Simple Solutions to Sacroiliac SI Joint Pain

[Music] hi i'm dr brant pedersen and today i want to discuss with you a common cause of lower back pain that often gets overlooked and if it's overlooked the conventional ways of treating lower back pain like physical therapy and chiropractic massage therapy acupuncture going to your md none of those are going to have lasting results the crazy thing is is that if properly diagnosed s-i joint instability and we're going to help you understand exactly what that is when properly diagnosed it responds really quickly to the things that you can do at home and the things that you can avoid i want to start giving you a classic example of a patient that came into my practice with this type of symptom she's a 19 year old dancer and theater student in manhattan and she initially got this pain by sledding she was sledding on some really hard icy snow bouncing up and down on her sit bones so this is your spine the base of your skull here and here these bones they're called your sit bones or medically they're called your ischial tuberosities when you're sledding she was bouncing up and down and hitting really hard on those bones what she started to have was pain at her sacroiliac joint um the joint between your sacrum and your ilium right sacroiliac joint um that then traveled into her hip up into her low back and was even causing pain down her leg she tried for months working with a chiropractor with a physical therapist actually with an acupuncturist as well to get relief and the relief was only transient it slowly over months and months and months got better and then she bent over to open a drawer and the pain came back she was right back where she started so frustrated again she tried going back to chiropractor physical therapist not getting relief and then she had a trip coming up to go to europe to track all around europe and she was thinking because the things that made her pain worse sometimes walking certainly standing for any prolonged period of time like in a line bending over carrying anything on her back and also prolonged sitting like on a flight or a train or a bus she was thinking there's no way that i'm gonna be able to do this trip to here she was back home prior to leaving for the trip and they found us her and her mother found us they came in i did an exam and what i determined was that she had instability of these si joints in diagnosing that and i'm going to teach you how to figure out the symptoms that many times are associated with it and then giving her the recommendations that i'm going to tell you in this video we were able to get her get her feeling great uh in less than two weeks she went and took that trip she was 100 pain free able to carry backpacks to all that stuff she was rock solid so that's what i want to share with you today what we're going to do where we're headed from here is i'm going to teach you the anatomy of the si joint because if you don't understand the structures it's hard to understand how to get them better the next thing is how does an si joint get injured so we're going to talk about the things that most commonly give someone an si joint or si joint sprain or si joint sacroiliac joint instability initially then how do you spot it how do you know if this is what you have and can't diagnose over youtube but i can give you some things that might resonate with you and that you can also take to your medical professional to discuss and then lastly what are things that can be done by you at home what are things to avoid that you might have been thinking were the right thing to do that have been leading to more pain so let's get going the si joint what is it what can go wrong with it first off this is your pelvis your sacroiliac joint is right here on each side you can see it here from the front and this joint has about it's supposed to have somewhere between one and three degrees of motion every time you take a step it's supposed to shear back and forth like this gives you that sachet in your hips the si joint is held together almost exclusively by ligaments so this is from the atlas of human anatomy by frank netter md and you can see here that this is the back of the si joint this is the front of the si joint so you can see that if those ligaments that are holding the si joint together aren't doing their job if they've gotten stretched or strained if we've injured them that it's going to be very hard to have stability across that joint at that joint there are a lot of muscles that stabilize things but specifically across that joint is your piriformis muscle goes from your lateral hip out here crosses through the sciatic notch and attaches to the front of your sacrum here that muscle is important because it can cause pain in our hips sometimes down the back of our leg also your sciatic nerve runs either underneath or right through that piriformis muscle and so the piriformis is trying to take over and be really tight and get trigger points in it because it's trying to take over the job of the si joint ligaments that aren't doing their job then we can get sciatic symptoms they actually call it piriformis syndrome so how does your si joint get hurt what brings it on usually it is trauma in nature a classic what would seem like an innocuous type of way to hurt it is stepping off of something a step or a curb that you're not expecting with a kind of straight leg in the jarring that that causes to your pelvis and spine another way is a fall so a slip on an icy sidewalk or falling doing a sport you're learning to to roller skate a rollerblade right you're ice skating um you're walking down some stairs and you slip landing on one of your buttocks creating a shearing motion into those side ligaments actually getting a sprain of those acid ligaments and making them so that they don't uh provide the stability that they should to the si joint the important thing is and why this is can be such a big deal is your sacrum is at the base of your spine and it is the foundation upon which the whole rest of your spine comes off of if you have instability on at one si joint on one side and the stability therefore is uneven it's like the foundation of a house if it's not level then everything else the walls the roof all of those are going to be off that's where this can cause problems that lead all the way up the back but a lot of times we see the pain here another thing to consider is people that have ligamentous laxity right we all run on a spectrum there some people have really really tight ligaments some people have really loose ligaments people that have loose ligaments they usually love things they require tons of flexibility like yoga or cheer or dance that type of thing one way to test is to take your thumb here and see if you can pull it next to your arm can you tell if i have tight or loose ligaments that's as far as i can go right also looking at your elbow if you take your elbow and put it out does it kind of go backwards right or does it stay this is as far as i can take mine right i have i'm on the spectrum of having more tight ligaments someone that has more loose ligaments they're going to be at a higher risk for having si joint sprains or problems so how do you spot it how do you know if you have s hi joint problems and if you have si joint instability first off work with a good doc and don't give up if you've been working with a doc and um just feel like stuff's not going anywhere look for someone else ask for a recommendation of a family or a friend if you're in the san francisco bay area look us up positive motion chiropractic don't give up and knowing the stuff that we're talking about in this video will help arm you to be able to have a more informed discussion with your doctor some things cannot be reproduced in a video so in my office some of the stuff i'm looking for in the examination is tenderness to palpation right over that si joint region right which would be right here or here do they have ligamentous laxity and we talked through that already i'm also looking for if i take and do a muscle test of a muscle that is crossing the pelvis hip region and then i do attraction across that joint like pulling the leg axial tractioning the leg a few times and then going back and testing that muscle does that blow out that muscle and it shouldn't right it should stay strong if it does blow it out that's an indication for me that there's a problem with those aci ligaments things that you can look for that you might have is pain at your si joints or pelvis or lower back hip or sciatic stuff that isn't resolving you're frustrated you're like i've tried all these things just like the 19 year old dancer we talked about in the beginning if you've had an x-ray and an mri and you're getting the answer like everything's all right there's nothing wrong with you but you know your body and you know that you're in pain this doesn't really show up definitely doesn't show up on x-ray and it'd be very poorly visualized if visualized at all on an mri so it's one of those things we've got to do a physical exam a good physical exam to find pain that is made worse by prolonged standing or sitting that sounds like although it could be other stuff but that is is pretty classic for si joint instability it's usually on one side and not on both sides and it's usually something that speaking from a chiropractor's point of view it's usually something that if we adjust manually that a person will feel really good relief for you know a few hours and then they say gosh my pain's right back that's not what we're looking for when we do the specific chiropractic to the joints when they need it the results are lasting so if you need to go over and over and over and over and the results don't last for very long it could be that you have instability and a manual chiropractic adjustment where you're getting adjusted by hand isn't what's needed in this case another thing that we see is someone that has a desire to stretch let's say they're doing hamstring stretches or they're doing a lunge type stretch or they're doing yoga and they feel like that's what they need and while they're doing it um they feel like they're getting improvement but when they stop the pain's still there it didn't actually help lastly we're going to talk about in this next section what can be done about it a trochanteric belt and putting that on right helping that helping to stabilize the joint and when someone puts a trochanteric belt on and this is what i see in my office they go wow like this is this is what i felt like i've needed like these months or years that i've had this pain like this is exactly what i've wanted and so your body it's amazing it has the ability to tell you um what it needs a lot of times so a person that puts that on and goes wow oh my gosh that's usually a good indication that you've had an si joint sprain or that you have instability so what can you do to help your asset joint feel better when someone has an si joint sprain usually when they're given the correct treatment they notice results really quickly work with your healthcare professional armed with what you now know could be what's going on with you they'll be able to help you figure it out talk with them and work through their recommendations but here's what i do in my office to help my patients first off i recommend using a trochanteric belt that is different than a lumbar corset brace very different and there's a lot of different quality ones the ones that i found work the best in my practice is the sarola sarola trochanteric belts i'll put links down in the show notes below to where i get them an si belt goes around your greater trochanters we loosen the straps back here and you're going to take and put it on around the widest part of your hips or your greater trochanters so we're going to go here like that i put this on underneath my pants so you couldn't see it and then i'm going to put a little additional tension on either side this is usually the thing that when we put it on people it looks so fashionable when we put it on people they go wow wow like that's what i've been wanting we discussed that already um so the trochanter belt it's a great simple addition that can make people feel a lot better really quickly how often do i have someone wear this i have them wear it during their waking hours and i usually have them wear it for about two weeks that being said i've had people wear it as long as six or eight weeks if they had a really severe sprain but the cool thing is is that it doesn't cause atrophy of any of your muscles so if you had a lumbar corset brace if you wear that for extended periods of time it'll actually atrophy your core muscles right making you a more risk of having low back pain or injuring your back or disc next thing is is avoiding activities that shear the si joint so remember we talked about the si joint moves you know one to three maybe five degrees every time you take a step when someone uh is shearing that joint they're actually putting stress on those ligaments that's the whole reason we're wearing the trochanteric pelvis to try and give some stability to those joints so that the ligaments can heal so things that can shear the si joint doing a lunge like a runner stretch doing yoga like warrior poses in yoga stair stepper riding a bicycle especially if your seat's down low where your legs are coming up really high and one of the best things you can do to strengthen the areas and to help with si joint instability is to go walk not going hiking crazy hills but walking on flat ground at a reasonable pace doing that we say three to four times a day for 15 minutes but if you can only get it in one hour long walk that's fine but that really helps the muscles and the joints there in your pelvis something that i use in my practice that i find helps the ligaments to heal and get people back quicker is something by standard process it's called ligaplex one again i'll put a a link to it down there but ligaflex1 is just a natural food supplement that helps the ligaments to heal can use it or not i just find that it helps things speed along and then chiropractic adjustments interestingly this is a joint that's moving too much that's hypermobile because of a sprain to the joints so an adjustment by hand a manual adjustment where you'd hear cracking as i've been taught that's contraindicated that's something that we wouldn't want to do what we can do to influence the joint if it looks like an adjustment as needed is do a low force adjustment so this is an activator tool it looks scary but it puts a small impulse in like that we can use that to get an adjustment here is an example of a tiny drop table we use for extremities but a drop table on a chiropractic table if your doctor has that um comes up like this and then based on the tension that's set there it drops and we can get a good adjustment of the si joints but again it's a low force technique called thompson drop technique so that's another way we can adjust if it looks like that's indicated if you've learned some good stuff from this video love it if you give it a thumbs up comment down below also if you've got other questions that's what feeds us to make new videos is helping answer your questions helping people get healthy love it if you'd subscribe to our channel we're always trying to help people understand their bodies better so that they can feel awesome here's to wishing you the best in health and if you're in pain that you get feeling better quickly [Music]

Channel: Positive Motion Chiropractic

Views: 3,243,906

Keywords: Chiropractor, SI joint, SI joint chiropractic adjustment, SI joint dysfunction, SI joint exercises, SI joint mobilization, SI joint pain chiropractor, SI joint pain relief, SI joint pain symptoms, SI joint self adjustment, sacroiliac joint, sacroiliac joint pain relief, si belt, SI joint instability, Sacroiliac joint instability, si joint pain fix, si joint pain diagnosis, si joint inflammation treatment, trochanteric belt for si joint, sacroiliac belt, Serola belt

Id: -lAIOBjgYkE

Length: 16min 33sec (993 seconds)

Published: Mon Jul 20 2020