Why a PT should always be clear about what they’re adjusting, and why

Hey everyone!

Here’s a subject that’s been coming up pretty frequently during my coaching calls recently–

There are a lot of you out there who’ve been to multiple PT’s (and chiropractors, which I don’t totally recommend). And they’ve tried different types of manual adjustments and mobilizations to the SI joints… and you’re not totally sure what they did, or if it really helped.

A PT should always be clear with you about what they’re adjusting, and why.

There are a few reasons why I say this. I think a lot of PT’s, and health professionals in general, often aren’t in the habit of explaining what they’re doing in detail. Either they assume patients aren’t interested in the long explanation, or they simply think patients won’t understand.

But that sort of mindset doesn’t really work when you have SI joint dysfunction, because you really need to be able to assess for yourself whether someone’s adjustments are helping. There are, unfortunately, many schools of thought out there, and not every type of adjustment will be right for every person.

So you really need to ask your treating professional to be clear with you about their thought process and which interventions they are performing, each step of the way.

I think a lot of treating professionals, whether it’s PT’s, chiropractors, or osteopaths, can also have a sort of “try and see” mentality. Where they might not know exactly what is causing a patient’s pain, so they try different techniques to see if these produce results.

I’m not going to say that’s a bad thing, but in my experience with the SI joint, sometimes too many adjustments can backfire. If you’re already dealing with sprained ligaments (which anyone dealing with a misaligned SI joint is) you really want to be sparing with anything that can further flare up those ligaments.

I think the best way to go about things is to have a clear process of trial and error, without trying too many new things, or new types of adjustments, at one time.

And again, this is really where it comes back to asking your healthcare provide to be very clear with you about exactly what they are adjusting, and why.

If you’re just starting to work with a new PT, it might be best to have him or her perform one or two simple, straightforward adjustments to start out with, rather than correcting every single imbalance they see. (Because if you’ve had SI joint dysfunction for a long time, chances are there a lot of things they could correct!).

The true test of an adjustment is whether or not it gives you results.

I’ve spoken with a lot of readers who’ve seen multiple treating professionals and weren’t quite sure whose diagnosis to trust. (Is the pain coming from a herniated disc? A sacral torsion? A rotated hip bone?).

Because, with the SI joint, imaging is rarely definitive, my perspective is that one of the best methods for knowing whose “assessment” of your problem to believe is by whether or not their treatments actually help you.

And again to do this, you really need to have a clear process of trial and error. Put the scientific method to work.

Isolate one variable at a time. Really evaluate how you felt before the adjustment, and how you felt after.

When you’re dealing with SI joint dysfunction, you really have to be your own scientist.

Think clearly, think logically, and always ask your treating professionals to give you the full explanations behind their interventions.

Keep a journal.

This is another big piece of my advice for people with SI joint dysfunction. I really recommend keeping a daily journal of your symptoms, what activities you do (particularly if you try any new movements or exercises!) as well as what treatments you’ve had.

In specific, this means that if you see a PT, chiropractor, or other hands-on professional, write down what they said when they assessed your alignment, and which imbalances specifically they corrected. Then you can not only note how you felt afterward, but your daily journal will allow you to later look back and see how you felt over the course of the next week.

Sometimes with the SI joint, patterns can emerge when we look back over time, when we may not have noticed in the moment.

Again, if a certain practitioner’s adjustments really are helping, you should be able to notice definable improvement within a few weeks of beginning treatment (if not immediately, when you get up from the treatment table).

The journal will help you make a decision and see if, over time, you did better when you were in alignment (at least, according to this practitioner’s method of assessment).

If, after several weeks go by, you really cannot notice any noticeable improvement– particularly one that correlates with the dates of your treatment– it may be time to have a conversation with your practitioner about what is going on, or whether it makes sense to seek out a second opinion.

I hope this helps!

If you have any comments or questions, feel free to chime in below! And you can always book a coaching call here.

I look forward to hearing from you!