Malalignment Syndrome (Vicki Sims video)

So. I feel like I need to preface this by telling you that the first time I watched this, I actually cried.

Something about it was just so overwhelming.  (This was sometime back in 2014 when I was still pretty lost, looking for answers).   For some reason, this video scared me and made me feel as though I was finally being taken seriously, all at the same time.

So… here’s what I will say.   Malalignment syndrome is a real thing, and it’s important for you and your treating medical professionals to be aware that having SI joint dysfunction is likely to create problems in other parts of your body.  (It would be pretty shocking if it didn’t).

However, at the same time, I would like to reassure you that, in this video, Vicki is giving you an overview of the many, many different things that can go wrong as a result of SIJD.  You will not develop all of these, and even if you do– the changes are more likely than not going to be reversible.

So.  Be glad that someone hears you, understands you, and is taking SIJD seriously.  Do not watch this video and assume everything Vicki’s describing is happening to you.

Okay.  So what is malalignment syndrome?

In a nutshell, it means that if your pelvis is rotated, the rest of your body is going to have to compensate.

One major reason why this happens is something called the “righting reflex.”  Your brain always wants your eyes to be level.  (I don’t normally link to Wikipedia, but in this case I think it has a good explanation).

Without the righting relfex, if your pelvis was tilted, it would mean your whole spine all the way up to your neck and to your head would also be tilted, and your head would be cocked to one side.

This would be horrible on an indefinite basis. You would be dizzy and have trouble moving through the world.

So, without your conscious awareness, the righting reflex will cause you to change the way you hold your spine and neck so that your eyes are level.  Basically, you will develop (reversible!) curves in your spine to compensate for the fact that your pelvis is off-kilter.

Now, please don’t freak out.  I can’t tell you how many times I went to my chiropractor and he mentioned the righting reflex.  But it was very matter-of-fact, just to explain what was going on.  It was never permanent, and, in fact, what my spine was doing tended to change from week to week.

Now, as you may know, I have mixed feelings on chiropractic adjustments for SIJD.  But I do believe my chiropractor usually knew what he was talking about, at least when it came to diagnosing what was up with my back from week to week.

So.  Before I let you go, I will reiterate that I was able to heal my SI joint problems, as well as my accompanying malalignment, and it is highly likely that you can too.


About Vicki Sims

Vicki Sims is a physical therapist who specializes in SI joint dysfunction.  She is co-director the physical therapy practice Gainesville Physical Therapy in Gainesville, AL, where people come from out of state for consultations on SIJD.

Vicki and Gainesville PT have a lot of interesting resources available on the Web, including:

SIDysfunction Youtube channel.

I definitely plan to review more of her videos and articles in the future, but here this is to get you started!

8 thoughts on “Malalignment Syndrome (Vicki Sims video)

  1. Chantelle Andrews says:

    I have had Si injections MdI guided 4 time and received no relief. This dysfunction has me in the psychiatric ward right now because I wanted to take my life. I have had it for 4! years and it has ruined and taken everything from me I can’t even care for myself. It is from my neck to toe on my right side. I have spent $25k trying to get help and finally gave up on Dr’’s.
    spending hundreds of hours researching myself. No sleep and in excruciating pain 24/7, I don’t know where to turn. What specific exercises can I do? Who can I go see that can actually help me?


    • sunlight in winter says:

      HI Chantelle, I’m so sorry to hear about this. I’m glad that right now you’re in a place where you are safe. That’s priority #1.

      I’m happy to try to help you in any way I can. It sounds as though injections aren’t going to be the answer for you, but that doesn’t mean something else won’t be. I personally got better through a combination of strengthening the muscles surrounding the joints, as well as learning to realign them through the Muscle Energy Technique, which I learned from a physical therapist.

      I bet you’ve probably had PT before, but the truth is that not all physical therapists are truly knowledgeable about the SI joint. There are a lot of advanced/continuing education courses they can take that will help them treat patients with SI joint/pelvic pain a lot better. Here is one example of such a course:

      As a patient, it’s hard to know who really is an “expert,” because we obviously don’t know the answers ourselves. Looking back I can see that the first few PT’s I saw were not particularly knowledgeable about the SI joint, but there was no way for me to know that at the time. It’s only when I found someone who *really* helped me that I understood.

      So I would try to look for a PT who has particular experience with the SI joint, and can say that he or she has actually treated patients with SI joint dysfunction successfully. I would also look for someone who is comfortable adjusting the joint using the Muscle Energy Technique.

      If you look on this page under the “Physical Therapy” section, you’ll see what it took for me to find the PT that really helped me, as well as some additional search tips.

      Since injections haven’t helped you, I think that looking for a knowledgeable physical therapist at this point might be your best bet. Doctors tend to recommend injections simply because that’s what they know best, but there are people (like me) who get better without them. I think you might find a lot of benefit in strengthening your muscles (particularly the muscles of the core, as well as back of the SI joints — aka the “glutes”– if you are also working with a PT who helps makes sure your joints are in alignment.

      Okay– I hope this helps! Feel free to let me know if you have any more questions!


  2. Kayla says:

    Gosh if only all PT’s could know that info above, that could have saved me a year of visits and would have expedited my treatment by a year. Unfortunately now I’m right at 2 years of having SI pain caused by pelvic rotation and this has lead to a labrum team. Sigh. The good news is that my rotation can be corrected with muscle energy, it just doesn’t stay that way.


    • Sunlight in Winter says:

      Hi Kayla– Sorry to hear about all this. But the good news is, the more you’re able to strengthen the muscles around the joints, the longer they’ll be able to stay in place! Wishing you the best of luck going forward.


  3. novaserve1 says:

    Thank you for all of the information you share and for this video and article. You mention that the sciatic nerve can be affected, which would cause leg pain and numbness. Can misalignment syndrome also cause pain and numbness in the arm neck and face too?

    Around 5 years ago I injured my sacral area after the birth of my daughter. It took around 9 months to feel almost completely better. Even though my sacral area felt better, anytime I would sit and the chair sinking in the back, I would experience lower back pain, lightheadedness and intense shoulder and neck pain. A few years later I was doing internal pelvic floor therapy and I started experiencing left side pain, numbness and tingling. This left side pain and numbness is all the way from my face down to my foot. I have noticed that I have less feeling on some of the parts on my left side of the body, even though those parts don’t exactly feel numb to me. Like when I lay down to get traction, I can feel the cold metal on the right side of my neck, but it does not feel cold on the left side of my neck.

    I experienced this constant pain and numbness for about 18 months until I had an ortho bionomy session. 45 minutes into the session, as she was adjusting my sacrum the pain left 100%. The pain and numbness returned two months later after having sex with my husband. Whatever is happening it is becoming more aggravated. Anytime I have sex I start experiencing left side pain, left side numbness and tingling and a very specific spot on the left side of my neck like there’s so much pressure and pain that it feels like a bone is about to pop out of it. One of the worst symptoms I have been experiencing is incredible dizziness. I have not experienced complete relief for over a year since the first ortho-bionomy session. Ortho bionomy still really helps me, but it has not been able to take it away like it did the first time. I also have been able to tell that Chiropractic Care helps a little bit and traction helps even more. Constipation / bearing down effects my symptoms like sex does. Other things that exasperate it include sitting on hard surface for a long period of time, sitting and turning my head to the left, sleeping with my head turned to the left, sleeping on my left side, sitting where the back of my bottom is dipping down in a chair.

    I am at a loss. I have had MRIs of my brain, cervical spine, and now sacral area. I am getting X-rays of my SI joint within the next week. It has been suggested to me that perhaps these are all psychosomatic symptoms. They’re not. I know my body. I have two young daughters, and it breaks my heart that I struggle to be physically there for them. There are so many Adventures that I would like to take, but I am unable to do. I miss being intimate with my husband and not having weeks ruined if I get constipated. I am currently feeling only minimal left side pain numbness and tingling, and my neck is not bothering very much at all at the moment, but it’s very dependent on how careful I am.

    Is misalignment syndrome can cause these type of upper body issues , then it may be just the thing I need to study to figure out what is happening to me. Thank you so much for your time.



    • Christy Collins says:

      Hi Maria, I am not sure if you will get a notification for this comment– I am so sorry for my delayed response. Sometimes WordPress doesn’t notify me about new comments the way it should. I did want to be sure to answer you.

      I would say that having some issues in your upper back and neck can certainly go along with SI joint dysfunction. This is because, when your pelvis is out of alignment, your body will try to compensate in other ways. One of those ways is to make your spine technically a little bit “crooked” or rotated, so that it can balance out for one hip being higher than the other, etc.

      I believe your pain is real and not completely psychosomatic. However, it is also good news that your x-rays and MRI’s are normal. I think sometimes we can be in an extreme amount of pain simply from muscle spasm and things being out of alignment, even if it is not an extreme thing that would show up on an image. I think that again, with normal imaging, some of the tingling and nerve symptoms that you have can also be because a nerve is getting compressed or irritated by inflammation and/or a muscle spasm. It’s crazy how painful these things can be sometimes– I wouldn’t believe it if I hadn’t been through it myself.

      Based on the pelvis/sacral symptoms that you describe, I would really recommend seeking out a pelvic floor physical therapist who has experience with SI joint issues and sacral torsions. The way you describe the pain as being relieved by an adjustment but coming back with certain pelvic-specific activities suggests to me that a long term pattern of muscle imbalance/muscle spasm could be going on here. Pelvic floor PT can help you address this.

      I hope this helps!


  4. Victoria says:

    I have suffered for 3 years with exactly what Vicki Sims video describes. I has robbed me of my life and job. Similar to others have have posted comments, I am often suicidal with it and distraught not to be able to play with my daughter or work.
    I cannot find anyone in the NhS who will take me seriously and any good private therapists (I’ve tried 12). Please could you let me know if you know of anyone in The UK that I can trust.
    I am nearing the end of my ability to live in this state.
    Victoria aged 42


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