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ginger -> Re: Reason for back pains, ischias, foot pains, stiff back, disc problems, headaches,. (April 1, 2007 1:23:00 PM)
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Anders, over the years I have had occasion to employ three different SIJ mobilising methods. The most immediately effective of which is bodyweight applied through one foot onto the prone patients sacrum, with mobilising effect gained by alternate flexion/extension of your knee. routinely about twenty seconds , up to three times is almost always successful in restoring significant SIJ movements. ( I am 85 kgs )
The other methods are less effective, but chosen on the basis of what patients will cope with.
method two. patient in side lying, upper leg in hip/knee flexion. therapist at the rear, with one hand forcing the illium ( of the upper side )to rotate rearwards, the other hand on the ischium assisting this pressure. Difficult in larger people, usually successful in the frail , tiny, young.
method Three. A manipulation of the inominate away from the sacrum . patient supine, therapist at foot of bench, grasps the foot and suggests relaxation after the briefest of descriptions, after a few 'dummy runs' where therapist pushes the leg into hip/knee flexion and back to straight , exerts a powerful yank into hip/knee extension ( pull the leg straight ), thus distracting the inominate away from the sacrum ( manipulating it ). Works well but usually only get one try at it. After first attempt most patients are too tense to allow sufficient ralaxation.
I've largely abandoned this method in favour of standing mobs.
Clearly some attention to the physiological/anatomical state of your patient must precede any of these methods. I have not had concerns, post treatment ,with any of these methods however.
Remember , restoring SIJ movements will be valuable in the long term for LBP sufferers, particularly the pronators. ( Pronation is a major cause of SIJ immobility ) But must be followed with appropriate orthotic anti pronation control to be lasting.
Cheers
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