Sacroiliac

[sheri]

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

[Bikegirl]

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

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.

[Physio Dace]

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.

[Bikegirl]

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!

[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.

[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

[Bikegirl]

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

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.

(...)

[Bikegirl]

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.

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.

[Physio Dace]

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

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.

[neuromuscular]

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.