Today I wanted to talk to you about a topic that hopefully will be reassuring for some of you (although not exactly 100% cheerful for any of us).
I’ve had people email me from all different countries for advice. (Some of the places that come to mind recently are Ireland, Switzerland, Austria, Turkey, India, and Bangladesh, just to name a few).
And I’ve noticed that many of you, in other countries, often remark at how limited the options are near you.
However… I want to reassure you (if this can be considered reassuring!) that finding SI joint treatment is pretty difficult here in the US too.
There is a reason why I had to go through eight different physical therapists before I was able to find the person who really helped me. (For those of you who haven’t seen my posts on this journey, you may want to check them out! Here’s a link to Part 1).
I may make it look easy, from where I sit now, in my comfortable chair, with my SI joints perfectly aligned 🙂 . But things were not always this way– not by a long shot. It was all a struggle, and I had to piece so much of this information together myself.
This is not to cast blame on any of you. I know our medical system here in the US has a great reputation (at least, for our medical knowledge, if not for our actual payment/insurance system. Don’t get me started on that).
But I just want to reassure you that I really struggled, too. In all of this time, I never actually found a doctor who totally understood me. (I saw a total of five specialists). And my primary care doctor still thinks I’m crazy.
I mainly pieced together what I know from the eighth and ninth physical therapists I saw (Paula and Natasha, for those of you who read through my entire series).
They are the ones who really taught me about how strengthening could help stabilize my joints and restore the functioning of my pelvis to what it ought to be.
Unlike previous PT’s who really pushed me to do things I knew were going to make my SI joints worse, Paula and Natasha listened to me in a really kind, detail-oriented way. They helped me work out a stretching and strengthening routine that worked for me, and didn’t make things worse. (Because your exercises have to work for you… not the other way around!).
So… it took a lot of time and effort. (Not to mention money). That is why I work so hard to share what I’ve learned with you here.
Although it is difficult, I really hope I’ve managed to encourage you to keep going. I know this isn’t the most cheerful of things to say, but the truth is… I think it’s difficult everywhere.
You may be encouraged to know that the more I’ve been doing research for this blog, the more I’ve come to find that there really are great researchers doing work on the SI joint in other countries. (I’ve cited a lot of them on this blog!).
For one example, check out the Interdisciplinary World Congress on Low Back and Pelvic Girdle Pain. It is chaired by two well-known researchers who are based in Belgium, where the 2019 meeting will be held, although it’s been held all over the world (including the US, Austria, Spain, Singapore, and the United Arab Emirates).
According to its website, the Congress is open to “practitioners, academics, researchers and policy makers from all continents and from clinical areas as wide ranging as medicine, orthopedics, neuro-surgery, physiotherapy, chiropractic, biomechanics, osteopathy, manual therapy, exercise therapy, myotherapy, and sports medicine.”
For those of you in Europe, I’m particularly familiar with Andry Vleeming’s work, as he has co-authored numerous research articles on the SI joint. Something you could do is check out scientific articles like the one I linked to here, and read the names of the authors– it may turn out that some of them are also practicing physicians. (This is just a little trick I picked up way too late to actually benefit from it myself! But doctors do actually write research articles– it can be a way to find someone knowledgeable, if you know what you’re doing with a search engine!).
Additionally, here are a few more examples I’ve come across while doing my research– both happened to be in Australia. I would totally be happy to be an SI joint patient at either of these places:
Back in Basics Physiotherapy– check out their awesome page on Low Back, Pelvic Girdle, and Hip Pain.
Dr. Barbara Hungerford and Advanced Manual Therapy Associates— Dr. Hungerford is a physiotherapist who’s completed a PhD on pelvic biomechanics. Check out AMTA’s website for some great articles, including Lumbopelvic Stability and Back pain. Whats the link? and The Integrated Pelvis.
Another tip, for those of you who might be looking: if you find the perfect place to go, but it just isn’t quite geographically possible for you… don’t hesitate to reach out and ask if people know of anyone good working nearer to you! You never know when someone may have a former colleague or schoolmate right around the corner from you.
Surgery (Europe vs. US)
Lastly: I have been meaning to write a longer post dedicated completely to this subject, but for now I wanted to briefly draw your attention to the work of Dr. Bruce Dall. He is a spine surgeon based in the US who has done a lot to raise awareness of sacroiliac joint surgery.
He has a lot of articles up on his LinkedIn page, and has also written a book, about why SI joint surgery in the US is actually lagging behind the techniques used in Europe, because the medical establishment here in the US has been so slow to turn its attention to the SI joint.
In particular, you may want to check his article on SIMEG, a European organization which recently hosted its 2nd International Congress for Sacroiliac Joint Surgery in Germany. He makes the point that the US has no equivalent organization overseeing sacroiliac joint surgery (which is why here, it is less regulated and more driven by medical technology corporations seeking profits). This isn’t to say that surgery anywhere is perfect– it’s all pretty experimental, in my opinion– but it’s just to say that the European medical establishment, as a whole, seems to take SI joint surgery a lot more seriously.
So… this was a lot of information, and I know it wasn’t the most cheerful. But the point I am trying to make is that it wasn’t as easy for me as you may think it was, and if I can find answers, so can you.
Sometimes you just really have to keep looking, no matter where you are. Keep searching, keep Googling. Call places, ask questions. Ask people for recommendations… and then ask the people they recommended for recommendations.
It really sucks that it has to be this hard. It really does. But hopefully things are getting better, and awareness is growing. In the meantime, you just have to keep going. Believe in yourself, and that answers are out there. If I can do it, so can you.
For further encouragement:
And by the way, just in case I have totally depressed you, check out my article on how SI joint awareness is growing, because I really do believe that!
If you’re struggling to find a good PT, you can also check out my post how to find a good physical therapist, Part 2: Search tips for more ideas, in addition to the ones I mentioned here.
And as always, if you have any questions you can email me at firstname.lastname@example.org. Thanks!