Sacro iliac Joint Dysfunction
http://www.kalindra.com/spinecenterguide.pdf



I like your comment that refers to "GPs"...I have posted a rather controversial ramble including that very point elsewhere regarding prolotherapy.



tontoni But it is forgotten. I went through over 20 doctors and medical specialists during 20 years and they found nothing that could help me. Only one chiro and one physio found "something wrong" in my pelvis, but they couldn't correct it. Finally one old doc checked my pelvis and diagnosed "vorlauf" on flexion test. Then he corrected it. No longer pain.
Afterwards I have been reading about it and many doctors think it is not possible to have such a problem in pelvis. And they never check that! Even there are millions of patients who obviously have it with the same or similar symptoms like I had.



tontoni I wonder if you can find any article about ilium or sacroiliac upslip from Lancet? If there is none, the doctors don't believe it exists!
Tom LeBlanc, PT
Symptoms of an Upslip
Do you feel as if you are walking on uneven ground, even though you know the floor is level? Does it hurt to sit too long? Do you sometimes misjudge distance, while walking through an open door, and bang your shoulder into the door jamb? Do you feel off balance and frequently have to catch yourself to keep from falling? Have you noticed yourself "running out of steam" much earlier in the day since having an accident or a fall? If you answered yes to any of these questions, you may be suffering from an upslip.
What is an Upslip?
An upslip, or superior ilium, is a condition where one ilium (pelvis bone) is slightly higher than the ilium on the opposite side.
http://www.home-entrepreneurs.com/html/the_upslip.htm
"The ilium can be rotated anteriorly or posteriorly. There can be an upslip (the most frequent) or downslip. Often, the sacrum is also rotated, placing strain on the facets (the joints of the spine). Those subluxations can be determined by clinical examination and reduced with various manipulations and exercises."
http://www.sidysfunction.com/anatomy.html
http://www.spineandsacroiliac.com/sacrodysfunction.html
"A chronic upslip will often present with tightness in quadratus lumborum, psoas major, and sacrotuberous ligament."
http://www.amta.com.au/article1.html
Wayne E. Rasmussen, MS, PT, ATC
"The pelvic ring dysfunction presented two alignment changes. The left side of Nichole's pelvis was rotated posterior and elevated. The elevation is called an 'Up Slip', where one seat bone was higher than the other."
http://www.flyingchanges.com/htmls/2002/Jan02Therapy.html
Upslips and Downslips: Ilio-Sacral Shears
"I want to introduce to you an IS pattern with which most of you probably are unfamiliar. The ilium can shear vertically on the sacrum; this is called an upslip or downslip. When this occurs is critical, because shears are nonphysiological patterns, rather than rotations within the joint's normal planes of motion. In this shear, the ilium has ridden superior or inferior on the sacrum, losing its normal relationship. Once you know how to assess for IS shears, they become obvious, and relatively easy to correct."
http://www.chiroweb.com/archives/21/03/08.html
"Most manual therapists, however, be they physical therapists, chiropractors, or osteopaths, appear to believe that appreciable motion exists in the SIJ, that careful clinical testing can isolate SIJ dysfunction, and that specific treatment procedures can affect SIJ dysfunction. Sacroiliac joint dysfunction is variously termed subluxation, "upslip," "downslip," or posterior or, more frequently, anterior fixed innominate.[2-5]"
[2] Lee D. The Pelvic Girdle. New York, NY: Churchill Livingstone Inc; 1989. [3] DonTigny RL. Function and pathomechanics of the sacroiliac joint: a review. Phys Ther. 1985;65:35-44. [4] Nyberg R. Clinical studies of sacroiliac movement. In: International Federation of Orthopaedic manipulative Therapists Fifth International Conference, Vail, Colorado, June 1992. 1992:A90. Abstract. [5] Grieve EFM. Mechanical dysfunction of the sacro-iliac joint. Int Rehabil Med. 1983;5:46-52.
And yet many doctors say it can not exist!
"MD’s, Radiologists, Orthopedist and Neurosurgeons rarely consider the sacroiliac joint complex a factor, either. Some surgeons believe this joint doesn’t even move."
"As Orthopaedic and Neurosurgical residents are not taught to consider S.I. dysfunction as a cause of back pain, it is not surprising that surgeons know little of diagnosis and treatment."



krunchie Don't fret tonitoni...there are plenty of doctors, orthopedic specialists and surgeons who do believe..or rather know..that it is possible to injur the SIJ and stretch the ligaments and that in some cases an unstable or imbalanced pelvis cuases stresses elsewhere that can cause pain - one of the orthopedic specialists I saw said that it was not possible to injur the joint but when I returned to tell him how my treatment went he contacted the other doctor and was very interested to learn about how to detect it and treat it - his opinion has now changed - he now refers patients to somebody who has a long track record of diagnosing and succesfully treating this problem. It doesn't matter if there are many who don't know so long as we know how to finbd the ones that do ! On the NHS that is of course very difficult but so is finding a dentist !