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alophysio -> RE: Re: Reason for back pains, ischias, foot pains, stiff back, disc problems, headaches,. (August 17, 2007 10:11:02 AM)
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Hi Tonska - i beleive that the treatment helped you.
I think what some people are saying here is also correct. You cannot simply assume that the SIJ is the cause of EVERYTHING.
I specialise in treating many people like the person in the video. I can tell you many similar stories. However, most important in all of those stories is that their diagnosis and classification was NOT accurate initially.
I could only help those people because an accurate diagnosis is a big step towards helping people.
Having said that, i have had MANY patients who have come to me for "pelvic problems" - they think their pelvis is twisted but sometimes it is the back that twists the sacrum or the thorax that twists the back that twists the sacrum. Sometimes it is the femur that is twisting from the hip that twists the sacrum. Other times it is the foot that twists the tibia that twists the femur that twists the pelvis etc etc etc. The bottom line is to accurate identify what is "driving" what and then treat accordingly.
If it encourages you, most PTs are sceptical of the SIJ...therefore it is good to raise it as a possibility for causing problems. Most people who have replied on this site do not seem to take your case study seriously because we are taught that one story does not make a rule. It would be like saying because 2 planes flew into the towers in New York that ALL planes that fly over New York will crash into buildings... I hope that is a bit clearer for you.
As for the SIj, Ginger's point about function over position is important. It only matters how the SIJ is working, not what position it takes in one moment of time (XRay). If it is working properly, and we have 2 tests that do that well (Stork and ASLR), then we can use these to help make an accurate diagnosis. The main categories are
1. Joint problems - these are rare without trauma (like a car accident or falling off something)
2. Control problems - these account for most SIJ problems. This is where the muscular system doesn't coordinate properly leading to the SIJ being vulnerable to dysfunction. Please note that i said dysfunction and not subluxation because the SIJ is inherently strong. Very strong. So strong that Ginger needs to put her 85kg onto a patient to mobilise this joint effectively. It does move however - in terms of millimeters and 1-4degrees of rotation.
The youtube patient seemed to be a joint problem. As someone earlier pointed out, once you free the joint, you will need to teach the body to coordinate the muscles properly to ensure proper functioning of the SIJ. This is where we as PTs can be so much help!
Good luck!
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