December 8, 2019

Sacroiliac Joint Pain: Everything You Need to Know To Cure.

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 opinion of course Adjust your posture Brad. Today we’re going to talk about sacroiliac pain everything you need to know to cure it We’re gonna basically talk about the anatomy, the causes, and then we’re gonna show you the exercises Yeah, this is a whole cornucopia Bob. This is gonna bring it all up I’m just gonna bring it all into one picture and you’re gonna have a good educational experience and have some success If you are new to our channel, please take a second to subscribe to us Please don’t make us beg, we provide videos on how to stay healthy, fit, pain free, and we upload everyday also But we will beg if you want Please go over to Facebook and “like” us so we don’t have to beg I distinctly remember as a child my mother would use the term sacroiliac And I don’t know if she really knew what it meant. I certainly did. I just thought it’s kind of a neat term Yeah, a lot of people use it They think I got sacroiliac pain cuz I have back pain, cuz a lot of times that’s right where it is, so let’s talk about where it is exactly here we’ve got Leopold our skeleton, but that’s not where it is We’re talking about down here in the sacrum, and then so that’s the sacral part, sacroiliac This is known as the ilium, this part of the pelvis, this big paddle shaped bone so it’s a joint right between the sacrum and the ilium sacroiliac. The sacrum is a triangle-shaped bone, and there’s a joint that it forms right with you So you’ve got two SI joints one on the right one on the left. Now if you can you zoom in on this close Don’t get Bob’s face in there because we don’t want to lose viewers. I’m out Okay, so if you look right here now this joint is not like an elbow joint or hip joint. It’s really quite solid. There’s actually some debate, does it actually move or not and that goes to the PhD level. But we’re gonna assume that there is some slight motion This is probably more than it would be. It’s got heavy ligaments that cover it up So it’s minimal, but it doesn’t take much to produce pain, so what we want to do is if this gets shifted Like this, or it can shift back, and we have to shift it forward. There you go, either way. It’s gonna rotate One way or another typically and there’s lots of PhDs discussing that, so if we show it from this side sometimes it gets rotated forward that way and sometimes it gets rotated back that way right so All right, so that pretty much covers the anatomy Bob, should we go on any further? No, let’s keep going. What are some of the causes, Brad? A common cause, like if you’re Walking across and use a curb or a sudden step down and you get that force going through your hip and that can jolt that SI joint and get it out of place. That’s one where you’re jumping off maybe the back of a pickup truck, anytime you get that sudden jerk Especially if it’s one foot, versus two feet, the landing at the same time. Trauma I’ve had people that are in a car accident, where they go forward and your knee goes into the dashboard And it puts a good jolt on that SI joint. A common one is women who are pregnant Because of the joint, the ligaments get laxed because of the hormones That’s a little bit different But you know this still could be used with that. Another one Brad is just sitting uneven. A lot of people sit on one side more than the other Or they cross their leg all the way the same time and that just puts a little bit of uneven pressure. If you do that year after year It can certainly cause things to be a little bit out of kilter That’s why we always talk about try to balance, posture, be upright, and yeah If you do something one way for a long time it’s good to correct it and maybe go the other way for a while So okay, common symptoms How do you know if this is back pain versus SI joint, it can be hard to tell. But some common things that we found over time is Typically SI joint pain will be in the back of a hip area, one side, usually one side and The pain typically it will refer down But not past the knee. If you’ve got pain all the way down to the foot, probably not SI Probably from the back here, which is interesting, but that’s a typical thing. I’ve seen pain in the groin from SI I see pain in the groin from a hip too But I think the pain with weight bearing is a common one, because when you’re walking you’re putting weight And if you remember what we talked about how that SI joint moves every time you walk, it can irritate that and get it to Shift a little bit up and down steps Walking or sometimes just standing and weight shifting. The problem is though you can get pain with weight bearing with a hip problem too, so that’s why it’s it almost takes a therapist to diagnose it But we’re going to show a couple tests you could try right Do that now okay Keep the video flowing. I know a couple comments that we babble on too much in our videos. Hard to believe it Okay, so if you lay down flat, supine, and not in a bed, better on a carpeted floor or a firm surface like this and We do the figure four so your ankle goes above the kneecap right on your thigh And then you let this knee drop down, and then we could put a little over pressure Yeah, and like as a therapist I actually put my hand on his pelvis and here and I do it that way to give a little cranking on there But you could do it yourself to see if it brings it on. Support here and here, and it doesn’t take much pressure. So even Bob as a therapist, he’s gently pushing here It’s just a little bit, you gotta get the leverage. He formed The number four right Yeah, we better get on with it. Okay, so we do this now what you’re looking for is the pain that you are experiencing, that’s bothering you. Now this could create a pain in the hip from a different source But we’re looking at the pain that doesn’t recreate your pain, the pain that you’ve been worried about if you go Oh god that feels just like the pain that is bothering me, then you know you’re right on You can do it on both sides now Just real quickly yeah, and then what’s the next one Brad? Compare one side to the other Yeah, I like to do this, this one you could do on a bed where you’re gonna Let this leg come off, make sure you don’t fall off, keep the shoulders way on. So I’m here. I’m being safe, and I’m gonna pull this and that’s gonna put a little torsion rotation on those SI joints and if I do this and I feel that same pain that we’re trying to get rid of And I pull this I say oh this is the same pain and you do that Then you know there’s a very good possibility that it is that SI pain You’ll want to do it on both sides. You don’t need to show it Brad, but you’ll want to test both sides All right And then the last one Brad is just a real simple test here Where you’re gonna need somebody else to help you out here And they’re gonna put their hand right about where the belt is cuz that’s usually where the ilium is and they’re gonna push on this and If that recreates your pain in the back here, this thing really shouldn’t hurt back pain. This would be something that would be pretty specific for a sacroiliac problem sure. And Bob’s not pushing real hard It’s just a gentle firm pressure. Now if you have a positive test on all three of these it may be a stronger indication that it is SI, not a 100% But stronger, the more that are positive, the more indication it is. Now the big thing is go right to the treatments and the treatment when you do it We got three of them, my favorite ones And I think Bob likes these as well. When you do these it should reduce the pain while you’re doing it And then when you’re done, it should feel better as well for the next hour. Double bonus. This is one I call I learned this one in PT school I’ve been doing it ever since, been supported by some continuing ed courses But see I’m gonna bring my right knee up I’m gonna grab my knee here around and support it, when my arm’s real strong. I’m gonna do an isometric push this direction It’s called a muscle energy technique in the therapy world He’s pushing, if his arm wasn’t there, the leg would actually go that way Yeah, so I’m gonna restrict that motion, lock that knee in, and I’m gonna push It doesn’t have to be a push as hard as you can But you’re gonna put pressure on there and while you’re doing that like oh that feels kind of good and when you get done It’s like oh that feels good, and then you’re gonna repeat that three to five times And if you get positive results that feels good, you’re gonna do that every hour And it won’t be too long and your pains are gonna be gone And now it’s possible like if the pain is on this side and that doesn’t feel better You might try it on the other side, this side might actually make this side feel better Yep, so you want to try it on both sides because it’s depending on which way your sacrum or ilium needs to be returned Okay, all right next one Brad You want a pillow yeah, I want a pillow You don’t need a pillow if you got carpeted floor, It’s not necessary, but this is a hard linoleum floor and It’s the tile I mean I want to protect my knee now. I’m going to stretch it I’m gonna be up tall like this not over like this And then I’m gonna bring this hip forward And that’s gonna Rotate that pelvis in this direction as you see my hand going, you can put your hand back here and push and again Just like I mentioned. It should feel good while you’re doing it Bob. Yeah, it’s like Oh boy, that feels like the right direction. It. Just feels like a good stretch. This one doesn’t work for me Cuz I know I’ve got some SI issues The next one is my favorite that works great for me if I throw it out when I go for a walk Or a run, and again you could do it on both sides, both legs again I’m not gonna do it because of the time issue Stool? I like a stool at home. I actually do it on my stairs outside cuz it’s the right height but I need something about this height and I’ll put my foot up on there and if you’re gonna do this you have to be stable, either something to hold on to or feel very stable you Should feel relaxed while you’re doing this. If you feel like your balance is off don’t even try it. You should be very stable, I’m gonna use this for some balance here, and I’m just gonna drop down and Even right now this feels great for me. I do this stretch Just because it feels good, but when I do have some back pain I’ll do this. It feels better while I’m doing it and I can walk around and it feels better. I’ve never seen that one before Brad I learned something today – it looks like a good one I was just going through it, yeah it’s turning it And quite often that is the way it needs to be turned Sometimes it needs to go the other way, but then again you might be again Sometimes if the pain’s over on this side it actually might help to do it on this side on the opposite side because it’s which way it needs to be turned so there you go That’s it I said, this is the cornucopia, this is it in a nutshell This is what we have to present, so good luck with your SI pain, and I think it’s gonna work well Thanks for watching You

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