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  1. #1
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    Brief Medical History Overview

    Age: 51, Presenting Problem Since: Over a year, Symptom Behaviour: Seems to getting slowly better, but with flareups, Aggravating Factors:: Standing/bending, Easing Factors:: Time/stretching, No Investigations, No Diabetes, No history of High Blood Pressure, Medications: Lexapro, Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues

    Body Tilted Towards Left

    Hi there!

    I’ve got a lot of issues (such as piriforimis syndrome) that I’m working through, but I’d like to focus on trying to solve one particular irritating one

    1. When I lie on my back with knees bent, my right knee is higher than my left, and my torso is tilted slightly to the left, such as abs very obviously not orientated correctly

    2. It used to be worse; I’ve been doing strengthening/stretches on my hips/glutes/inner thighs, etc, and it’s less pronounced, but still there

    3. I thought I was adequately stretching my lower back (pelvic tilts), but turns out I wasn’t; my physio gave me new exercises: lumbar extension in prone, which I have been doing for the last couple of weeks

    4. I have problems with a sore/stiff/cramping left lower back, and a history of it coming on/getting worse if I’m standing/walking/bending over for a while, though it takes longer to happen with those stretches. It still flares up at times. When I lie on my left side it feels like that area is being compressed

    When I’m lying on my back, knees bent, and extend my left leg, I often get a clicking from my back, left lower, middle, I think

    5. I habitually sleep on my left side, with a ergonomic pillow between my thighs (designed for it). I can’t sleep on my back because my piriformis syndrome makes that unbearable after a time, and when I lie on my right side it aggravates the side of my right knee; I have a strong hunch this a big part of it, but I’m not sure what exactly, mechanically it has done to me.

    6. I suspect my left lower back may be weaker than the right. My left quadratus lomborum is, and my left hip flexor/gluteus medius was, strangely my right hamstring was weaker than the left, and I think my right glutes may be.

    7. I have a history of right sacroiliac joint problems, which are pretty much resolved now, a lot of work to where I don’t thrown them out all the time, and the physio said it was fine last time. Strangely, as I resolved my right sacroiliac problems, this new problem popped up, or maybe I just noticed it more due to not being so focused on my right lower back

    8. I asked my physio (I was there for a piriformis flare-up) to checked my pelvic alignment, and he said it was fine; we didn’t have time to into detail into what was causing it, and I don’t want to just rely on my appointments, since physios only have a certain amount of time to see you, and I have a history of complex problems, and like being proactive with trying to work out what’s going on and resolve it. I’d like to get some input on what may be happening, mechanically and, if nothing else, get ideas on what to ask my physio next time (in about a month)

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  2. #2
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    Re: Body Tilted Towards Left

    Is sidebending to right limited and is it painful on right side of back to sidebend right?


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    Re: Body Tilted Towards Left

    Quote Originally Posted by mmwr715 View Post
    Is sidebending to right limited and is it painful on right side of back to sidebend right?
    No, I can bend to the right with no issue


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    Re: Body Tilted Towards Left

    HI rainbowdragon008 and thanks for your post. Wow if seems you are really focused on all this. Firstly is it not unusual for people to feel a click if they pull their knees to their chest and then extend one leg. The snapping is not really a problem but may be the hip joint itself or the psoas complex 'flicking' over the anterior hip joint. It's possible that the EIL exercises will make that a little more pronounced as you work to releasing the hip flexors and allow more movement of the lumbar spine. Often there is excessive extension at the lower L4/5/S1 joints and what you need to do it restore more thoracolumbar segmental movement. Doing the same exercise with a seatbelt strap or even with the hands more forward will shift the focus up a little. You would also then add a shift of the pelvis laterally to see which EIL is tight with the same movement and work to release that, perhaps adding in a rotation to look over the shoulder at the top of the movement. And always reverse the posture into a child's pose or some other lumbar flexion position in between reps of the exercises.

    As you restore movement you need to also strengthen the abdominal complex to be able to stabilise the pelvis and be able to correct it in standing/walking if you fall into too much lordosis. It's a journey and a life long one at that. Your presentation is normal for 80% of the population at some point in their working life so be happy that this is the case. I do agree with the restoration of hip joint movement, e.g. in a deep bodyweight squat is important for longterm mobility and maintenance so perhaps you can use the ability to do that and how symmetrical it is an an objective measure for how you are progressing.

    Talk to your therapist about the next steps in the progression of their plan. This might also include lateral pelvis shifts in standing against a wall.

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  5. #5
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    Re: Body Tilted Towards Left

    Quote Originally Posted by physiobob View Post
    HI rainbowdragon008 and thanks for your post. Wow if seems you are really focused on all this. Firstly is it not unusual for people to feel a click if they pull their knees to their chest and then extend one leg. The snapping is not really a problem but may be the hip joint itself or the psoas complex 'flicking' over the anterior hip joint. It's possible that the EIL exercises will make that a little more pronounced as you work to releasing the hip flexors and allow more movement of the lumbar spine. Often there is excessive extension at the lower L4/5/S1 joints and what you need to do it restore more thoracolumbar segmental movement. Doing the same exercise with a seatbelt strap or even with the hands more forward will shift the focus up a little. You would also then add a shift of the pelvis laterally to see which EIL is tight with the same movement and work to release that, perhaps adding in a rotation to look over the shoulder at the top of the movement. And always reverse the posture into a child's pose or some other lumbar flexion position in between reps of the exercises.

    As you restore movement you need to also strengthen the abdominal complex to be able to stabilise the pelvis and be able to correct it in standing/walking if you fall into too much lordosis. It's a journey and a life long one at that. Your presentation is normal for 80% of the population at some point in their working life so be happy that this is the case. I do agree with the restoration of hip joint movement, e.g. in a deep bodyweight squat is important for longterm mobility and maintenance so perhaps you can use the ability to do that and how symmetrical it is an an objective measure for how you are progressing.

    Talk to your therapist about the next steps in the progression of their plan. This might also include lateral pelvis shifts in standing against a wall.
    Thank you!

    Yeah, I am determined to get as close to perfect posture/pain free as I can

    I dropped the ball once (stopped physio exercises), which led to my five years + of sacroiliac joint problems + other ongoing (like piriformis) problems and I do not want to do it again



 
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