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 PT 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. (I did have one failed attempted previously, with the third PT on this list).
But when Paula did it, 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.
The first PT I sought out for manual therapy (that means hands-on therapy) was also certified in Muscle Energy Technique. (Again, she’s #3 on my overall list of PT’s).
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 SIJ’s could handle.
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.
That other PT (ugh) did a bunch of different things, and probably had her hands on me for a good 20 minutes… with absolutely no improvement afterwards.
When someone really knows what they’re doing… you will know, too.
I’ve since seen a second PT, Natasha, who’s really skilled at using the MET for the SI joint as well. With her, it’s the same thing. Just one or two motions… less than 5 minutes. Because, as she told me, it can actually backfire to do too much, as well.
So Paula and Natasha were both able to achieve dramatic results, in less than 5 minutes… because they actually knew what they were doing.
Now, to be fair… I am not a licensed medical professional, and even if I were, I couldn’t diagnose any of you over the web. So I can’t tell you what to do or what not to do.
But I do want to offer up these experiences to those of you with doubts about your current treatment.
There are PT’s out there who can improve your alignment and reduce your pain with less than 5 minutes of intervention.
Many of you write to me and say the options for treatment are limited in your area. 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– that I just had some mysterious freak problem no one else could understand. Wasn’t true.
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 Paula. 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!
For a related post, check out Key Point #7: Learning to Adjust My SI Joints
Also, be sure to check out our new SI Joint Facebook Discussion Group. My goal is for us to eventually have enough people in there that readers who live in the same geographic area can connect and share doctor and PT recommendations.