New research: No such thing as "stuck" SI joint

[alophysio]

Hi Neuromuscular,

We can of course go on for hours about this.

I can use your arguments about your APAS against the OLST/Stork etc and vice versa.

Your "facts" about your APAS are not peer reviewed, nor published, nor statistically analysed so i would still call it "raw data" or "observations".

For researchers to acknowledge more research is required is not exactly a new concept...

To break down each subcategory in each main category would require thousands of patients...it aint going to happen - no one has the time or the money or the willpower to embark on a decades long project...case in point is your APAS - you are not even doing the research yourself but getting others to do it for you...!!!

This all started because of your statement "There is no such thing as a stuck SIJ" and i responded to the contrary and i believe your proposal has logical flaws which has been discussed.

The stork test is not superior to your APAS test nor is your APAS test superior to the stork test - they are both load transfer tests which measure movement at the pelvis in different planes.

As to your comments above, whilst you believe one muscle can be responsible for a problem in the pelvis, i think it is more realistic to acknowledge that muscles work in groups and there are synergies and it is impossible to put your finger on ONE muscle for the problem.

Also, you cannot ever be completely research-evidence-based in your practice otherwise you would have never come up with your APAS - it would be unethical to use your APAS to diagnose your patients because it has never (and still has not been) research tested, peer reviewed and published. So using that against the Stork test is plain stupid.

I have my own data, just like yours and my data is just as valid as yours. Therefore to say that the model i prefer has less data is simply stupid because it has as much research (actually much more research because at least some papers have been published and research done on different parts of the model) than your APAS.

I am getting upset sitting here simply because i can't believe you cannot see your own ignorance and arrogance in your statements!!!

You accuse others of tunnel vision and you cannot see yourself that you are stuck on your own model and your own tunnel vision and cannot acknowledge that the Stork test works on the Saggital Plane and your test works on the coronal plane!!

There is research on force closure, there is research on the emotional aspect of low back pain, there is research on form closure...

I AM NOT GOING TO DO YOUR RESEARCH FOR YOU - do your own work. If you don't know how to look up Pubmed.com, then learn how. I have given you hundreds of dollars worth of information for free.

The fact that you don't understand the model and thus dismiss it simply means you don't have an inquiring mind. Have you asked "how does this work"? Just because you have a limited evidence base to draw from doesn't mean that others out there don't have more to offer...

Buy the book or go borrow the book "The Pelvic Girdle" if you want more information. It is easily found in a university library if it an institution that educates physios. Otherwise Amazon is a good source...and before you cry poor, researchers often have to source their references for their research so if you seriously want your APAS model to be taken seriously, then put serious effort into understanding the competing theories etc.

Also, if you are going to cherry-pick your quotes, i will republish them fully for you...please note, there are tests that have withstood scientific scrutiny (unlike your proposed APAS test)...

So far, these are the only tests which have withstood scientific scrutiny for the
assessment of load transfer through the pelvic girdle; its primary function. Therefore it
is still not possible to be totally evidence‐based in clinical practice if evidence‐based
means only using those tests which have withstood scientific scrutiny. However, what
does evidence‐based practice truly mean? Sackett et al (1997) defines evidence‐based
practice as the process of integrating the best research evidence available with both
clinical expertise and patient values. Clinical expertise and the models which evolve
from it are still necessary to bridge the gap between what we know scientifically and
what we need to know practically to treat patients with pelvic girdle pain.

In Summary
- there is published research to support the Stork test. There is NO published or properly run research to support the APAS.
- the stork test uses sagittal plane motion, the APAS uses coronal plane motion so becareful in direct comparisions
- don't write of a model because you can't be bothered to go find the articles yourself. I have given you plenty of references and they ALL have reference lists that you can go and investigate.
- Lastly, i don't know or understand why you fight so hard against something you can be collabortatively working to help?! There is no need to trash a model to make yours seem better. Your APAS test tests in the coronal plane - it did NOT add anything to my clinical practice and i have given it a fair go...have you given the stork test now that you have read the evidence (or have you) about how it works??

[neuromuscular]

Dear Alophysio:

I find it quite amusing at the strength of your passion to defend something. It is like Lady macbeth of which was said " Me think the lady doth protest too much!"

If you are so sure of your test methods and results, please calm down. I would surely not want to be responsible for you having a heart attack.

If you wish to continue to attack the APAS test by all means do so. I have no problem with you doing so.

It is of interest that I have had the most vicious attacks from AUstralia. I am not sure why? You say I am arrogant. Is that so - for questioning something that has not defined itself better? Really?

How much "form closure" have you found in reality? 10%? 20% 30% 40% 50%? or just how much in real time - in clinic? I can say that I have found no true form closure problems, even in patients over 70 years of age. Our brain has tremendous power that has been under rated. It can tune itself to many different structures. Our ears are as individual as our fingerprints, yet the brains still hears regardless of how the outer ear channels the sound into the inner ear. Do we think that the difference of form from one person to the next really matters that much? The Nazis had the idea that there was one ideal for everything. I do not share that view. Our brain can tune to a large or small SIJ; a may facetted one or a less facetted one; one with many ripples or few ripples. It will accomodate the SIJ as it finds it.

As for neurological, how often do you find it? 1%? 2% 3% 5%?
I would say from my experience that it is rare at best and marked by cerebral palsy, MS, polio or similar unless you include entrapped nerves or compressed nerves in this catagory.

I find mostly neuromusclar control problems. By this i mean guarding responses or protective spasm or adaptive shortening or whatever designation you wish to call it. Force closure in the sense of muscle "weakness" i rarely find as there is more inhibition than weakness.

As for emotional, most patients are distraught over their pain that no one has addressed than as a cause. It is more an effect of no relief than a cause of the problem.

Again sorry for your being distraught.

Don't take it so personal.

Best regards,

Neuromuscular