How to tell when an SI joint adjustment is working.

Hi everyone!

Here’s a concept that’s been coming up pretty often lately, so I wanted to make sure I got it up on the blog.

What I’m talking about is the various types of adjustments a physical therapist can perform for the SI joint.

So what I want to say to you is this:

When an adjustment is really working, you should feel a difference right away.    

Now, I don’t mean you should expect to get up from the treatment table and run a marathon.  

But, in my experience, when the PT really knows what they’re doing, you can tell.  Immediately.

Maybe you won’t feel perfect– and it’s certainly possible to still have pain from some remaining inflammation– but you should have some indication.

My physical therapist Paula was the first physical therapist to successfully use the Muscle Energy Technique on me, which is the kind of adjustments I really think are best for the SI joint.  

As you may know from previous posts, it took me eight different tries at physical therapy before I found someone who could actually help me.  Unfortunately, several of the PT’s on this list claimed to have had some training in Muscle Energy Technique, and yet still failed to really fix my problems. 

But when Paula did went to correct my alignment, I knew that it worked.  From the moment I sat up, I instantly felt better.  Not only did I have less pain, but that sensation that one side was “locked” was gone.  My legs felt like they were the same length again (when the pelvis gets rotated out of alignment, it can make one leg “feel” shorter than the other).

It’s not that things were perfect– in the beginning, my body didn’t actually “hold on” to the adjustment, or stay in alignment, for more than a few hours.  (This is why it’s so important to work on long-term strengthening!).  

But the point is, I knew that the adjustment worked.  It didn’t cure all my problems in one appointment, but there was a clear difference before and after.

Some of you have contacted me saying you’ve seen a certain physical therapist, or an osteopath, or someone who performs hands-on adjustments for months, with no improvement.  

There are a lot of reasons why you might not get better, despite having the right adjustment.  Maybe your muscles aren’t strong enough (no amount of adjustments will “heal” you if your muscles are weak).  Or, maybe you’re doing something in your daily life that’s destabilizing you on a regular basis, preventing your ligaments from healing.


With all of this being said, you should still feel some kind of an improvement after an adjustment, even if it’s temporary.

In my opinion, if you can’t tell if the treatment is working… it likely may not be.  

Before I found Paula, the first PT I ever sought out for manual therapy (that means hands-on therapy) was also certified in Muscle Energy Technique.   

But honestly, I hate to say this… I think she was just a bad physical therapist.  We literally got into an argument during my second appointment.  She actually made me cry, by insisting I wasn’t going to get better unless I did the exercises she wanted me to do, which I didn’t think my SI joints could handle.

And surprise, surprise.. her adjustments did nothing.

Contrast this to the first time I saw Paula… what a huge difference.

Paula knew exactly what to correct, and was able to explain to me in clear terms why she was performing this adjustment.

She was very targeted and precise, and the whole thing took less than 5 minutes.

The previous PT did a bunch of different things, and probably had her hands on me for a good 20 minutes… with absolutely no results.

When someone really knows what they’re doing… you will know, too.

There are PT’s out there who can improve your alignment and reduce your pain with less than 5 minutes of intervention. 

I know that many of you feel as though the options for treatment are limited in your area, and wonder if you’ll ever find the right person.  I just want to encourage you to please keep looking!  Sometimes you just never know what is out there.

I thought there wasn’t any help out there for me, either.  Now I can see that belief only kept me stuck, and know I know I could have found answers if I’d just kept looking. 

So please, keep this in mind.  If you’ve been doing the same thing for months with no improvement, it may be time to look for a second (or third, or fourth) opinion.

Just remember.  I had to see eight PT’s before I found the right person.  Yes, that’s right, eight.  It sounds crazy, but that’s what it took.  And now I understand that it’s not a reflection on me… it’s a reflection on how difficult our medical system can be to navigate.

So… keep going!  Do not lose hope!

There is someone out there who can help you better understand your SI joints.

Things got better for me, and they can for you too!


Published by Christy Collins

Hi, I'm Christy! I'm a health coach who helps people overcome SI joint dysfunction and chronic pain.

4 thoughts on “How to tell when an SI joint adjustment is working.

  1. You write so well! So to the point! And i hear everything you say. We re so similar. You re the only one i can relate to…

    Thank you for taking the time to share this



  2. I know previously you mentioned that you only do the MET once a day, but can you tell me how many times o. Each side to do? Is this a strength exercise or just something that helps at the time? Curious about doing this if I have no pain some days.


    1. So actually, it’s great that you have no pain on some days. On those days I wouldn’t do MET at all. MET should *only* be used to realign the joint, and you don’t want to overdo it and accidentally end up strengthening your muscles in an asymmetrical way. My PT told me 2-3 holds of about 30 seconds each (of VERY gentle contractions!).


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