pelvis out of alignment on both sides

[neuromuscular]

My physio has told me that my pelvis is twisted on both sides - the right side has slipped forwards and the left side has slipped backwards. I was just wondering how common this is, and also any idea what might have caused this to happen? Was it caused by an accident (I ride horses and have had many falls over the years), or is it just the way my body has developed? (I am 39 but I reckon I have had this since I was a teenager)

I also have other imbalances - right leg longer than the left, scoliosis with head off-centre etc. I'm assuming these are all connected, but I don't know which came first!

u

Dear Caz:

In your other post you mentioned that you have scoliosis. From my research, it has often been that people with two different pelvic angles such as you are describing have scoliosis.

As the acetabulum is not in the center of rotation for the innominate bone of the pelvis, the rotation causes a functional differring of leg lengths. This puts the body on a slant or slope. Which, in turn, causes compensations which lead to scoliotic patterning.

Hope that you find this helpful.

Best regards,

Neuromuscular

[caz]

Many thanks for taking the time to reply - what you say makes perfect sense. I think I've got more information from this site than I have from the health professionals I've seen to date! I had one GP who refused to believe I had a problem and just told me I 'looked quite straight' (without examining me of course!). My own GP recognises I have scoliosis but doesn't seem to think this could cause me pain so is unsympathetic about my situation. The 3 physios I've seen have been lovely, but have all dismissed me after a couple of months, saying they can't do anything for me.

I don't even know what is causing the pain - the physios seemed to think it was the twisted pelvis causing the pain, whereas another doctor I saw said it might be a problem with a disc.

I find it quite distressing at times, although I do my best to get on and make the best of things - I'm not the sort of person to sit around complaining and I'm doing everything I can to help myself - I do pilates and yoga, I have joined a gym to improve my general fitness and I take Alexander Technique lessons to help with my posture. But unfortunately I'm still in pain, with a GP who thinks I'm a hypochondriac, and I don't know where to turn next. I'm not sure if it is worth trying a private physio, or whether I should just accept that nothing can be done...

Anyway, many thanks for your interest in my case - it is most appreciated.

[neuromuscular]

Many thanks for taking the time to reply - what you say makes perfect sense. I think I've got more information from this site than I have from the health professionals I've seen to date! I had one GP who refused to believe I had a problem and just told me I 'looked quite straight' (without examining me of course!). My own GP recognises I have scoliosis but doesn't seem to think this could cause me pain so is unsympathetic about my situation. The 3 physios I've seen have been lovely, but have all dismissed me after a couple of months, saying they can't do anything for me.

I don't even know what is causing the pain - the physios seemed to think it was the twisted pelvis causing the pain, whereas another doctor I saw said it might be a problem with a disc.

I find it quite distressing at times, although I do my best to get on and make the best of things - I'm not the sort of person to sit around complaining and I'm doing everything I can to help myself - I do pilates and yoga, I have joined a gym to improve my general fitness and I take Alexander Technique lessons to help with my posture. But unfortunately I'm still in pain, with a GP who thinks I'm a hypochondriac, and I don't know where to turn next. I'm not sure if it is worth trying a private physio, or whether I should just accept that nothing can be done...

Anyway, many thanks for your interest in my case - it is most appreciated.

Dear caz:

It must be very frustrating. I was told that I needed asurgery or would be in a wheel chair in ten years - that was over 30 years ago.

However, contact a physio or other professional who will take the time to do a pelvic assessment from all four sides and with hip abduction.

Then the most common treatment that I have seen to work well with what you describe is to treat the adductor longus and adductor magnus on the left and the psoas on the right. If you have someone who can do this see what effect it has on your pelvis and scoliosis.

The usual is that the pelvis levels and the scoliosis is moderated.

There is much more to do than just this, but it would probably make you much happier.

Best regards,

Neuromuscular.

[caz]

Thanks again - so it sounds like it is worth giving physio another go. All I need to do now is find a good physio who has a good understanding of these issues...

I'll let you know how I get on.

[caz]

Sorry to come back with yet more questions!

I spoke to my GP about this, and he discussed the full report from the last physio I saw. The physio had tried to correct the pelvic alignment but came to the conclusion that this could not be corrected because it was a 'long standing' problem, and was associated with scoliosis. The implication was that the structural changes are permanent so it cannot be corrected. I think she is right that I have been like this for a long time - I am 39 now and I remember back in my early teens there were signs that my body was out of alignment (even though I thought nothing of it at the time, and it didn't give me any pain so it wasn't investigated).

So if I have been like this since I was a teenager, is there any chance it can be corrected, now that everything else seems to have gone out of alignment to compensate?

My GP has said nothing more can be done, so I'll not get any more treatment from the NHS physios. I would be prepared to pay privately if it would help, but there is no point going down that road if it is the case that it is too late to correct my alignment.

I'd be interested to hear what you think....

[opihiman]

what are your pain behaviors like....When does it hurt more, and when does it hurt less?

OPI

[neuromuscular]

Dear caz:

I guess that I am of a different opinion.

*I cannot see that a pelvic misailignment as permanent unless there is physical damage or neurological causes or some other factor that is a medical condition.* I have treaterd several people with long standing misaligmemnts with resolution of the misalignment in the majority that lasts unless there are ergonomic factors wich produce RSI or trauma injuries.

Many feel that idiopathic scoliosis is permanent, but opinions change as more research is done.* I am treating a paitnet with idiopathic scoliosis of forty years ago and with the new research we are getting very pronounced changes that will be confirmed by an MRI in late December.

The assessment of the pelvis using the four sided test with landmarks and hip abduction give the necessary information to treat these type of problems.
Hope that this is of benefit to you.
Sorry that I am in* another country as your case would be of interest in the research project.
Best regards,Neuromuscular.

[caz]

Neuromuscular - yes, from what I've read about this, there seem to be very different opinions about the causes and treatment of scoliosis. I wonder if the UK is a bit behind in this idea that scoliosis (certainly as an adult) is permanent. So what I need to do is try to find an enlightenend physio who has done some of the research you've done and is prepared to try to fix the problem, rather than just deal with the symptoms. Yes, what a shame you are so far away - you seem to have a very good grasp of the problems and what can be done to help!

Opihiman - I have a continuous low level ache in my lower back and right hip -its never a sharp pain, its more like toothache - a deep, throbbing kind of ache. But sitting causes me the most pain, and I also find standing still is painful - in fact I just don't stand still, I tend to wiggle my hips and move from side to side, which helps a bit. Movement in general seems to help - so I am constantly changing position. The most comfortable position for me is lying on the floor with my feet on a chair.

So I have no idea what all that means - I'd be interested to hear your opinion!

[opihiman]

Does Lateral flexion stretching help or hurt more

OPI

[caz]

Bending to the right makes no difference, but bending to the left makes the pain worse.

Some further information, in case that helps you work out what is happening - I have no problem bending forwards, in fact since I've been doing my hamstring stretches, I can now touch the ground without difficulty although I do sometimes get pain when I straighten up again.

My movement leaning backwards is more restricted, and does cause me pain (across my lower back, but worse on the right side)

Thanks for your continued interest

[opihiman]

I would beg to differ on bending forward being OK. Sitting which is the flexed position held over a longer duration, and your HS stretching both cause you more pain. which would be an indication of and overall bad direction.

Lateral flex R on the other hand sounds like a possibility...try stretch out you lateral flex R. and see what impact it has on your other movements.

Good luck.

Bending to the right makes no difference, but bending to the left makes the pain worse.

Some further information, in case that helps you work out what is happening - I have no problem bending forwards, in fact since I've been doing my hamstring stretches, I can now touch the ground without difficulty although I do sometimes get pain when I straighten up again.

My movement leaning backwards is more restricted, and does cause me pain (across my lower back, but worse on the right side)

Thanks for your continued interest

[Canuck Physio]

Dear Caz,

Hi I became very interested after reading your case, the issue being that pain usually is a sign that there is some form of manifested dysfunction in the body that is telling us that something needs to be done to rectify it. Even if you have scoliosis True, there is no reason why you can't be placed into the best alignment against gravity for your current situation. The common fallacy these days is the belief that we can not change long term problems. Although it is quite obvious that these long term problems are exactly what we need to rectify;

a visual example to make point:



On the other hand, could you help us out by answering:

- When did your problem begin?
- What incident caused it? Trauma/Insidious Onset
- What happened initially, what did you do? Pain?
- Who did you contact/see? What did you do?
- Where did you go  admitted?
- What Rx did you receive – how did you feel? How did it affect you?
- What investigations did you have? What happened next?
- How were you before this incident?
- How have you been since?

How is:
- General Health
- Any previous similar injuries, surgeries, fractures?

Also this helps:

Bending to the right makes no difference, but bending to the left makes the pain worse. Great! a clue!

Some further information, in case that helps you work out what is happening - I have no problem bending forwards, in fact since I've been doing my hamstring stretches, I can now touch the ground without difficulty although I do sometimes get pain when I straighten up again. Pain! Where?

My movement leaning backwards is more restricted, and does cause me pain (across my lower back, but worse on the right side)Would be great to have a body chart about now ...

Can you describe the pain more spefically
- where is it,
- is it constant or intermittent
- Is there any time its not there,
- How bad is it at worst, how good at best?
- Is it improving, the same, or getting worse generally
- You mentioned some things that make it worse, any movements that make it better?

Also, if you can paste a body chart of your problems that would help a million.

Regards