Adam Meakins/The Sports Physio: A critical view of SIJ treatments (that I don’t completely agree with…)

Here are two links to posts from Adam Meakins, a physiotherapist in the UK who writes the blog The Sports Physio.

What is the best way to assess the Sacroiliac Joint?

What is the best way to treat a painful Sacroiliac Joint?

He also shares some valuable information in this podcast interview with the Strength Physio.

I am including these links because I think there is a lot of valuable info about things I’ve been wondering about, even though overall (for whatever my opinion is worth!), I do think he is underestimating the prevalence of SIJD, as well as the impact it can have on the overall kinetic chain (aka, how a stuck SI joint can affect the movement patterns of your entire body).

First, I’ve gathered in a few different places now that education on the SI joint is much more common in the UK.  Adam Meakins mentions how he learned about the SI joint in detail in physiotherapy school.  I do not think that seems to be the case in the US at all– I’ve encountered many PT’s who were really not aware that it could cause problems.  It seems to be more of a continuing education thing for PT’s here– you develop an interest in it, so maybe you pursue additional educational opportunities once you are already working as a PT.

Based on Meakins’ post, it seems that PT schools in the UK are a bit farther on the other end of the spectrum– that perhaps they are going into detail on the SI joint in ways that may not be super useful.

I can’t say for sure, but even learning about these differences in PT education has clarified for me where some of the SI motion terms I have heard come from (upslip, outflare, etc).  I’ve never encountered a PT or a chiropractor here who used those terms.

There is a lot of other information here– some of which does not mesh with my personal experience at all– but I am not going to write off any article that links to so many peer-reviewed studies.

I definitely disagree with Meakins on the idea that you can treat a stuck SI joint with exercises alone.  As I have said in previous posts, when my SI joints were REALLY stuck (which luckily has not happened in a few years now) I could barely lift the leg on the affected side.  My entire gait was thrown off– I had to shuffle along and lead with my good leg.  The only way I was able to get stronger at all was by doing non-weight-bearing exercises in a pool.

However, at the same time– I personally have not really ever found any use in terms like upslip, outflare, etc.  My own focus and self-adjustments for the SI joint have really only focused on one simple set of motions: anterior and posterior rotation of the ilia.  (I will talk about this in detail later on, but in plain English: whether my hip bones are rotating forward or backward in relation to the base of my spine.  They are a set of opposing motions: if the hip bone on one side goes forward, the other side has to go backward).

(Ilia= the plural word for the ilium, aka hip bone).

I know my chiropractors have sometimes used other terms, or talked about the movement of the sacrum itself, but again, as far as my own adjustments go, it’s only ever been to correct the anterior/posterior rotation of the ilia.

And since I’ve started to do much, much better since I’ve stopped seeing the chiropractor and having my sacrum “adjusted” at all– I’m bound to think that those adjustments to the sacrum were unnecessary (if not harmful).  It never really made that much sense to me to think that my sacrum could be “out of place” anyway– it’s like the foundation of your whole upper body.  If it was severely, pathologically out of place… wouldn’t you just fall over?  Wouldn’t you know it was out of place?  It’s the base of your entire spine.

My life changed once I learned how to perform those self-adjustments for the rotation of the hip bones, however.  Without them, I would probably still spend most of my time limping along, leading with my good leg.  My life has come back to me because I’ve discovered how to free my own legs, when I start to get that feeling as though someone has tied a belt around my upper thighs.

However, as I said, I am linking to Meakins’ post because it does provide a lot of useful information, and links to useful and relevant studies.

Hope you enjoy!

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