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Reason for back pains, ischias, foot pains, stiff back, disc problems, headaches,.
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 27, 2007 2:12:00 AM
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Sebastian Asselbergs
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From: Barrie, Canada
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...and the cause for most divorces, global warming, autism and England's poor showing in the Worldcup
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Mundi vult decipi
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 27, 2007 2:17:00 AM
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Sebastian Asselbergs
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"Youtube" as a reference?!? LMAO. Tonska, you may want to look up the grading of what is considered scientific evidence. A single case on Youtube - wait for it.....- does NOT rank very high....
I have seen lovely videos of people swearing that the cow bone marrow "cured" their lunch cancer. Should we take all lung cancer patients out of the hospitals and give 'm bone marrow from cows?....
Oh hell, why do I even get into this? Must be a masochistic moment....
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Mundi vult decipi
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 27, 2007 4:52:00 AM
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FLAOrthoPT
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let's say all was well. but what does he do to reinforce the behavioral pattern and motor control to stop that from happening again. Manual therapy without nm re-ed is like 50% of the Tx. not that this guy didn't do anything after the video stopped, but i see too many manual based clinicians be it DC or PT stopping at that point. The why is the body in a torsion has to be addressed be it ground reaction force problems, leg length discrepencies, postural habits, poor recruitment, hs tension, etc, just throwing it out there because we all seem to be a bit manually biased on here, but just get frustrated when i get patients who got some decent manual tx but only like 50% of the problem being addressed.
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 27, 2007 6:49:00 AM
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jlharris
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And, of course, literature shows that SI ligaments are _calcified_ by about the age of 50, so subluxation cannot be happening in those populations.
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 27, 2007 4:42:00 PM
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FLAOrthoPT
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i would say that younger usually is hypermobile probs and older hypomobile/OA problems. Same with herniations, common younger, stenosis and spondylosis common elder. But the SI is a true source of pain even in the elderly, I think even a semi-fused SI when tweaked real good in a slip and fall in the elderly becomes relatively hypermobile compared the the opposite side and can be perceived as the body as a hypermobile segment with the corresponding guarding, tone, etc..
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 27, 2007 4:56:00 PM
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jlharris
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We also need to be careful to automatically assume LLD or "palpated" inomonate rotations, slips, flares, etc are unnatural and need to be fixed. Doing so puts us into the same boat as the orthopods and neurosurgeons fusing spines under the assumption just changing the structure will eliminate the pain. This may be absolutely true for some patients, but a perceived rotation or up slip is just that in isolation.
Additionally, we are _not_ symmetrical beings. We all have legs longer than the other, or one foot bigger than the other, and normal variations in the protuberances on our ilium. Just because a PSIS _feels_ higher than the other doesn't make it so.
BTW, all the palpation done on this fellow was done with him lying awkwardly and slanted in a prone position. Might as well put a book under one foot, take a standing x-ray, and then comment on how everything looks out of place, lol.
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Jason L. Harris, PT, DPT
My PT Blog
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 27, 2007 9:43:00 PM
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tonska
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Dear Sebastian. YouTube is only a place I put that video. The material in it has references to doctors and medical studies.
Dear Jason, legs only seem longer when you have twisted pelvis. Even X-rays lie because they are not 3-dimensional. If you take an X-picture from a patient's legs they can easily have LLD shown in picture if pelvis is twisted and other hip is closer to camera than other. And it is very common mistake doctors make...
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 28, 2007 3:51:00 AM
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SJBird55
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For you therapists out there... let me remind all of you that Tonska was a patient that proportedly had a sacroiliac subluxation that everyone missed, except one professional. Tonska's goal is to raise awareness of that particular condition. Very creative, Tonska, in choosing YouTube. That's exactly where I go for medical information! ;)
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 28, 2007 6:08:00 AM
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proud
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Tonska,
I may refer you to an article by peter Huijbrets: sacroiliac joint dysfunction: Evidence-based diagnosis. If you type that into google you can download a pdf file.
Your Youtube submission is amusing but hardly worth my time and effort. But as a responsible healthcare provider...I wanted to direct a little bit.
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 28, 2007 9:45:00 AM
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tonska
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You don't seem to understand. I put that video on youtube, so I can show it to patients. I have similar videos from 30 different patients, but that one was in english and I decided to show it here. I have links from my web page that has similar stories from over 100 patients (most of them are in text format) and those youtube videos are linked to my web page that gives information to patients that they can't get from doctors. And I will add more videos as I have time to interview patients. There are so many of them... So youtube was just a place to put those videos to show them on internet.
You know that sacroiliac subluxation is documented to exist in medical world, but because doctors don't know what it is nor how to treat it they don't use that information... Here is a link to TherapyFennica that contais all medical documentations that are legal way to diagnose a patient (text is in finnish):
http://therapiafennica.fi/wiki/index.php?title=Kuva:TFA_0318.jpg
I am just trying to bring out that there are a lot patients like me who have had hard time finding the right treatment because (almost) no-one seems to know what sijd is and how to treat it...
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 28, 2007 10:12:00 AM
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proud
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Tonska,
Read the article I guided you to. Your youtube information is rather misleading.
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 28, 2007 2:36:00 PM
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ginger
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From: Melbourne Victoria
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Tonska, your submissions have done what many could not , ignite a flurry of interest in SIJ issues. Don't be upset too much if amongst the responses you get a few who **** with faint praise or push patronism to the limit. These people are struggling too.
As to your experience with SIJ dysfunction , and I do recall having read posts from you in the past on this matter. One wonders what you have to gain by approaching health care professionals on a dedicated web site. The most you will create is interest. Likely to cement already profoundly concrete views in some , and prompt lengthy replies from others with vested interests. Wish you well Tonska , but it could be that your best method of alerting the world to your experience is to write to a health related magazine and try and tell your story to a mass market. There will no doubt be interest amongst other sufferers and their families. Sometimes the only way forward is back.
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 28, 2007 2:39:00 PM
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joelkphysio
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There is a great reference out there by Wolf Schamberger titled "the Malalignment Syndrome", which covers pelvic alignment and its effects on other aspects of the body. He is a well published sports med doctor from UBC...
check it out, a much better source than youtube...muh.
J
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 28, 2007 11:42:00 PM
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tonska
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Yes, Wolf Schamberger has good texts.
Proud, about that article. I have seen it before but I have to read it again. But here is something:
"A joint block is a highly specialized procedure, hardly available in everyday clinical practice; it is also not indicated for every patient with LBP."
It depends who is investicating and how. If you use provocation tests then yes, it can not be found from all. But provocation test are for pain search not for subluxation or block search. Blocked sij does not cause pain to itself.
More from that source:
These special tests fall in three categories22-24:
1. Positional palpation tests
2. Motion palpation tests
3. Provocation tests
If you use provocation tests you will get misdiagnoses, because the pain is usually on others side than the "block". The pain is not in sij but in ligaments and muscles around it. And the pain is usually on the side of the longer leg (there are studies on this). And when sij is blocked, the leg gets shorter... -> pain is often on the unblocked side!
Motion palpation is difficult and requires very good feeling through skin to a bone.
Position palpation tests are the best. But you have to understand that many times both are blocked. Then they move symetrically and are leveled with each others...
"Palpation in standing of the iliac
crest, PSIS, and ASIS levels yielded 35.29%; 35.29%; and37.50% agreement, respectively."
Why to do it on standing?
"The same tests in sitting produced 41%.18; 35.29; and 43.75% agreement, respectively.
None of the tests were significant for the goodness-of-fit"
As you can see sitting position gets different numbers. But when you sit the bottom of iliums are levelled. If you did that on lying you would get much bigger numbers on unleveling...
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 29, 2007 1:51:00 AM
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Sebastian Asselbergs
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From: Barrie, Canada
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And motion palpation is poor in intertester and interobserver reliability. It does NOT stand up to scientific scruitiny. And don't say I don't know it.
I have practiced manipulative and manual therapy for 24 years - heck, I saw Wolf for the first time at a convention in 1991 - where we compared notes on manual techniques. I have "found" minute dysfunctions in joint "alignments", "positional faults", "apparent LLD" etc etc. Used it for years.
I have the same results these days NOT doing that type of work. I am not saying the SI
is not often a contributor to painful conditions - I suggest that the whole "culture" of specialised manual treatment around the darn joint has not shown any solid evidence for effectiveness. Global maipulative techniques - yes.
So tonska - good for you. Glad you got helped.
My point still stands - there is darn little evidence showing that specific treatment to a specific joint has validity.
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 29, 2007 1:36:00 PM
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nari
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From: Australia
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Tonska - it is good that you found a solution, but that does not mean it is a panacea for people with LLD and pain. Many people live happily with LLD and it is not a routine cause for pain, with or without SIJ block.
Motion palpation sits with the 70s and 80s drive for precise, specific management of stiffness as a cause for pain. In this country, it has largely gone out of fashion due to studies which indicate, as Sebastian has said, poor intra- and inter-reliability.
Nari
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 29, 2007 9:34:00 PM
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ginger
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From: Melbourne Victoria
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Nari , I'm personally not inclined to be driven by fashionable approaches to understanding the aetiology of LBP , any more than you are .
It is clear to me that the SIJ plays a role in LBP however. being a large pair of joints , the SIJ's provide a torque reducer for forces coming from the legs, which , without the small movements of that pair of large joints , would arrive at the lumbar spine and contribute to ongoing protective responses , leading to LBP.
It is clear also that when the SIJ's are not mobile, the likelihood of chronic LBP is greater. Wether one accepts this notion or not , I get much better long term, results when SIJ dysfunction has been adequately adressed and function returned. Intertherapist reliability/unreliability is really a clever way of saying , some folks are good at it and some are not . What's new with that.
So Tonska , it is the FUNCTION of this pair of joints that is of concern , not , it's position . When full function is available , normal biomechanical effects are so , leading to a considerable drop in abnormal forces associated with the lumbar spine. It is likely that in your attempt to understand the changes that have occurred in your back, you have missed the point a little . function is relevant ,position is not.
Cheers
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 29, 2007 9:53:00 PM
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tonska
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"that does not mean it is a panacea for people with LLD and pain."
It is possible.
!"Many people live happily with LLD and it is not a routine cause for pain, with or without SIJ block."
Yes. Like ginger explaned...
I did too. I lived many years with LLD without much pain. LLD is just a result that joints are not at normal position in pelvis. And the pain comes usually many years later after muscles have tired of giving support to asymmertical movement. I no longer have LLD that I had over 20 years.
"Motion palpation sits with the 70s and 80s drive for precise, specific management of stiffness as a cause for pain. In this country, it has largely gone out of fashion due to studies which indicate, as Sebastian has said, poor intra- and inter-reliability."
Motion palpation is not for stifness but for asymmetrical motion of PSIS/SIPS! That asymmetrical motion causes stiffnes when other side is carrying more body weight than the other...
Yes they are leaving out that because they can't do it well enough. So that is why patients are misdiagnosed so many times these days or now they don't get a diagnose at all. Now doctors tell the pain is only imagination when they can't see the cause. They call scoliosis a sickness but it is just a result of a pelvic asymmetry.
"So Tonska , it is the FUNCTION of this pair of joints that is of concern , not , it's position . "
Yes. And malfunction comes from malposition of other or even both joints. If the joints are perfectly at their right places there will not be any malfunction. And when you manipulate those joints back to their correct places the function becomes normal and symmetrical. Then muscles and spine are no longer stressed with malfunction.
I have seen 50 and interviewed over 100 cases. All the patients said they felt the change. Walking got easier and pelvis more mobile. Also the posture got better. And pains were gone! And I still have few hundred similar patients to interview...
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Re: Reason for back pains, ischias, foot pains, stiff b... - March 30, 2007 3:11:00 AM
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ginger
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From: Melbourne Victoria
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"And malfunction comes from malposition "
You are still missing it Tonnie old son. malposition may arise because of malfunction , but is largely irrelevant. One cannot tell , for instance , wether a pair of SIJ's is mobile or not, by their position. The two variables are not related. The only usefull variable is movement. In other words, look to function for whether or not these joints are involved or not in LBP.
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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