change in leg length in lying down do not create a confusing situation - it just means that in lying down your legs are not much different in *apparent* length and when you walk, you *feel* the right leg is longer.

I have changed gait and apparent leg length discrepancy by joint means (manipulation of "stuck joints"), by muscle changes (stretches, soft tissue releases), my motor control changes (coordination exercises then reasses) and with visceral releases (changing the fascial pull on bony structures).

in summary, I like to keep it functional... any other ideas out there?

[Bikegirl]

Hi everyone.

First of all I want to wish good luck to everyone with SIJ problems. I suffer from it too and I know how bad the pain is!

It all started from a fall on the coccyx 5 years ago. The pain was increasing by the minute. I seeked help with doctors, physios, massage therapist, Rolfers, acunpunctors, chiros etc.

I went through x-rays, scans, MRI and nuclear medecine nothing showed on the tests.

I met a sports doctor back in 2005, he assumed I injured ligaments in my right sijoint. I stress the fact that he said that I probably injured ligaments. He couldn't tell from a firm point because the tests he did didn't show anything, but the symptoms I had were pointing him towards the ligaments injury.

Those symptoms were and still are: feeling of short leg on right side, numbness in right foot sometimes in both (increased when I do cardio), a lot of coughing, light headed and vision of silver spot (like when you get up too fast), cramps in the abdomen and lower back, muscles pulling and tightness in lower back ,abdomen, legs and calfs, weird taste in the mouth, unable to sleep or stay in the same position for long periods, extreme fatigue, and the major one: pain around L5, sacrum and hip on the right side. If I touch my lower back towards L5 and my sacrum I can feel lumps, the Rolfer could undo them and it would bring my back to normal but it wouldn't hold. The doctor, also added that I would be hungry and would have to eat more than usual as the body required a lot of energy to heal this kind of injury.

He advised me to go to the gym and do as much cardio as I could. Ligaments are supposed to be healed by cardio workouts in order to stretch them back into place.

So I went to the gym, for 2 years I did a weight training program 5 days a week and cardio program 6 or 7 days a week. There is no words to explain the energy it took to do so, all the while working full time as a sales rep. on the road.

The doctor mentionned that I would go through the following phases:
1- improvement in my condition as I worked out
2- the lack of sleep would increase especially towards the end of the healing process
3- about half way into the healing process I would reached a point where I would no longer be able to workout due to the fact that my body would be too tired to recover normally -- I reached that point 2 years into the training in the summer of 2007
4- after that resting period I would have to go back to the gym to finish the process otherwise my condition would stay the same i.e with no more improvements
5- the remaining sensations and pains should go away as I keep working out.

I went through all these painfull steps and I was able to get back in the gym in August 2008 to start my cardio workouts and in September 2008 I started my weight training on top of the cardio. I don't work at the moment, because this is taking all of my attention and energy.

I am wondering if anyone out here experienced the same thing?

At this point, I still feel the pain and the numbness in my foot, but it is totally different then what it used to be. I see and feel improvements, but it is a very slow process. I still can not sleep well, I either can't fall asleep or I wake up 4-5 times a night. This is due to my back going into an active state. I can feel and hear the ligaments or tissues trying to get back into place, it comes with hot flashes or chills. If it happens during the night it wakes me up and must eat in order to go back to asleep, if it happens during the day I have to lie down and rest or sleep (if I can) and eat as soon as I wake up.

From all the specialists I have seen, the Rolfer acknowledged that something was wrong with my ligaments, but his treatments didn't work, all the physios couldn't figure out what was the root of the problem and kept working on muscles, 1 ostheopath acknowledge that something was wrong on my right side, but couldn't find anything else to help me, all acunpunctors found something on my right side but couldn't find anything to help me. All doctors I have seen except for the above mentionned, said that it was impossible that it could be my ligaments and didn't know what was wrong and wrote it off as a psychosomatic problem. Frustration frustation let me tell you.

I eat very healthy, 3 meals a day, 3 snacks a day (usually raw veggies and nuts) and sometimes eat when I wake up at night. I drink at least 3 liters of water a day. I avoid caffeine, sugar, unhealthy fats and processed food. Put it this way, I can not eat healthier or better, I took nutrition classes and seeked a lot of help, including a biochemist analyse to figure out what were my best options and I stick to it.

I welcome any comments, suggestion and so forth from everyone out here.

Deep down inside, my instincts tells me that I am doing the right thing with the workouts and that I am on the right path, but my mind always wonders. I would feel a load off my shoulders if I could find exactly what I have.

Thanks!
I look forward to your replies
Bikegirl