By Jonathan Cluett, M.D.October 9, 2003
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SIJ dysfunction is very common disorder. SIJ pain is just one symptom of many it can cause. And usually the pain is on the healthy side. You don’t believe? When you get an upslip of ilium it moves up compared to sacrum and usually rotates too. That lifts hip bone too and the rest of the leg has to follow. When standing and walking you have to get that leg touching the ground so you have to twist your pelvis so that the leg at upslipped side can reach the ground. That way your sacrum is leading to the upslipped side. But your upper body has to lean to the other side to keep the body in balance.
So as far as 80% of your body mass can be carryed by the other side SIJ with every step you take. So eventually muscles and ligamenst get tired and cause cramps and pain, sometimes even inflammation. And also on that side the nerves are more compressed bacause the scoliotic curve of lumbar causes more pressure on that side. It is not always like this but most cases are. Many other subluxations of pelvis can happen too and they can cause different posture and functional changes.
And medical sudies tell back pains are in 70-80% of the cases on the longer leg side. They just think that length difference is anatomical. Even if you look from X-rays there can be length difference because pelwis is twisted and iliums are not equally positioned so other femur is closer on z-axis than other, but on 2-dimensional picture you don’t see the z-axis. You see only 2D prjection of 3D world and that can shorten other leg easilly 1-2cm depending of the picture angle.
Some say SIJD is mostly women’s disorder. They are right, but many men have it too. About 80% of people have it causing them many different Muscular Skeletal Disorders. For women it is easier to happen because their pelvis is buld to give up easier. So smaller trauma can cause them upsplips, subluxations etc. And after giving birth those problems arevery common…
Most common SIJD case is upslip: Other ilium has moved out of it’s natural range and got stuck because of a trauma, fall, slip, or other accident. usually it is also rotated forward (anteriorly). When stuck it has no schock elimination and all those forces from down to up go to spine and causes countinuous stress there: wear and tear of spine and discs.
When pelvis is not functioning symmetrically it stresses the spine. There you get scoliosis, extended lordosis, wear and tear in discs and vertebra. Also altered pelvic ring posture causes piriformis tightening, ischias, leg weaknes, muscle imbalance, back muscles tightening, bad body posture, neck problems, shoulder problems,.. And to legs not only hip problems but also knee, ankle, achilles and many others too because it changes the way you walk.
But because the pain usually comes after yers of walking with SIJD that is difficult to diagnose. The trauma that caused it is so far in history. And it is not only a disorder for adults but also for children too. To children it causes ie. idiopathic scoliosis. See those pictures they use describing scoliosis: 9 out of 10 have pelvic bones malaligned. They say scoliosis causes that. But if your pelvis is not levelled the spine can not be straight. Can it? It was corrected from me at the age 35 by pushing it back by one old doctor. I had had mild scoliosis, short left leg and unleveled pelvis for all my life. Not any more!
And when they diagnose that rotation scoliosis, it means your other ilium is more forward than other (upslip and anteriorly rotated). It causes that twisting force to lumbar spine. And up in shoulder level you willingly fight against it trying to compensate that twist…
And when you have both SIJS upsipped you will get very exteded lordosis and you walk like Donald Duck …
This was a short message about SIJD and I am just an exSIJD patient.
hi i was in a car accident april 07,i think i have sijd. pain in middle and lower back, tight and painful thigh muscles, painful and swollen knees, sore ankles, short leg and dipping shoulder. i have been to dr., chiro and pt. i was told i have fibromyalgia, i dont believe i have. who helped you? i dont know what to do but i feel i am getting worse all the time. thanx
hi toni pleased to hear you are much beter,who helped you as i desperately need help thanx
Who helped you and are you totally pain free now? Mine is getting worse everyday. Need help.
hi toni what kind of treatment did you get and by whom chiropractor?
I was recently diagnosed with this disorder by my physiotherapist. I have been given a strict regime of exercise and stretches and so far I can feel the difference. The pain initailly increased (as to be expected), but now it seems to be getting better. I went running yesterday (though only on a treadmill, as road running has too much impact) and I could feel the imbalance in my leg length…. Toni you said you had yours ‘pushed back’, how is that done and by whom?
I think I may have SIJD. Are the symptoms often exaggerated following childbirth or during pregnancy? I had extreme lower back and pelvic discomfort during my last trimester – which I attributed to normal pregnancy discomforts… It is now one year since I had the baby and I have been exercising regularly (mainly running and some weights). Lately that pelvic and lower back pain has come back with a vengeance. I notice the pain most after sitting or lying down, when I go to stand. I’m only 35 and it makes me feel like an old lady! Does this sound like a case of SIJD? If so, could running aggravate the problem?
After reading some of these comments I know how you feel. I am 29 year old male and have had arthrits in my si joint for 5 years now. It came on over night, I didn’t know what was wrong with me. The day before I was completely normal, then when I woke up, I could barely walk. Extrem amount of pain was in my lower back. For 3 years I did everything possible to heal myself before I finally gave in to go to the doctors. The doctors was my last option, but I had no more options, they diagnosed me with arthritis im my si joint. I was angry and upset. I have been very active all my life with sports and even played college basketball and did very well. Patience did not come easy to me, they were going to give me the cortison shot but I weaked out last minute, ( the needle is huge that they use). Eventually the doctors gave me medication, I was feeling great after about a month. It worked for about 2 years, then I noticed it wasn’t near as effective as it had been. I gave up on the medication, and then it hit me real hard, I couldn’t walk. I was literally crippled, I could’t walk, and could barely crawl. I would cry when trying to sleep, the pain was so bad just even roll over or even move an inch. I had to do something, and I did, and it has changed my life forever. I completly changed how I eat and it has worked wounders. Sugar destroyed me and causes extrem amount of inflamation in my si joint. My diet consist of large salads with a lot of vegtables, fresh fruit, very little meat, not much red meat at all, the red meats can cause inflimation. Water only. I make what I call a green smoothie and have it every day. After 4 days of my diet change, I was almost back to normal. 2 weeks later I was playing basketball again and enjoying playing with my kids. My wife has helped me a lot through this, and I couldn’t have done it with out her. I hope this has helped, but most of all, I wanted to share how I feel
Thank you for sharing, Tim. I am so happy for you. I am 33 and have scoliosis and have moderate back pain. I am on a sugar-free diet as well and your post has encouraged me to keep this up! Thank you.
I have an upslip – rotation that has caused achilles problems. I have seen 3 chiropractors over 15 yrs and done PT 3 times all without any real change in my condition. How do you fix this and who do you see to do it?
SI joint pain, especially with rib cage pain and pain in other joints that is worse in the morning and after inactivity can be from Ankylosing Spondylitis.
can you please refer me to someone who can help me with
my upslip? Thank you–desperate after 5 years . . . . .
YOU ARE AMAZING! Thank you so much for your detailed comment, which all makes so much sense, considering all of the different pieces of the puzzle that I am trying to put together from PTs, chiropractors, osteopaths, and information on the internet about these problems and solutions. Thanks for taking the time to post.
I am trying to figure out my calf pain and I know that my pelvis is out of alignment (I can just feel it). The calf pain is only when I run or power walk. It is centralized to the middle back of calf but the I feel the tendon from my heal to my hip. My lower back is tight and there is some pain in the upper hip area. I do yoga and it doesn’t hurt while I do it but I do stiffen up throughout the day. Does the calf pain seem related to the pelvis back. How do you get it aligned, does chiropractor work. I have also been sensing that sugar makes it worse. Thanks for any help or suggestions.
I thought I would leave my story as it is quite relevant and may be of help. For those who have these issues, I seriously encourage you to do ALL in your power to correct as soon as possible after the injury. The longer you wait the more the injury and imbalnces are set and harder to correct.
I am an ex-downhill ski racer. At the age of 16 I had a bad accident witha SERVERE impact to my pelvis, I’m now 38. I flew 120′ at 75mph and landed on hard ice with my left side pelvis, dislocated the same hip and damaged ligs in low back and had a pelvic slip. All these years later I’m struggling daily with back pain, hip degeneration and major muscle imbalances from head to toe.
While the severity may seem extreme, I want to impress upon you that I had been extremely active and happy and pain free all these years up to just about three years ago. I tore my hamstring just while working out, and my whole pelvic issue came crashing down on me. Within days I was unable to even walk through the grocery store. I could feel my pelvis grinding and popping. Anyway, had I had the original injury assessed and corrected I do not doubt I’d be fine today.
I have gone through a series of adjustments that did help but not long term. The one life saver for me was Prolotherapy. While particularly tortuous the treatments saved me!! The chronic pain went away. I was no longer grumpy and moody from enduring daily life. I got back into working out got strong again. A few years later, the pain is creeping back and I’m in need of prolotherapy again.
Moral of the story: Do not be casual about getting this fixed. If you’ve injured the ligaments. GET THEM FIXED! get the joints restabalized, don’t be casual about it because you feel ok. The main reason, is that as the injury ages it makes you MORE injury prone, and MORE likely to develop serious postural issues.
Good luck, and don’t give up!
I have this problem , have adjustments all the time works well , only problem is it won’t stay in place. Did u have surgery.?
I believe i have this problem. In the last 2 years, i’ve seen 2 PT’s and 3 Chiropractors and nobody has been able to help.
Is there someone near me that you can refer me to? Or some kind of specialty that i should look for?
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