QuestionQUESTION: I wish to get explanation what sacroiliac sprain is and what is the difference between it and sacroiliac dysfunction, SIJ subluxation, ilium upslip, rotated ilium/innominate, etc.?
When it is blocked/hypomobile and when hypermobile? Those are mentioned in (DC) literature of possible functional problems of SIJ.
What is the difference in functional behaviour in each different possibility? Like what are the signs for blocked SIJ or hypermobile SIJ?
Where is the pain on each case? Many times it is not there where the disorder is! But when it is there and when it is not?
Which of those can cause LLI/LLD as (functionally) short leg? Many anatomical leg length differences are not really anatomically but only seems they are because they are diagnosed from 2D picture that is a projection of 3D world. If other ilium is anteriorly rotated (very common) then other femur head is closer to camera and it looks longer. You can easily see 1-2cm difference in leg lengths even it isn抰 anatomical but a perspective error because of viewing angle.
What other symptoms they can cause on our muscular and skeletal systems?
-Disc degeneration because other SIJ has lost it抯 capability as shock absorber for forces coming from below pelvis?
- What if both SIJs have it?
- Idiopathic scoliosis because of an upslip?
- Hip joint arthritis because of the rotated ilium and changed angle of femur bone?
- Any other? -I know many. I had much more!
And what kind of tests you have for testing those each? (palpation with flexion or palpation with supine/standing? Or provocation tests?)
Literature shows so many different tests and there are a lot of practical studies that show there is no test that using it even two experts would get the same results. Is that a lack of skills or lack of understanding the problem?
Why can抰 anyone tell what is the right test and how to do it? Or are there any other signs you can see it?
And (approximately) how common are they each? Many experts say subluxation/malposition is very common with LBP-patients and that is causing SIJ dysfunction. Some are telling it is a cause for problems up to 90% or even 98% of them. Do you agree? Why not? Some MDs say it a cause of pains in is less that 1% of the cases. What is the reason for so huge difference in opinions?
Do you agree that many children can have it, but they just don抰 have any SIJ pain? Pain comes later after walking years with unstable pelvis like I had. And pain comes usually to the other side. And not always even there but sometimes only to groins, buttock or to somewhere else...
I had subluxation/dysfunction on my left SIJ since I was a child and it took 25 years to find someone who found it and knew how to correct it. My low back pain was on my right side so everybody tried to treat that side. Some experts might have tried to treat my left side (I don抰 remember because they didn抰 explain what they are doing...) but didn抰 get any results, perhaps because of lack of skills I guess.
Even when I had short left leg, tight muscles on the back of my left leg, right heel pain, scoliosis, extended lordosis, bad posture, etc. I also had leg weakness on both legs, high blood pressure, small heart troubles, headaches, shoulder pain, etc.
I don't understand why they treated that other (right) side because my left leg was shorter and my left SIPS lifted up when doing the flexion test causing positive signs (also spinal curvature was found) for scoliosis. I guess they just followed the pain and not the cause of the pain? Most of them didn抰 check leg lengths nor other landmarks at all...
Toni
ANSWER: Dear Toni,
Thank you for your posting and its numerous questions. Before I try to answer you, can you tell me the resource(s) you found with all the information you've provided? Is it a pamphlet from a chiropractor's office? Is it a book? Is it from multiple sources? This may help me understand the context of your question better.
Sincerely,
James W. Healey, DC
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QUESTION: My resources are almost countles. Most of them explain only a small part of the problem. Most of them are conflicting with each others and many are useless because obviously not describing the problem at all.
I have also interviewed many experts. Many of them explaned things from very different views. I followed those who told pain is usually in some other place than SIJD and I listened those whom patients told they got best help...
I have collected hundreds of documents from all over and most of them just don't really seem to understand it. One seems to be Dr. Amaral:
http://www.spineandsacroiliac.com/sacrodysfunction.html
He writes: "Sacroiliac pain is due to subluxation of the joint."
Sounds good!
But then he writes: "The two sides are compared for symmetry with the painful side considered the abnormal one"
That is completely wrong! And many "experts" try to explain that same. But not all of them. Few experts disagree!. As I have experienced myself: The pain is usually on the other side! And that same are telling those hundreds of patients I have interviewed. They too have visited countles times on different experts who only follow the pain and try to find a dysfunction where the pain is. And when those patients have ended up to the similar place I got help: diagnosing the cause of pain to be on the other side they felt they got the best help for their pains. Many of them got rid of pains with only one treatment like I did after years of pains.
And like DC Kierstyn (in Chiroweb) explained me in her answer: Pain can be on the other side than the cause and the pain is just a symptom that comes after years of walking with twisted pelvis caused by SIJ dysfunction causing scoliosis, disc degeneration, short leg, muscle development inbalance, etc.
So I think SIJ sprain is just a symptom of SIJ dysfunction on the other side. And ofcourse SIJ upslip can happen to both sides. So how can you diagnose that if you are comparing them to each others?
Here some links that explains the problem but not well enough:
http://www.kalindra.com/dontigny_mechanics.pdf
http://www.healing.org/only-3.html
http://www.kalindra.com/critical.pdf
http://www.yumeiho.pl/o_terapii_en.html
http://abcphysicaltherapy.com/Main%20Pages/physicians.htm
http://www.firstchoicehealthcare.com/assets/docs/012405.pdf
http://www.getprolo.com/sacroiliac_joint_dysfunction.htm
http://www.somatics.de/Torsion.html
http://www.cacr.ca/news/1998/9812Schamberger.htm
and many more...
AnswerDear Toni,
Thank you for providing more information. I now have a better understanding of what you are seeking. It turns out that yours are questions similar to those I have heard from others who are investigating chiropractic. Unfortunately, though, much of what you have gathered so far is based on some misconceptions or skewed viewpoints. In order to answer you properly, I抣l first need to give you some background on the chiropractic profession.
There are two branches or schools of thought in chiropractic. Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else). My expertise is in non-therapeutic straight chiropractic.
Therapeutic "mixed" chiropractic is the more traditional approach based on a split from the founding principles of chiropractic about a century ago.
Non-therapeutic "straight" chiropractic is the more modern of the two. It deals with a particular, common situation called a vertebral subluxation. You referred to this term in your question, so I know you抳e heard it before. It is clear that the resources you have so far do not address it accurately, however, so I am glad you also asked for some explanation as to what it is.
The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones. These nerve pathways carry information or messages between the brain and the cells of the body. These messages are essential for the life of the cells. Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.
Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential. People with vertebral subluxations are not able to get all they can out of life.
Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses. These stresses can be physical (such as accidental trauma, sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups. In short, a vertebral subluxation can occur for a multitude of reasons.
Tragically, vertebral subluxations are rarely obvious to the individual they affect. They usually have no symptoms. The reason is that most of what goes on inside you happens without your awareness. As an example, try to "feel" your liver. What's it doing right now? You can't know, so you can't know if it's functioning at its best or something less. To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever. The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected. As a result, in order to know if someone has a vertebral subluxation, it is necessary to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis." This involves objective criteria, not symptomatology. In other words, sacroiliac pain or any of the other symptoms you list in your question are very poor measuring sticks of whether a vertebral subluxation is present. When a vertebral subluxation is detected using a valid analysis, though, it is obviously important to correct it as soon as possible.
Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life. Each person has a unique potential in life. With vertebral subluxation, it's impossible to realize that potential.
A key question to ask for your purposes, then, would be, Is someone who has sacroiliac pain better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open? It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise, including whether they are experiencing sacroiliac pain. It抯 not that you should see a non-therapeutic straight chiropractor FOR your sacroiliac pain or other symptoms ?you should visit one in an effort to be free of vertebral subluxations, even WITH such complaints. Non-therapeutic straight chiropractic is not about diagnosing and/or treating sacroiliac pain or any other therapeutic-model or medical condition. It is entirely separate in its goal. Pain is not the reason for attending to the vertebral subluxations. In fact, those who understand the effects of vertebral subluxations choose to have their spines checked regularly and on an ongoing basis independent of symptoms. This is the best recommendation that anyone can give you regarding vertebral subluxations. I have no reason to tell you otherwise.
The distinction between the therapeutic and non-therapeutic viewpoints may be illustrated by way of an analogy to food or diet. When someone eats food, they typically do so simply because it is better to be nourished than starving. It抯 not a treatment for an ailment or problem, it抯 just a good idea if one expects to get the most out of their body and life. Certainly, it may be that this will allow that person to have their highest levels of resistance or healing capacity, but that抯 not the goal nor can it be realistically assured. Have you even known or heard of someone who was a diet fanatic who nonetheless died of something other than old age? That doesn抰 take anything away from the wisdom of striving to be properly nourished. Similarly, having all of the nerve channels open or being free of vertebral subluxation is like keeping the body nourished with the vital brain messages of life. It抯 a wise idea with benefits that are simply beyond our ability to control or presume. Certainly, every part of the body must have connections to the nerve system so that vital information may be transmitted between the brain and the cells. The question of how your individual body carries out the myriad of activities just to maintain life is enormous and would require your Creator抯 (or creator抯, for the agnostic) knowledge, or at least far more than our educated knowledge of the complexities of life.
Now that you have more information about the body and vertebral subluxation, how do you make use of it? Well, first understand that this is not an explanation of why you may have various pains or whether these may be related to vertebral subluxation. Are there reasons for what you抮e experiencing? Even though they may be beyond our ability to identify, yes, there are; but pinning them down is not relevant to the matter of whether you will benefit from being free of vertebral subluxations. Vertebral subluxation is, in and of itself, detrimental to your life. It is not valid or reliable to try to connect it to pain or any other organ or tissue conditions.
As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service. It is clear that you have investigated only the therapeutic viewpoint thus far, even though the term subluxation was apparently used by one or more of your contacts. Because of some of the other conclusions you noted, it is certain that it was always in a therapeutic mixed context.
Toni, I can appreciate the frustration you are feeling as you search for answers. It may be that you were unaware of the two different viewpoints or that you have only an interest in therapeutic concerns. I can tell you it would certainly be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor, even if you elect to have therapeutic attention for such things as the complaints you had mentioned. Remember, the two objectives are not the same. If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or directly at
[email protected]. You may also visit www.gschiro.com, a site that represents non-therapeutic straight chiropractic on a state level.
I wish you the best in finding answers and in understanding non-therapeutic straight chiropractic. It has been my pleasure to provide you with some information.
Sincerely,
James W. Healey, D.C.
