Hey everyone,
Today I wanted to expand on a really important concept, that I think will help you all conceptualize what you’re going through in a larger framework.
One big theme I’ve been talking lately about is the impact of my genetic hypermobility condition on my SI joint dysfunction. Please trust me when I tell you my life would have been a whole lot easier if I’d known this about myself sooner.
Basically, if you’re genetically hypermobile – like up to 20% of the population is- it means your body produces connective tissue that’s a little more stretchy than the average person’s. In the case of the SI joint, it means that the ligaments holding the joint in place can be more easily injured, and you’ll likely have more trouble maintaining proper joint alignment.
Over the course of my coaching, I’ve come to find that many people who struggle with SI joint dysfunction are hypermobile, so it’s a topic I’m always sure to address.
A big aspect of my recovery came from learning to prioritize the most gentle interventions possible. For example, while chiropractic adjustments helped me in the short term, in the long run I did much better when I switched to the more gentle Muscle Energy Technique.
Same with exercises. The more I discovered which exercises let me work the muscles while placing the least amount of stress on the joint itself, the more stable I became. So, it wasn’t just about making my muscles stronger – it was also about allowing the ligaments to heal.
This concept made up a huge part of my recovery over time. The more I replaced techniques that stressed the ligaments with techniques that left them alone, the less inflammation I had, and the more stable my ligaments became. This was no less than life-changing for me, and a big part of why I want to share this on my blog is that so few doctors, chiropractors, and PT’s know about it.
However, today I also want to talk to you about the other end of the spectrum — people who are not genetically hypermobile, like my sister Becky.
It’s funny, right? Becky and I share a lot in common– brown eyes, brown hair, similar laugh. But one thing which we do not have in common is that she is most definitely not hypermobile.
Becky is a geriatric nurse practitioner in a skilled nursing facility, meaning there is often a good deal of patient lifting and transfers during her day. Occasionally, one of her SI joints will start to hurt and feel “jammed up” but she has a totally different experience than me.
Sometimes, she goes and sees her orthopedic surgeon for a cortisone injection in the joint. And that will be enough– one injection will be enough to reduce the inflammation and things go back to normal.
Sometimes, that won’t be enough, so she’ll take time out of her schedule to go back and see our chiropractor back in our home town.
Now, from my story, you’ll realize that a big turning point in my story came from realizing that chiropractic adjustments were making me less stable, because they had such an impact on the joint.
For Becky, it’s the opposite. Sometimes her SI joint will just get so “jammed” as she puts it, that she needs to go to Dr. K and have him do a full, Grade 5 adjustment. (Chiropractic adjustments run on a scale from 1-5, with 5 being the most forceful).
Usually, that will do it. She might go back once or twice more again, and then things will settle down and she’ll be good for many months to years. Like me, her bad side will switch, depending on which way she happened to be moving and lifting clients. It isn’t always the same side that’s the bad side.
However, where we really differ is that more gentle adjustments don’t seem to cut it for her. Back when I went to see Dr. K., he would only use his Activator tool on my SI joints, which would put the force of the adjustment at more like a 2 or a 3. For Becky, the Activator wasn’t enough to get her jammed SI joints to move- she always needed the full force adjustments.
We also really differed in how we felt after the adjustments.
In my case, I always felt less stable for the next 24 hours or so after an adjustment. My joints would be in the right place, but I’d have to be incredibly careful about how I moved — especially in that first hour or so– or else the littlest wrong move would make the joint go out of place. I didn’t know what was happening at the time, and it took me very many years to figure out. Now, I know that it’s because my hypermobile ligaments weren’t responding to the stress of the adjustment well. Although Dr. K. was technically putting my bones into the right place, the method of the adjustment itself wasn’t right for my ligaments.
Years later, I would switch to using the much more gentle Muscle Energy Technique., and that would finally allow my joints to become stable.
For Becky, it was the total opposite. The more gentle adjustments weren’t enough to get her joint to move. One Dr. K really put her joint into place with a Grade 5 adjustment, she’d feel great and would go on with the rest of her day like normal.
That is really the key difference between someone who’s hypermobile, and someone who’s not.
With my clients, I always urge caution, and that you use the most gentle intervention possible. The fact is that any time you have a practitioner perform any adjustment on the body, you are obviously running some level of risk. It’s true for any type of therapy. So, why not use the method with the least level of risk that you can?
Additiionally, I’ve had many clients come to me who were actually injured for the first time by a chiropractor. And these are not necessarily people who are hypermobile. I’ve just heard multiple stories of people who went to a chiropractor for some *other* type of problem – usually upper back pain — and the chiropractor adjusted their SI joint, which didn’t even hurt. In my experience, the chiropractic field is just not well-enough regulated– you don’t always know what kind of practitioner you’re getting.
So, it’s not necessarily as simple as looking at whether you are or are not hypermobile, and then going for full force adjustments if you are not. Truly, I recommend caution for everyone.
But I wanted to tell you this story to show you the difference that factors like your genetics can make, in terms of how you experience SI joint dysfunction. Whether or not you’re hypermobile can make a huge difference on how your symptoms play out. And if you’re not fitting the mold of the “typical” client and your chiropractor/PT/doctor starting to seem confused by how “sensitive” you are– you are very likely hypermobile.
So, I just wanted to give you this information to show how two people who are closely related, can still experience SI joint issues that are so different.
And for more on how I got my diagnosis, check out the posts in my Hypermobility section.
Hope this is helpful!
My Sacroiliac Joint Saga 