SI Joint Dysfunction Myth Busting | Sacroiliac Joint
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SI Joint Dysfunction Myth Busting | Sacroiliac Joint
• SI Joint Dysfunction M...
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This is not medical advice! The content is intended to be educational only for health professionals and students. If you are a patient, seek care of a health care professional.
As someone in constant agony with both S.I joint dysfunction, I think its easy for you to say. Live in my body for a week. That will teach you.
No one would survive a hour in my body. My pain is unbelievable! 2 lumbar fusions and I'm so much worse than I was before. It was my si joints all along 🥺
your muscles are keeping it that way, he is definitely wrong about it not being able to be stuck
@@julierogers4473 Ouch, this sounds really painful. Do you think, changing your diet may help you to feel better. May be add more collagen, like bone broth and reduce flour and sugars to reduce your muscular inflammation. Also, add magnesium supplement as it will help with your pain. Good luck.
Physiotutors are not questioning SI joint pain, they are discussing the validity of some assessments for the SI joint!
Find a pain free that will do the SI injections it helps!
I want to comment as someone with a severe form of EDS, we can and do fully or partially dislocate all over our bodies daily! Most doctors and even PTs will not believe that someone can have an SI joint dislocation without a severe traumatic cause (car accident, etc). My left hip goes out from simply walking from one room to the next in my house and I just turned 30. Recently the left hip went out but the left side of the pelvis rotated forward and the right side rotated back, so my joint couldn’t pop back in. Luckily I know an excellent PT who taught me how to use my own muscles and movement to correct the pelvic rotation and the upslip on the left side.
Hip or SIJ? No doubt people with EDS are more mobile, still doubt there is massive degrees of freedom in the SIJ. We'll look into the literature a bit more to see if there is research done in people with EDS
The main thing is to not listen to Physiotherapists. They are not qualified to handle Si joint problems. See a Sports Physician
I’m 21 and I deal with this
@@Physiotutors so what did you find out after looking into eds patients?
As a practicing physical therapist, I too was taught this approach to SIJ assessment, as many still are. Unfortunately, the research does not support this method of assessment for determining the SIJ as the pain generating structure. The SIJ can be the pain generating structure, however, there are specific tests that research does suggest are better at determining SIJ pain. The concept of "hips going out" is an old school concept based on osteopathic approaches that are not supported. It is a concept that fosters dependency. Again, this is not to say that you are not experiencing SIJ pain. However, given your age and certainly a diagnosis of EDS, it is much more likely that you are experiencing lumbar disc or discodural pain that is referred into the SIJ area. What we can all agree on is that if what you were taught works to decrease your pain, fantastic! The mechanism may just be different than what we think. The other thing we can all agree on is that most 30 year-olds, but especially individuals dealing with EDS, need to focus on protection and neuromotor control training of the lumbopelvic spine.
With kind regards -
Telling someone with an SI joint slip they actually do not experience such thing is like telling someone with habitual shoulder dislocation it is all in their head.
Ignorance is bliss to someone who hasn't experienced it. And the fact that often times a little manipulation and a pop followed by relief of agony cannot be overlooked. It also takes strengthening and balancing the muslcles, core and body alignment to bring long lasting relief. There once was no evidence that the world was round or that we rotated around the sun either. Just observation. Amazing how that works. Hope you find relief from a QUALIFIED professional.
Then tell me why after adjustment my leg strength returns.
BBg Reg how bad is your si joint pain
BBg Reg Yes. Chiro is good. Sorry but this weakness or out of balance.. I don’t buy it.. I get an adjustment and the strength returns. I do exercise daily.
BBg Reg pain going down both legs sounds like sciatica or even lumbar . Pain can refer to other areas.
But if the SI joint is joined together with ligaments, and my ligaments are very lax due to hypermobility/EDS, it seems likely that mine is moving. The pain I have is definitely the SI joint.
I also have EDS and this is my exact situation too
Me too! I have EDS and severe pain in my SI joint.
I'm stiff a a board and can't imagine having this, even though the symptoms I have are the same as people who have EDS. I've been trying to hang in there for nearly 10 years and have lost pretty much everything in that time.
@@solgato5186 maybe you have eds?
Mine to 👍🏼
51 year old hockey player, bowler here. been playing hockey for over 30 years and bowling for around 5. I have an SI joint problem now, this makes me feel much less hopeful for a recovery of anything other than maybe an ability to walk some, reading the comments makes me feel like im now permanently screwed. Just a few weeks ago, I was keeping up with the best 20 somethings on the ice, now I can barely get out of bed and walk.
How are you doing?
I was in severe pain for 4 years until a wonderful doctor who happened to have SI joint instability herself gave me a series of Prolotherapy injections using dextrose. It has been a complete game changer for me. 100% recuperation 😊
Very informative thank you
My friend thank you. You Nailed it. Most all of my doctors all said do not trust anyone saying they can manually assess the SI Joint as you have shown. They have particular tests to put people through that do induce movement.
I beg to differ but I can FEEL mine slipping and popping in and out.. a diagnostic injection confirmed it was my SI joint. I also have ehlers danlos hypermobile type.
I know that the diagnostic injections are said to help prove the injuries exact area...But, i firmly believe the injections are only 1 piece to the puzzle. I personally would try to get as much evidence to show where the injury is located exactly...
I am not a Doctor but i have had more than a dozen non evasive and surgical procedures and have found that the back is more complicated than a lot of specialist make it out to be...
Take care,
Jack.
the ehlers danlos was diagnosed w a scan or w what test? thx
I can feel mine move about more like a shifting feeling. And it pops so hard and so loud gives a moment of pressure relief. But the pain in my psis is so bad if pressed I nearly pass out. I been like this since 21 now 42 going dr to dr looking for a cure. Ruined my whole life this pain I’m devastated seeing a renowned surgeon in 2 weeks who was on tv one of just 10 Drs who are the best hip surgeons in the country. If he doesn’t think it’s my hip and it is my SIJ or piriformis I’ll focus on finding help for that.
@@erenix3909 my EDS was diagnosed through as clinical exam with a geneticist.
Finally someone just like me. I have the same popping and slipping but also some grinding. I also have EDS. I wonder if that’s why it’s different for us. We simply don’t have the ligaments to hold it right once it’s gone out.
I have EDS and my SI joint has been extremely unstable since the birth of my children. For years I thought it was my actual hip (which pops out as well) or my lower back.
These issues have been progressively getting worse and its information like this that have caused me to not get the proper care that I need.
I am now under the care of a PT, Chiropractor and a Phyiatrist, I am waiting for a SI Fusion using the iFuse. If the SI Joint didn't have some issues in some cases why are there specific surgeries to fuse the joints, abolation of the nerves and injections into the joint to relieve pain and correct the problem?
Visit a Doctor of Osteopathy specialising in Osteopathic Manipulation(OMM) if you're from North America. Good Luck.
@@longce-imingti9014 thank you. Getting any kind of treatment here has been an absolute sludge. I have been trying but just keep getting passed around in circles for the last 7 yrs. I will ask and see if anyone I'm under the care of will offer this
Hi. this was very helpful. Can anyone tell me if they can feel the bone sticking out more on injured side? or if they see a bulge on the injured side? I have all the symptoms but also i can see a bulge on my lower right back which is very worrying
Certain SI joint tests work very well to confirm SX and to direct effective treatments especially muscle energy techniques.
When my si joint is "out" for lack of a better word I physically can NOT stand up straight. Not because of pain, it's like its fused. I lay on a massage ball applying full body weight and Slightly rolling i hear a "click" somewhere in between the Si and tailbone. What makes that click noise and why does it provide instant relief? Thank you in advance
Why is no one responding to you? I’m going through the same exact thing and I need answers!
Sameeeeeee it’s been 1 year I hate this shittt
@@kevin3.0t frustrating as hell...a sneeze first thing in the morning can cause something to displace and its a week of hunch back of Notre Dame lol
how you going now mate?
@@dj.culture6590 after initially finding that sweet spot with the ball (i always assumed it was my spine) I started doing hip flexor exercises and strengthened my glutes which has made a HUGE difference. As soon as I start feeling that sharp feeling I start the process. I dealt with it for 10 years or so until discovering this information at a rate of 3-6 times a year id be hunched over for upwards of 2 weeks. Since I strengthened my glutes/flexors and used the ball when I feel that pinch in the SI it's only happened once and only for 3-4 days. Thank you for asking, I hope paying this info forward saves someone years of unnecessary pain
If you bend down to pick something up and feel a burning pain in that area it's something going on with the si joints? Because my hips were the thing hurting me for the last two years and the past two weeks it's in the si area plus hip pain shooting down both thighs. I couldn't move almost paralyzed from the pain. I have to wait until November for insurance. Getting a compression hip brace for now.
My si joint / sacrum was locked solid on one side and moving on the other 6 years of agony until I started to go to the chiropractor and it took several weeks to start to unlock everything. Even if there is minimal movement that still is a functional joint.
That’s what I wanted to comment about. Maybe it is another misunderstanding, but I was told my si joint was locked solid. It did not move when I turned or walked. the Chiro freed it up.
Is this evidence of si joint dysfunction or something else? I’d like the video guy to answer…
Demand actual anatomical medical terminology from your providers. What is "locked" supposed to even mean? If the term is hypomobile, hypomobile needs to be used, for ex. It provides a much better understanding of what is anatomically and physiologically going on.
My SI joint popped out and back in last summer. And now again yesterday. It definitely moves. You can feel and hear it when it does.
I can slip on command and often do to release uneven pressure and severe pain after activities. I have bent my tailbone/Coccyx twice as an adolescent,, multiple falls directly to knees that affected SI/Lumbar.
@@sarahwilson7825 Yikes
I feel your pain, I can hear mine and feel the immediate burning, sharp pain. I usually have to try to bend in such a way that it comes back in place...and get to experience the sounds and burning feeling- eventually it goes away. It's all about how I move and bend, there are certain movements I should not do- unless I want pain.
@@andreawilliams7802 yes, I can't believe how accurately your able to explain the motion. I have specific stretches that create the optimal position, always lay flat after an adjustment ! It helps the inflammation. I end up with sciatica like pain if i dont.. Planks, holding bridges 20 seconds per rep , and gentle extension and rotation .I'm always on the floor 🤣...but getting down there and back up are so difficult.
I never hear a thing and there is no pop. Why am I in so much pain after a year of physio and exercises?
In actual fact the sacroiliac joint moves between 4-6mls. Its regretful that there is such inconsistency in palpation skills!
Plz provide your videos with subtitles...I really like your channel
In which language do you guys want subtitles ?
Mine pops 20 times a day I’ve been in severe pain since 21 I’m now 41. Drs have just brushed me off letting my life waste a away. I’m too afraid of si fuse so I’m looking into a procedure called cornerloc. And it’s not true mine moves down and up like you wouldn’t believe. I place my fist in si and twist and you’d be shocked at the clunk sound. I can literally feel my si move in and out up and down. Also a technique I’ve evented myself because of what my body instinctively craves. Is where I ask family and friends open their hands in a wing position, press left right left right over and over in a tittertotter way. I then with hard pressure will feel the si move into right position and of course a loud thunk. And it’s my body I know exactly where I feel all this and it’s right smack in si. Drs and pt need to start listening to the patients too in order to learn. I’ve been studying the body for around 7 years so I can help Drs diagnose me and help me because I’ve lost my life. Moment I’ve been sucessful of getting it in place where it feels right I immediately have reduced pain. But in order to keep it I have to not move and not moving forever would be great once I get it in.
Omg, that is exactly what i have been experiencing. So glad im not going mad. Thank you for sharing!!
This is what I think I've been going through for almost 7 years. I had constant shoulder dislocation when I was 15 in both shoulders and was told I had arthritis. I hear something pop in and out after the best stretch I can do this is really bad for years.
@@johnankrah299 Welcome seeing a renowned hip surgeon soon who was on the news. Been to at least 100 hip surgeons with no answers this guy is the real deal. Gonna have him tell me if he thinks it’s my hip or something else I think it may be SIJD or piriformis syndrome. What has thrown me of is the fact I have severe tightness and pain in lateral thigh like in the semitendinosus muscle with snapping in front of hip. I’ve wondered if it’s snapping hip but I just don’t know cause some with SIJD do report snapping. I also have severeeeeee pain in the psis omg like so severe I can’t even lean back on the car seat or a chair. I’ve been recommended to try hydrodisection before I consider any kind of surgery there’s a top surgeon in Illinois want to see after this Dr in Marina Del Rey if he doesn’t think he can help me. If he thinks it’s SIJD I’m going to ask him what he thinks I should do and where to go.
So I have pain coming from my si joint and cortisone shot and was pain free for about an hour. Nothing else worked. If not si joint what else could it be what should I do next? Can't find 2 people to agree on a treatment
So if I understand this is suggesting that palpating SI joint movement is not likely, however it is not dispelling SI joint dysfunction? Am I correct?
Is it possible to have problem with SIJ without pain in joint area but lot of muscle imbalances and spasm and inhibition? Also no pain whit SIJ tests ?
What is your opinion in relation to the argument that different biomechanical dysfunctions in the body can, for example, create compensatory patterns which cause problems to occur elsewhere in the body.
For example, the arguments are often that a dysfunction in the SIJ does not necessarily hurt, but it can create problems in the back or hip or possibly anywhere else.
So maybe you dont have pain in the SIJ, but the so called "dysfunction" creates problems somewhere else in the body.
What is your take on this.
This person is not qualified to answer these questions. Every physiotherapist contradicts each other. After seeing every person imaginable, I have found that sports physicians are the best people to see.
Can you make a video on if there is an evidence for accupressure like things as many physios are opt-in from these
Good morning, any thoughts on lunbaarisation of s 1. Thanks
May I ask how SI Joint pain should be assessed (since the manual methods don't appear reliable)? I have been struggling with SI joint pain for 10 years and despite going to countless doctors and PT's, no one has been able to figure out how to fix it. (I've done corrective exercises persistently during that 10 year period.
It has 6 tests, and it should be positive at least 2 of 4, or 3 of six. And you can doubt about it if your other tests and movements did not show any change in pain.You can check Robin Mackenzie books for it.
If you are hypomobile (stuck) how is your illiacus ? Can you stand back to the wall and push you lover back flat while kneling? The illiopsas muscle strength and flex is pri for free SI joint movement,
You said that a chiropractic manipulation should not actually move the hip in relation to the sacrum. I a, still trying to figure out what happened to me. Perhaps you have sone ideas.
I had treatment for some pain on my RIGHT SI joint. The chiropractor did 5 drops in the bed.
The next morning, after i started moving, I had severe pain and numbness on my LEFT side - everything from the hip and groin and buttock, and all the way down the back and side of the leg to the foot.
It rendered me bed bound with agonising pain every time i got up. I started using crutches so i could at least walk around the apartment. The pain reduced and localised but i still cannot walk without crutches a month later. The pain is right over the left SI joint.
I am fused L5S1 and have a dynamic stabilisation L4L5.
My doctor has been treating me for SI joint pain with PRP injections.
My question re the video is that if the chiropractic treatment hardly moves the joint, how could a force on the RIGHT hip do so much damage to the LEFT SI joint? Is it possible he accidentally pushed down on the sacrum and this tore the ligaments between the left hip and the sacrum?
Any thoughts welcome?
Ha! My orthopedic surgeon actually felt and heard mine pop open. She said I have barely any ligaments left there and I even have huge "back mice" due to the injury. They are talking fusing them because I'm in a wheelchair most of the time. She has never seen them this bad. I have EDS, in bad car wreck and had 3 babies.
How are you doing
How are you now?
at the site of one of my SI joints there appears to be a protrusion at si joint, it can be very painful at times and I can feel movement of kinda a pop at times.
Would recommend to get it checked out by a local medical professional!
Is it like a little lump like a little pea or grape in your back
@@PaigePlates I have what you described. 😟
Great documentary, someone with wrist pain what to do please?
Thanks boss Love you ☺️
I do not believe you have busted this one.
I injured my back years ago. I was told that essentially what had happened was my S.I. joint was sprained. And being where the injury is it never fully heals. Does that sound feasible to you?
I relate to what happened to you. After a fall on ice as a senior in HS, I have experienced pain ever since. I was 16 then and am 77 now. I now understand that I sprained my S I. When left untreated it won’t be able to be fixed, it becomes chronic. I feel better knowing why I have ongoing issues, especially groin pain.
how are you going now mate? Jack
@@dj.culture6590 I have good and bad days with it. I have to be very aware of how I lift or turn when working. I have to live with an ice pack on my back whenever possible. I was using a lot of Ibuprofen until I heard what it can do from long term use.
@@GRADGRAD-jq9nk take care. Yes anti - inflammation tabs are really bad.
@@sandranovakovich688 Sorry you have to deal with the pain. But kind reassuring to know I`m not the only one. Sometimes I feel like all I have to do is try harder, Then my back reminds me it`s not that simple.
Im studying in the Netherlands for Physiotherapist . What is weird is that we've been teached always to apply Evidence Based Pratice , but then when we get to the exams wich are different physiotherapist then our study master , they will actually ask u about doing examening SI with palpation-movement ... Can't wait to bring the fire next time with some of these EBP articles and show how the student has become the master :D
Exactly the same experience in Finland! Teachers already hate me 🤣
Good luck with that!
Guys, the same in Poland :D
Yeah its really horrible lol , It really got me confused at times , will i practice what ive learned in my studies or will i please the examiner...Hmmmm :P
@@Venom0007 Yesterday was a tough day debating evidence on lifting with a rounded back....
Gapping of a joint which returns to original position is still gapping
Let's stipulate that if there's movement in the SI joint, it's extremely minimal. This is ensured by the network of ligaments that surround it; instead of automatically looking at the SI joint as a pain source, it might be more sensible to examine whether there's any laxity in/injury to these ligaments (particularly at their attachment points) that's causing the pain.
Medicine has long suffered from dogmas. Extremely minimal is not smth that produces excruciating pain and goes away when repositioned.
Something that isn't supposed to move at all really is going to cause a great deal of pain when it does minimally move...those ligaments may hurt as well but the misplacement will hurt too. Especially when it puts other things out of alignment. A slight misalignment is going to cause greater misalignment the further it is from the source....compensation
@@rossianabojinova6589 Next time you get a papercut, ignore it. It's too minimal to cause pain 😒
Yet those of us with Ehlers Danlos Syndrome we have more movement than others.
That's true, but the question is still if you can feel 3° of movement instead of 1°
Then why is my one leg longer than the other when I have SI joint pain. After manipulation my legs are the same length again and the pain starts going away?
Your pain goes away because of neurophysiolocigal changes in your body.
Your legs are still the same langht no matter what. You cant change that.
@@TheStizzel Yes I know the actual length stays the same, but because of the hip rotation when you do the test the one is longer than the other one. A slight movement on the SI joint is magnified on the leg length because of the mechanism.
So if not SI joint where is pain coming from around the iliac crests and low back?
I've had my SI joint slip out of alignment so bad I could barely stand or walk, and the only thing that fixes it is 3 or 4 days in bed. I have three herniated disks that hurt all the time, but that's nothing compared to the pain of the SI joint whan it decides to slip out of alignment.
What makes you think the SIJ slipped out of alignment?
Try foam rolling to reset you SI joints. Works every time.
@@Physiotutors When someone has this you can compare it with a person knowing that their shoulder bone moved in its socket. One just learns to detect that when it happens repetitively to them. When slipping out happens walking on opposite side-walk with opposite incline often can reverse it. Trusting with one foot on a step can reverse it. You need to know which foot to put on the step though. You are welcome.
@@rossianabojinova6589 Thanks, I'll have to look that one up before the next time it decides to slip for no apparent reason.
@@Physiotutors My doctor.
I had a spinal fusion L4/L5 6 months ago and my lower back right at my belt line kills when I try and standup or anytime my back is not totally straight. If I bend over even an inch forward my back kills. What could be the cause of this? I am not looking for advice just ideas about what I should ask my surgeon when I go in on 10/14. Could it be my bones have not fused? Could it be the spacer they put in digging into my bones? Could it be a disc issue at L5/S1? I can tell when I talk to the surgeon he thinks I should be further along. I was out of the hospital the day of the surgery and off all pain meds and any meds the 2nd day. I was walking about a mile a day the 2nd day after surgery and was way ahead and did nothing but walk for 4 months. Now scratching my head because I am in so much pain in those positions. Laying flat I have zero pain. Sitting down and twisting hurts or bending. Any ideas what I should have looked at. I have a high pain tolerance but I am not able to do simple things without pain. Reaching for something below my waist out in front or to the side of me kills as well.
For health-related questions, please get in touch with our partner from yourphysio.online
@@Physiotutors Great Idea and I will post what they say!!!!
Tried your hyperlink got this message "This site can’t be reachedyourphysio.online took too long to respond.
YOU SURE THIS IS THE RIGHT WEBSITE OR IS IT DOWN?
@@Physiotutors This hyperlink seems to not be right? Can you check it?
SI Joint pain is extremely common in people with spinal fusions. Because your spine can't twist or move normally it puts extra strain on the SI Joint.
I had my right side done no issues you sure your not feeling the other side? I need a bilateral and I feel the left side but right side is good to go.
Please also provide some solutions
As someone with hypermobility who was taking 6 200mg ibuprofen a day because my leg would buckle and a couldnt walk with out my walker. I went to get that adjustment last week and now I'm off ibuprofen and my leg isn't failing, I walk fine. Still have weeks of treatment but at least I can move again with out my walker.
Please tell me same problem
How I treat
I can feel my SI joint move and I can feel the pain.
So I wonder if they're trying to hypnotize us and tell us nothing is wrong there.
Too bad, it didn't work on me. I am still having lax joints, subluxated/ dislocated joints, and still having pain.
Very nice
I'm not sure if I misunderstood but it sounds like you're saying that because it has limited range of motion, it doesn't cause pain to the extent in which we are told by our doctors?! Kind of crazy to suggest that!
Unbearable pain in area and bulging for me
Tried several things but the pain is increasing
I disagree. I treat this disorder regularly, successfully. Repositioning pre-post testing as well as pain level reduction is proof. Muscle imbalance is often the culprit, but occasionally trauma causes it. The studies sited do NOT correspond to actual treatment (read: before and after manipulation of actual patients), nor mimic actual testing positions of actual dysfunction. Take a sharpie, mark the SI, and do the Stork test and Gap test yourself. What do you see before and after treatment. There it is. Hinging treatment protocol criticisms on such limited studies is a common trap within PT.
anecdotal evidence is not evidence.
So your wrong.
@@TheStizzel if anecdotal evidence is not evidence, then why did you call it evidence?
@@Vitamin.Z Because that is what it is called. You cant use anecdotal findings, and say it is science. You cannot reposition the sacrum or the illium via manipulation or mobilization. Science has clearly shown that its impossible
@@TheStizzel, “you’re.”
Well then explain why my one side hurts so much and I feel it shifting back and upwards when i run on it even a little.....
This may be true for “normal” people, however it is not true for people with Ehlers Danlos syndrome. My SI joint is currently subluxated to one side and I cannot wait to get to my EDS knowledgeable physical therapist tomorrow so he can help reposition it. I cannot relocate myself this time since I currently have a lot of inflammation in the area from an activity yesterday. We know it’s moving because when one side has an upslip, my one leg “seems” to be a full 1/2” shorter than the other side when I do a bridge and he extends my legs. After the manipulation, my legs appear the same length again and there is immediate pain relief in my lower back and pain & pressure relief on the top of the iliac crest.
Don't think there is a lot of data on patients with Ehlers danlos. In pregnant women it's still unreliable as movement is around 3 degrees instead of 1. Manual therapy can have an effect on pain, but highly doubt that biomechanics can be changed
Physiotutors there’s actually plenty of information on Ehlers Danlos patients available if one chooses to look for it. However, it is uncommon and that’s why most doctors aren’t aware. Maybe they don’t believe their patients and choose not to learn, or maybe they just hear hoofbeats and assume it’s a horse, when in fact it’s a zebra like me! The fact remains that your video is spreading false information... but I suppose someone had to graduate at the bottom of their class.
How do you know if you have upslip?
stacey brown yes, there’s “credible research” if you choose to look for it. As far as my qualifications, I’ve lived in my body for 43 years, and I have a medical team that backs up what I’ve stated here. That’s enough for me to know what’s factual for my own body, however, every “body” is different and I would encourage everyone to do their own research. I certainly wouldn’t trust one video on UA-cam or someone in the comments claiming to know what they’re talking about 😉
katie I’m not qualified to describe that about anyone except myself, but if you thinking it could be happening to you, I recommend finding a knowledgeable physical therapist :)
So he is saying it takes hardly any swelling and movement to fire up that nerve .When I get prone I seem to be fine relax and pain goes away.. work cars walking step up and down and then you know maybe it was l2 or si
The thing is that there is a severe blockage in mine, no matter it moving or not. There is a knot right there, since I was a teen and only one person has been able to give me immediate, yet temporary relief.
It's not the movement of the joint itself...... It's the ligaments surrounding the joint.... often the ligaments are hyper-extending often causing pseudo sciatica. Treatment that is highly successful out there is prolotherapy and PRP prolotherapy.
Can you provide evidence for the effectiveness?
@@Physiotutors www.caringmedical.com/prolotherapy-news/sacroiliac-joint-pain/
www.practicalpainmanagement.com/pain/spine/platelet-rich-plasma-prolotherapy-low-back-pain-caused-sacroiliac-joint-laxity
The small motion is important to relieve torsional stress on the bony pelvic ring. Hyper-extension of ligaments in an SI joint may cause asymmetrical motion and provoke pain on the more mobile of the two joints. This imbalance in mechanical forces can cause ligamentous and articular irritation
@@goodlifetony for what reason? What's the issue you've been dealing with? How do you like it?
It's not a myth pal It is a real condition I had my right Si fused after developing year of sacrolitis I couldn't walk or stand for any length of time and now i'm doing everything again so keep your myth to yoru self because i'm a real life testimony
reading braille thru steak. < This is SPOT ON when I am trying to pinpoint the exact pain location in my lower back. I cant!! Drives me crazy.
I used to get a lot of relief from trigger point massage therapy, but the PT I was doing was all wrong and I ended up breaking my own back (surgery worked out fine and fixed the horrible sciatica it was meant to fix, but the original unreleated shrieking pain in the SI joint came back within the year)--literally! I'm hearing "cauterisation" from a new doctor, which means at least they take me seriously enough to not think I'm "just" drug-seeking (I hate that anyone's pain gets dismissed at all regardless of whether its origin passes our stupid society's obstacle course of taboos), so maybe there's some relief on the horizon.
However. I would suggest that when considering serious disability with significant MSK issues like CP, Duchenne, Ehler-Danlos, dystrophies, etc that ranges of movement and integrity can be very different.
We can imagine that, but no sure or aware of any evidence that shows how much ROM is increased. If during pregnancy 3° of rotation is tops, assessment of dysfunction will still be completely unreliable
@@Physiotutors Agreed, it is very poorly researched though some insight can be gained from papers regarding surgical intervention in CP as to what they see and deal with in orthopod theatres. What I can tell you from experience (I'm a clinical specialist OT - Complex Seated Posture and Wheelchairs) is that hypertonia, paratonia and diskynesia, can make joints bend in seemingly impossible ways. Pelvic trauma can result in infinite complexities too. A good caveat for your excellent videos might be "... unless you can associate issues with a significant trauma". A case in point from a commenter below, he knows where it hurts and can associate it with a direct experience with a heavy jack-hammer. 3 degrees does not sound much but that influences about 10cm of ant/posterior movement at shoulder level.
I broke my back in 3 places and messed up my si joint. I got suicidal my si joint joint hurt so bad and my sciatic nerve. I was slammed in a seat that bottom out on steel in a scoop, a coal mining machine. It screwed my entire left side up. It shifted my si joint and I've had problems ever since and my back is constantly having procedures done
Nice
I have hEDS and with last 3 lumbar levels fused and still flat palm the floor. what else can be moving? Prolotherapy only thing that has worked. Can't say it's in my head since I have taught myself hypnosis and haven't use novocaine for a root canal or crown in 14 years nor do I use lidocaine for my injections either but I can't stop the SI joint pain.
i also have hEDS! 🦓
if adjustments work, stick with them. with hypermobility, our connective tissue is much looser than most peoples. it's easier for our joints to shift out of place. talk with your doctor about it, don't change up your care plan because of some dude on youtube!
@@shank2733 Thank you, I have to agree. My doctor tells me my SI joint shifts 4 times more than a normal woman, my prolotherapy doctor said my pelvic ligaments are like a woman who has had 20 kids. LOL I had 1 child and that was an overrated and painful experience with all back labor. I don't think many ppl understand what hEDS does to a body. Pop a rib out once and they would change their tune.
The Hesch method of diagnosis and treatment is the best that could accurately examin the pattern with the SI dysfunction.
I felt mine move and get stuck when I was deadlifting 450lbs on day i had minor si discomfort and should have rested instead of workout. Maybe it doesn't move much on its own but it surely can with the help of gravity and sudden impacts. I also felt the rest of my spine slowly adjust and compensate for an out of alignment si joint over the next three months and the felt the associated pain with that. I also felt it, with the help of gravity again, pop and move back to where it should be and all associated pain and pressure was immediately gone. In the next 3 days my upper neck and moved back into alignment and everything felt normal again. You can say 1 degree or 2 degrees is all it moves and that's fine. But I'm proof that 1 or 2 degrees can be a motherf@#_er if it doesn't go back.
Do you recommend chiropractic? I was doing deadlifting and mines got injured as well
@@chalcodelvolga8800 yes go to a chiropractor. I wish I would have went. I would have been back to lifting sooner
@@jwill9877 Thanks for your response. Are you pain free or have some episodes of pain?
@@chalcodelvolga8800 pain free and back to normal. It took a few months to gain my confidence back though. In the back of my mind I thought I was going to injure it again.
@@jwill9877 I am glad to hear that. Thanks for detailing your experience
But why is your thumb moving down when you raise one leg?
Might be movement of the SI, might be movement of the skin, might be pareidolia. We can't even reliably palpate the SIPS according to studies so we shouldn't expect that we can reliably palpate a rotation of 1 degree. And even if this was the case, who says that this is dysfunctional and not just normal anatomic asymmetry like we see in other joints and body parts?
@@Physiotutors thankyou!
Does anyone know what sudden, INTENSE, stabbing, pain in the SI area, especially when transitioning from sitting or bending to a standing position could be? It kind of feels like somethings slipping out of place or maybe being pinched. I’m talking a 9 on a 1-10 scale of pain. It goes away in maybe 10 seconds though. I can’t sit long or it gets uncomfortable and I eventually get that stabbing pain even if sitting. I’m only really comfortable lying down.
Hi! That is/was exactly my case. It started some months ago, and if I went back in time I would take care of myself earlier, because I am now in a state where is not so easy to do so because it has worsen.
So, although it hurts, if you are still able to walk and move yourself, go to an oestopat. It worsened for me to the point I couldn't walk, went to my normal doctor, to a physical therapeut, a reflexologist, a masseuse, and it didn't change much. Hopefully I will now go to an oestopat so he can put things in place. One thing I remember was in a day of stress (rent due) I beat with my large toe on the street and everything worsened from there. I saw a therapist stating that you can move your pelvis by stomping with your toe, no big accident necessary!
Anyway sorry for any English mistake and I wish you get well soon and that we get well from the misterious ailment.
Good luck and blessing!
Oh and if you get a diagnost of what it is, can you share here?
@@ritarosa6824 Hi, it’s nice to finally hear from someone who is experiencing the same thing as me because I haven’t come across ANYONE else talking about this, but I’m also very sorry you’re going through this too, it’s terrible.
I don’t recall ever hitting my toe against anything or beating it on the ground, I’m not sure how I injured myself aside from maybe decades of sleeping in a bad position, I sleep on my stomach with my knee pulled up and stomach sleeping is supposed to be the worst position to sleep in.
I’m in America and the way our medical system works is in order for our medical insurance to cover the expense we have to go to our general medical doctor for most things and he or she has to refer us to a specialist if they think it’s needed. We could go directly to a specialist but if we do we would have to pay for it “out of pocket” or on our own and medical services in America are the most expensive in the world I believe. So I have to sadly trust my doctor and hope he knows what he’s doing and refers me to someone if needed. I got rid of a previous doctor who wasn’t listening to me and said there was nothing wrong with me lol, he then said it was back spasms, no it’s not, my mom had those and this is not that… in America doctors aren’t really incentivized to help patients. My new doctor is nice and seems to be genuinely interested in helping me, but like a lot of doctors in America he tends not to listen to what I’m telling him… but I’m giving him the benefit of the doubt… for now… that it’s his process to eliminate possibilities to get to a root cause. I have another appointment tomorrow, I may get X-rays or an mri to see if that will tell us anything.
Yes of course I will tell you if I get a diagnosis, but to be honest, I feel like I’m a long way off from that and more importantly, in America doctors don’t always diagnose things, especially when it’s pain related, they just try to mitigate symptoms, so there’s a good chance I’ll never have a diagnosis.
Some questions for you, is your pain on one side, both sides or does it alternate? Do you have a hard time sitting? Do you mostly get the pain when standing from a sitting or bending position? Have you ever experienced pain shooting down your thigh or leg? Where do you have the pain, just the buttocks area (SI joints)? Or also at your waist, pelvis and hip? Do you have arthritis anywhere in your body or any autoimmune disorders? Is there anything else of relevance you think may be important to mention? (Sorry to ask about your personal medical history, that’s private and I obviously respect your decision if you would rather not answer any of those questions, so please don’t hesitate to tell me if you would rather not answer, I won’t be offended).
Good luck & blessings to you as well.
@@The.Hawaiian.Kingdom hi, of course I can easily answer your questions :) I will reply with more time, but the pain was/is only on one side, my left leg, and from my understanding of the human body, at the sacroiliac (also on the left side).
It all started in the end of the last Summer I believe, sometimes when I would get up in the morning I would have that shooting pain, if I sitted down to have coffee it was the same, but then the rest of the day, I was usually moving around I would get better.
I kind of got used to if I would sit then when I would have like one minute or two of horrible pain and then I couls walk normally.
But I didn't go to the doctor and let time pass, and it got worse. I am glad you are already looking onto it. Then I started to have that sacroiliac pain really bad. To the point I couldn't stand straight, like something is out of place. I guess it always were, but in the beginning I adapted my muscles and nerves to stand and hence that horrible pain. From what I suspect, something is slightly out of place in the sacroiliac and then it affected the rest, but in the beginning what I started to feel was the symptons not the cause, because I would naturally stand upright, I don't know if I am explaining right.
So the physio teraupeut, my doctoelr, traumatologist they all agree I ad inflammamtion in the muscles, my sciatic nerve was apparently damaged from that effort. Because the muscles, nerves etc were adapting to a new position and straining because something is not well above.
@@The.Hawaiian.Kingdom here in Portugal, the medical services were amazing but it really deteriorated in the last years. Cancer, diabetes got a lot of free services, but this kind of cases are dismissed and my doctor didn't even made me do aditional exams like an rx or magnetic ressonance although I could barely walk or stand when I went to see her.
I am now doing things with private consultation. Osteopathy, here, at least, I couldn't have a consultation in the hospital because there they only have orthopedy, that is based in medication and surgery. And osteopathy can put things back in place, adjust.
I have a consultation after tomorrow, and I let you know what diagnost I got.
Oh, apart from the pain medication my doctor got me, I am taking bromelaine, which is an anti flamatory derived from pineaple, you can buy it at natural places, pharmacies, etc, and it completely aliviated my muscles inflamation.I was told it can be taken with most AINE except with aspirin.
I am also taking L-Carnitine from Solgar. In case it is a herniated disc, it helps it to recover.
Guys, I am not a physiotheraphist and I don't get it... What causes pain and popping in the SI joint? As I understand from this video, it is not the bad alignement of thr joint that causes pain cuz the joint does not move so much.. what is it then?
Impossible to say from afar, would suggest to get it checked out by a local physio.
@@Physiotutors or better still an osteopath.
Osm sir
Osm?
I would just like to say that those of us with connective tissue disorders (such as Ehlers-Danlos Syndrome), can have extremely noticeable SI movement. So much so that my partner with absolutely no medical training can feel a bulging differences on the side of my slips.
Wrong.
@@TheStizzel You clearly have no idea what you’re talking about. I’ve been having my SI subluxations fixed, weekly, for 15 years... and I have medical records to prove it, complete with imaging. 😑
@@StalkAlexHere Please ignore the troll. He doesn't know what he is talking about.
Hi Alex. had a question from you because you are the only person mentioned a bulge. Do you see a bulge on your back because of this condition? or can you feel your bone sticking out more on one side? I have these symptoms and other symptoms of SI but no one mentioned such a thing. Thanks :)
Is Ehlers-Danlos Syndrome the new Fibromyalgia ?
Hi, after my pregnancy I couldn’t walk, literally I crawled to walk for about 3 months!!! Doctors said that it was because of weakness. I could walk after 3 months but the pain was still there. It comes as I stand in the kitchen. I did MRI, which showed that I have an arthritis, a small inflammation on my ride side of back. Recently, I came to know about this word ‘SI Joint’. The symptoms are exactly the same. How to find out whether it is SI joint pain or not. Can it be found out by x-ray ? Looking at the MRI, the doctor didn’t tell me about SI joint, he only told me about arthritis. Please help. Thank You.
Their are lots of physical test to examine si joint but the only golden way doctors use in america is giving anesthetic injection in si joint and if pain goes away then it confirms the si joint dysfunction..but its not needed you can go to chiropractor and he can solve it with adjustment
Not SIJ dysfunction but SIJ pain. Two different things
mayank sharma really, is chiropractic the best way to solve this problem? I’m so confused to be honest. First, I didn’t even know the cause of pain, I thought my body was weak because of pregnancy as everybody said so. But, when I saw a you tube video with an explanation of the word SI Joint, that’s how I came to know the root cause of my back pain. All this time I was unaware, I was just using “back pain” but not “SI Joint pain”, thanks to that u tube video. And now that I know about my pain, i am confused about how to solve it.
Physiotutors what is the difference? How to find out ? And where to go for resolution? A Chiropractor or A Specialist or A physiotherapist? Please advise, your advice will be really appreciated as you have more knowledge in this area.
smritee dahal I would like to know the answer too!!! I am hypermobile I don’t have much low back pain but my chiropractor said I’m out of alignment (spine?) down there. I stopped going but wondering if I should go back now that I’m strengthening that area.
Thank you for this clear to the point statement. We as PT Students still learn these asessments without getting critical information like this!
So none of you have never seen a pt with eneven hips, but no true length discrepancies?
Yep. Often. I am a wheelchair and seating therapist and see all extremes of posture. What you describe sound like pelvic obliquity and or sacral obliquity
Where is the announced movie about the explanations why techniques are working nonetheless?
Search for “how manual therapy works” on our channel
so would there be a reason to palpate the SIJ? besides trying to identify painful structures...
Only thing that makes sense is to use provocation tests
1. Muscle guarding tissues --> which tissues? Visceral, arterial, lymphatics, venous, periosteum, FASCIA, nerves, muscle themselves etc...
2. SIJ has "inflammation", could it be the microvascular system, where you can find the lymphatic pump mechanism is dysfunctional due to certain cytokines IL 6 etc.. causing a reflex --> causing pain --> causing "restriction".
3. Evidence of catching up in some of the pain science but it is still a long way to go. Basing your opinion on current science of ebm, we won't be performing lot of life saving surgeries i.e. heart transplant etc.. no RCT
I cannot find their theories that might explain why manipulation of the SI Joint 'appears' to relieve pain for the countless people that have had it. I clicked on all the links but no luck.
1. Seleroses are noted at the both S. i joints.
2. joint spaces are bit reduced
This comments show my x- ray report
Please explain this report
How i cure permanent this problem my age is 18 yrs sir plz tell
Have a look at our exercise video for SIJ pain
Need more busted content
I am stuff as crap and unable to fold my legs probably.
There is no pain at normal position, but when I fold my legs the area around it like my groin, bum and lower back is pain!
Theory vs experience.
Poor video good comments 🙌
So.... Any solutions?
Check out our other videos on the SIJ
I fully understand the palpation myth, however am I to believe the sacrum or illium cannot shift as well? And if not then what about the other subjective or objective findings such as pain and or leg length discrepancy if illium up slip, down slip or sacral torsion does not exist?
The SI joint can of course be painful, they’re highly innervated. Though upslips or downslips are not to be expected according to what we reference seeing that there is such great variability even in a
symptomatic patients
Physiotutors so what do I do if my pelvis is visibly wonky and I have pain that’s stopping me moving? And when I do muscle energy techniques my iliac visibly moves back into place? What is the dysfunction if the joint doesn’t move?
you don't really need research to know it's not reliable .. clinically, if you and another therapist did the same test, it's very likely that both of you come up with completely different findings !
Measuring = knowing so having good research to back up a claim is a good thing
Si joint related pain is for real, how do i know? I had it for 3 years. And when i treated it correctly the diiferance was night and day.
Mine was stuck on one side because of muscle inbalance in the hip muscles. By sitting on a chair and bending sideways, the range of motion differ a lot between left an right. Only because the si joint only moves a little - the movement is a desimeter at the fingertips Don’t listen to someone telling you SI Joint movement doesn’t matter.
Important things to consider is iliopsas muscle strenght, core muscle balanse and listen to the body pain signals, they tell you a clue where the problem is.
Also test your core muscles for strength imbalance - i tested mine laying on the floor with straight leg raises, my left leg could’t reach 90 degrees, problem found.
Which exercises you did for iliopsoas strenghtening?
I've been going to chiropractor and a deep massage therapist and I know my core is been weak I am bodybuilder I train legs every week one day I woke up my left hip was in pain amd than went to chiropractor to do adjustments and he did the next day whole my hips was on fire I guess my muscle wasn't use to it but anyways I've been taken care of it by resting, ice and heat and minor exercise in da morning to build glut muscles and palvic floor muscles and core is been my 4 weeks and changed my diet more antioxidant food so see been much better maybe is not si joint but chiropractor said was out of a alignment need to adjustment so hope it will go away
Amazing video and mind blowing information✌️✌️ I felt like my entire DPT degree was a joke!😂😂
This video is like a teacher telling you that your answer on a math test is wrong, but then not teaching you what the right answer is, or how to find it... COMPLETELY USELESS. Thanks but no thanks.
Thank you for making this video!!!
ur welcome!
Is this anything like facet syndrome? My doc looked at my mri and took My history and diagnosed me with facet syndrome
That's different. Facet syndrome are higher up your vertebral spine
@@Physiotutors only way to fix that is manipulation and strengthen the muscles so your not having excessive movement only way. Many times its ure hips out of alignment and throws the sacrum off cause the sacrum distributes the force movement to the hips . 90% of the time lumbar is off also the hips and the sacrum is yo base u r e lumbar won't stay aligned until those things are taken care of. I had si issues hips back problems and a good chiro that went to palmer school will do it . Check your leg lengths and adjust. Its like the chicken and the egg structure has to be adjusted then muscle training to keep it strong and flexible to your joints what comes first???? I here oh you have to do pt first thats great but.for si problems chiro is the best bet.
So to the many commenters here, understand that the therapist in the video is relaying results from scientific studies. You might feel something in your body, no one can refute that, but it is difficult to reproduce in a clinical study, and thus no evidence for that being the case.
And understand, this is a video by physiotherapist, for physiotherapist.
I DEFINITELY THINK THAT SOMETHING ON ME WAS LEFT CROOKED AFTER FALLING ON MY RIGHT BUTTOCK AND NOW I CAN ALSO HEAR A CRACKING NOISE ON MY GROIN WHEN MOVING ALL THE WAY TO THE RIGHT OR THE LEFT MY RIGHT LEG ....
true
Historically speaking, physical therapists compared to other professions have been under trained in the evaluation of the vertebral column and the sacroiliac joint complex. It find it disheartening to see a physical therapist criticize other approaches to the sacroiliac joint.
The studies you mentioned are far and few in between, conducted by competing professions and you fail to mention peer-reviewed studies to the contrary of your attempt to belittle other approaches.
Your video is typical of a person with a lack of training in the more sophisticated approaches to evaluating and treating the sacroiliac joint. To palpate the sacroiliac joint requires a more advanced and thorough education than a simple physiotherapist education. It takes years and specialized courses to learn the finer points of palpation.
By the way, I have a training of 6 years in an accredited university in the United States, been a department head in a hospital that has been used in a Harvard University case study, personally visited over 27,000 patients in 35 years of practice, and have been under contract for a serie "A" soccer/football team working in symbiosis with medical doctors and physical therapists in Italy for the last 17 years so I think a young upstart like you should give my comments some thought before you attempt to discredit other approaches.
You can feel free to contact me at your convenience for further clarification.
Seems to make a point about sensing movement is like reading Braille through a steak. Can u recommend any videos? I sat on a vibration plate and alternated which sitting bone sitting on plate. locked side felt full body vibration non locked side next to non. Next day couldn't replicate...maybe it loosened it up, maybe I was imagining..
@gil Antonio.
Seems like you cant handle the truth. The evidence is clear. You can’t palpate for positional faults. You can’t even reliably find sips or sias. You can’t move the sij via manipulation or mobilisation. Just because you think you’re an expert doesn’t mean it’s true. Just because you have done something (apparently the wrong way) for the last decade , doesn’t make it right.
It seems like you should keep up with the evidence. Your statement is laughable. Educate yourself. Read some study’s. get smarter. Seems like an advice you could use
@Gil Antonio Are your case studies freely avaiable on pubmed?
Spot on.
Manipulation of the sacroiliac joint normalized different types of clinical test results but was not accompanied by altered position of the sacroiliac joint, according to roentgen stereophotogrammetric analysis.
Likely this fancy stereophotogrammetry isn't accurate enough. How are babies born? Basic Obstetrics science has shown that the SI joints move to let the baby out. The problem w today's health care is that barely anyone looks farther than their limited books and articles, where commonly "more research is needed" ends up the writings. Why would there be even joints if no movement took place there, it would all be one calcified and monolith pelvis, wouldn't it ?
@@rossianabojinova6589 i agree.and some important stuff just hasnt been researched enough. Recently I attended a disection course where the professor told us that he had a PHd student examine the sutures of the skull under the microscope and only found 3%calcification and 97%fibrin. Another one examined how the plexus lumbalis runs through the psoas and found great variaty. The biologic reality often looks different than the paradigms
I had back surgery, and that led me to be disable for over 10 yrs, finally got diagnosed with SI dysfunction and got injections and was cured the moment I was injected with the shots.
@K Barnes it's an SI joint injection. I had it done in California from Dr. Roshan. He literally saved my life. Good luck there are other doctors out there that do these injections but not many. Also look into SI joint fusions www.pacificpainphysicians.com/provider/daniel-roshan-md
I got to si joint fusion I woke up from surgery pain free . Had surgical pain but not bad at all. Can't wait to get left side done.
@@OffroadCpl I've had several si injections, only works for a little while for me. I had CornerLoc "fusion" surgery on left side in October. I only had a few good months after. It only stabilizes the joint while everyone hopes for fusion, not guaranteed. It did stop the most excruciating pain but my si joint on that side still "goes out" and the pain is an 8-9 instead of a 10. More injections...lasted a month until I got a flat tire. I put on the spare, was in so much pain I went straight to chiro. Both si joints, hips, and tailbone shifted. It has been 2 1/2 years of exercisrs, chiro, PT, surgery, injections and im only 10-15% better.
I've never been certain doing segmental palpation tests .. and many times I can't feel anything esp. when there's too much fatty tissues in that area ..
Absolutely
My SI joint is on fire and I can’t move.
I’m in hell for the second time, or is it the third.
free quizzes please
We're working on something like quizzes for our webpage
All of us with EDS are not happy about this video so please redo the video and add that to it
Riiiight. It's "fake". That's why it shows up on x-rays, MRIs, CT scans... and it hurts so blessed much.
We know the cracking is liquid movement, could it just be this tiny liquids movement relieves some stress at this joint!
You don't get cavitations when manipulating the SIJ
@@Physiotutors does manipulation move it more than IRL
Manipulations don't move it more than the 1 degree it can move. It doesn't put anything back in place and the effects are probably Neuro modulation
Video is not about you remove your picture and insert a disk 3d shape any disk shape
Thank you so much for making this video. I am attending to a fellowship and was told to correct a certain positional fault for SI joint. What a fruit for thoughts!
BS, not measurable!
I don’t care what the reasoning is, my pain is always relieved after adjustment.
I was always the same way. An adjustment at a chiropracter would relieve the pain noticeably.
@@alan4sure You get pain relief from neurophysiological changes in your body. Not because something moved.
Manipulation helps bc your removing interference on the nerve