Hi folks, I'm Bob Schrupp physical therapist, Brad Heineck physical therapist, together we are the most famous physical therapists on the internet In our opinions of course Bob, we're like superheroes Today we're going to talk about immediate relief and self treatment of the sacroiliac joint or the SI joints We're going to show you where it is And we're going to show you some things to try because we're not going to have you try to diagnose what you have specifically going on with it because it's too difficult for you to do that But we can show you things to try and if it takes away your pain, c'est la vie And these treatments when they work they work right now and you're gonna feel that pain come down, if they don't or sometimes you irritate it a little bit Then you're gonna stop those, we'll clarify that and so make sure you wait for that but Bob has something to mention to everyone Yeah, in case you are new to our channel, please take a second to subscribe to us We provide videos on how to stay healthy fit pain-free and we upload everyday Also Brad's gonna do his job here, go over to the Facebooks and like us because Brad and I as children it's sad you're tearing up a little bit, were not liked and now we're trying to turn things around So you go to Bob and Brad. There you go, Bob and Brad and now SI information Sacroiliac Bob that's a big term and it really I think kind of throws people off because I've heard some people think that their back pain is sacroiliac just because it sounds like well, I'm having sacroiliac pain It's really their back. But it is often in that same region, sure That's why people it could be, should we use Sam? Sam to help So the SI joint sacroiliac, the word comes from, here's the sacrum and here's the ilium The sacrum is a triangle-shaped bone, big solid one right at your buttock, and these are the two pelvis, kinda on each side of it So, that's the ilium. You're right. And so the joint is right here. It's where the two bones connect It's not a joint that moves very much at all. And that's controversial in the medical field We're not going to get into that, there's a lot of big heavy ligaments that are holding it in place, right So if you see an anatomical picture of it You'd see why it doesn't move much, right, we think there is some movement, sure Okay, so that's the SI joint now can, now this is gonna be something new for for Elizabeth Can you zoom in right in here? So here if you can see, Bob, can you hold the sacrum? Sometimes Liz we have to be at a certain distance from you. Does this work out okay? We're gonna ignore the the nerves and get that out of the way So here's a sacrum and here is the ilium now the joint now this is what can happen There can be slight movement in there. I would actually show that from the side too Brad Good idea. This can, see how that rotates, so it can be rotated back That's the posterior, and get kind of stuck that way or rotated forward and kind of stuck that way So we're gonna try getting some movement in there to see if that relieves your pain, right So that's what these exercises are gonna do, specifically, and if you get it to move the right direction The pain is going to drop right down. You're gonna feel it I think the other thing we should mention while we're here Brad is: what are some of the causes of this, good real good point It's like if you're walking and you, we'll back up again Inadvertently step off of a curb and you come down real hard and you put some jolt Through that, that can take that joint and rotate it. So if you as a matter of habit are always sitting like let's say you sit with even your legs crossed and you're always putting weight on one side You know year after year after year, you're actually putting stress on the you know The ilium is different in a different way and it can actually cause a little bit of rotation if you're in a car accident and your knee goes into the dashboard if you had That kind of force into that, that can shift the SI joint, if you have one leg longer than the other there you go, that can actually often I see that quite often in people that are That have you know especially if it's a little more than a half inch, it can really make a difference, or you get a total knee and maybe they Didn't quite get them right and all of a sudden you have a sudden change And you got a shorter leg after a surgery And one of the more common ones which Liz our camera woman can attest to is when you're pregnant, right There's those chemicals that help loosen up the ligaments, right and it makes them easier for them to rotate and can cause you problems, chemicals No body chemicals, they call them hormones. Yeah well They're a chemical aren't they? I would imagine yeah, it sounds better to be--hormones Now let's say as a matter of fact this just happened to me two weeks ago in the clinic and it works so well It's like man we got to get this out to our viewers. Sure She had back pain, typically if it's SI, it's when you walk or put weight through it is when it's worse Yeah, when you sit down typically feels better or laying down Hills are worse stairs are worse, right that weight-bearing, putting force making that SI get pushed and painful Pain is typically here. It can't go down the leg usually not below the knee I've seen it referring to the groin too Brad So with that in mind This is what you're going to do If your symptoms sound similar to that, you may have an incident of the causes that we mentioned This is what the first thing you're gonna do is, I wish I had a chair Bob here We're really prepared here today, well, it's not far away Bob Okay, if you're in a nice firm chair, you don't want to do this on a couch or some Soft chair like that, good firm chair with good posture If you take your knee up and lift it and say this is a painful side This is called a muscle energy technique in the therapy world I'm gonna push down and hold it and actually do an isometric and this patient that I had just a couple weeks ago She did this immediately she said boy that feels good. I mean it was very clear. So her home exercise program was to do this hold it for about five seconds and relax. How often were you having her do that Brad? I told her to do it every one to two hours, sure, you know That's the thing is you don't just do it once a day. You're doing this constantly to try to help Gradually adjust that so that it stays back in place and feels better So, you know she came back and it was working but it kind of plateaued it got about 50% better So then the next thing you can do and if that one doesn't work, you could go to this and You go to the side of the bed Don't fall off, yeah don't fall off, you take the painful side and you gently let it down on the side of the bed and Then we're stretching Technically we're trying to get a posterior tilt into an anterior tilt with both of these techniques don't worry about that if you do this and this is her situation. This just felt good She just said oh that feels good, you'd probably want to lock it in place wouldn't you Brad? That's a good point Yeah, you want to hold on to that knee and let this one hang down and that's gonna help again adjust that SI It's something you try and see if it feels better and if it doesn't if it hurts you don't it, you just scratch it, especially if it makes it worse, right We've got two other ones that you're gonna try both of those don't give you that immediate relief Then you go to this one. Actually, you can stay laying in the bed, to me sometimes Brad is that if this actually makes it worse I'm sometimes happy about that because that means maybe if I go to the other side, it's gonna make it better, precisely yeah So this I'm still on the same leg. That's the painful side. Those two techniques didn't work I'm gonna take this knee and bring it up to my shoulder and Then I'm gonna hold it and I'm gonna take my knee and push it that direction While I hold it, we're actually doing an isometric another muscle energy technique hold and push and if that feels like good pressure, feels good I've got an SI problem on my right side, that's feeling good right now and I do I do these too on myself on a regular basis I actually like to go around like this because you're a little more stable and then push like that But it doesn't matter whatever makes you feel better Now you can take this leg and put it down or here or up whichever works better gives you better results And again, you're gonna hold it three to five seconds. So again if he wasn't holding it that knee would come right down, right So I'm gonna do that three times and then you're gonna repeat that throughout the day again Once every one to two hours until you reach the plateau with your progress and hopefully it'll be gone. There is one other one That's similar to that, is that the stool one? Yeah You can do this on steps because it's different heights. If you got a rail, it can help you do it better This is a little high for me but it gives you the right idea so you're gonna go up there, if you're doing it on a stairwell you're gonna hold on to the rail and then you just lean into it and once again, it should feel like oh, this is a good stretch. It's making that pain feel better And then when you're done you walk around, it also should feel better Then you know you're right on, so there you got four different options for SI joint pain that are going to immediately cause relief, if it's the right one. And then you can also try basically, if you want to try a belt, an SI belt, you could do that Oh sure. You can give that go. Just happened to have one Bob And basically what you're trying to do is you're trying to hold the pelvis together and this is again in those cases where the hormones are taking place and If you're pregnant, now Liz she's had a couple children and she has one that she has to watch in addition to that: Alex I always like that joke. Yeah, that's her husband, by the way, but she tried it you had good success with it, right Liz? Now you didn't have this one, but she had one that was made for a pregnant woman, right So it puts force around here and stabilizes those joints So yeah the way I determine whether or not it might help someone is I actually go up to the person, no Brad And I actually push on their pelvis and I have them walk and I know this is kind of a goofy thing to do, but you walk behind someone and if that gives them relief then there's a good shot that the belt's gonna help alright, so you get one of these SI belts and you put it on here And it has to be on the pelvis not too high on the waistline. The pelvis is right here Starts right here. So it's below the pelvis. Yeah, and you can tighten it up from both sides. You get it nice and snug Should feel good. And then you wear it throughout the day, and a lot of times, you know once you get it calmed down it stays calmed down Yeah, that's the whole idea, you know when things get inflamed It can be very difficult to get that inflammation to come down. So that's why this can help with that So a lot of different options and once again, Bob I really like to tell everyone here, we can fix just about anything throughout the body, except for a broken heart. There you go But we're working on it, we can give you advice too on, you know, if you're lovelorn and you having trouble finding a date Well we could, it might not be good advice. It's not good advice, but we could give advice. So thanks for watching
