Hi folks, I'm Bob Schrupp physical therapist, Brad Heineck physical therapist, together we are the most famous physical therapists on the internet
In our opinions of course Bob, we're like superheroes
Today we're going to talk about immediate relief and self treatment of the sacroiliac joint or the SI joints
We're going to show you where it is
And we're going to show you some things to try because we're not going to have you try to diagnose what you have
specifically going on with it because it's too difficult for you to do that
But we can show you things to try and if it takes away your pain, c'est la vie
And these treatments when they work they work right now and you're gonna feel that pain come down, if they don't
or sometimes you irritate it a little bit
Then you're gonna stop those, we'll clarify that and so make sure you wait for that but Bob has something to mention to everyone
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Sacroiliac Bob that's a big term and it really I think kind of throws people off because
I've heard some people think that their back pain is sacroiliac just because it sounds like well, I'm having sacroiliac pain
It's really their back. But it is often in that same region, sure
That's why people it could be, should we use Sam? Sam to help
So the SI joint sacroiliac, the word comes from, here's the sacrum and here's the ilium
The sacrum is a triangle-shaped bone, big solid one right at your buttock, and these are the two pelvis, kinda on each side of it
So, that's the ilium. You're right. And so the joint is right here. It's where the two bones connect
It's not a joint that moves very much at all. And that's controversial in the medical field
We're not going to get into that, there's a lot of big heavy ligaments that are holding it in place, right
So if you see an anatomical picture of it
You'd see why it doesn't move much, right, we think there is some movement, sure
Okay, so that's the SI joint now can, now this is gonna be something new for for Elizabeth
Can you zoom in right in here?
So here if you can see, Bob, can you hold the sacrum?
Sometimes Liz we have to be at a certain distance from you. Does this work out okay?
We're gonna ignore the the nerves and get that out of the way
So here's a sacrum and here is the ilium now the joint now this is what can happen
There can be slight movement in there. I would actually show that from the side too Brad
Good idea. This can, see how that rotates, so it can be rotated back
That's the posterior, and get kind of stuck that way or rotated forward and kind of stuck that way
So we're gonna try getting some movement in there to see if that relieves your pain, right
So that's what these
exercises are gonna do, specifically, and if you get it to move the right direction
The pain is going to drop right down. You're gonna feel it
I think the other thing we should mention while we're here Brad is: what are some of the causes of this, good real good point
It's like if you're walking and you, we'll back up again
Inadvertently step off of a curb and you come down real hard and you put some jolt
Through that, that can take that joint and rotate it. So if you as a matter of habit are
always sitting like let's say you sit with even your legs crossed and you're always putting weight on one side
You know year after year after year, you're actually putting stress on the you know
The ilium is different in a different way and it can actually cause a little bit of rotation
if you're in a car accident and your knee goes into the dashboard if you had
That kind of force into that, that can shift the SI joint, if you have one leg longer than the other
there you go, that can actually often I see that quite often in people that are
That have you know
especially if it's a little more than a half inch, it can really make a difference, or you get a total knee and maybe they
Didn't quite get them right and all of a sudden you have a sudden change
And you got a shorter leg after a surgery
And one of the more common ones which Liz our camera woman can attest to is when you're pregnant, right
There's those chemicals that help loosen up the ligaments, right and it makes them easier for them to rotate and can cause you problems, chemicals
No body chemicals, they call them hormones. Yeah well
They're a chemical aren't they? I would imagine yeah, it sounds better to be--hormones
Now let's say as a matter of fact this just happened to me two weeks ago in the clinic and it works so well
It's like man we got to get this out to our viewers. Sure
She had back pain, typically if it's SI, it's when you walk or put weight through it is when it's worse
Yeah, when you sit down typically feels better or laying down
Hills are worse stairs are worse, right that weight-bearing, putting force making that SI get pushed and painful
Pain is typically here. It can't go down the leg usually not below the knee
I've seen it referring to the groin too Brad
So with that in mind
This is what you're going to do
If your symptoms sound similar to that, you may have an incident of the causes that we mentioned
This is what the first thing you're gonna do is, I wish I had a chair Bob here
We're really prepared here today, well, it's not far away Bob
Okay, if you're in a nice firm chair, you don't want to do this on a couch or some
Soft chair like that, good firm chair with good posture
If you take your knee up and lift it and say this is a painful side
This is called a muscle energy technique in the therapy world
I'm gonna push down and hold it and actually do an isometric and this patient that I had just a couple weeks ago
She did this
immediately she said boy that feels good. I mean it was very clear. So her home exercise program
was to do this hold it for about five seconds and relax. How often were you having her do that Brad?
I told her to do it every one to two hours, sure, you know
That's the thing is you don't just do it once a day. You're doing this constantly to try to help
Gradually adjust that so that it stays back in place and feels better
So, you know she came back and it was working but it kind of plateaued it got about 50% better
So then the next thing you can do and if that one doesn't work, you could go to this and
You go to the side of the bed
Don't fall off, yeah don't fall off, you take the painful side and you gently let it down on the side of the bed and
Then we're stretching
Technically we're trying to get a posterior tilt into an anterior tilt with both of these techniques don't worry about that if you do this
and this is her situation. This just felt good
She just said oh that feels good, you'd probably want to lock it in place wouldn't you Brad?
That's a good point
Yeah, you want to hold on to that knee and let this one hang down and that's gonna help again adjust that SI
It's something you try and see if it feels better and if it doesn't if it hurts you don't it, you just scratch it, especially if
it makes it worse, right
We've got two other ones that you're gonna try both of those don't give you that immediate relief
Then you go to this one. Actually, you can stay laying in the bed, to me sometimes Brad
is that if this actually makes it worse
I'm sometimes happy about that because that means maybe if I go to the other side, it's gonna make it better, precisely yeah
So this I'm still on the same leg. That's the painful side. Those two techniques didn't work
I'm gonna take this knee and bring it up to my shoulder and
Then I'm gonna hold it and I'm gonna take my knee and push it that direction
While I hold it, we're actually doing an isometric another muscle energy technique
hold and push and
if that feels like good pressure, feels good
I've got an SI problem on my right side, that's feeling good right now and I do
I do these too
on myself on a regular basis
I actually like to go around like this because you're a little more stable and then push like that
But it doesn't matter whatever makes you feel better
Now you can take this leg and put it down or here or up whichever works better gives you better results
And again, you're gonna hold it three to five seconds. So again if he wasn't holding it that knee would come right down, right
So I'm gonna do that three times and then you're gonna repeat that throughout the day again
Once every one to two hours until you reach the plateau with your progress and hopefully it'll be gone. There is one other one
That's similar to that, is that the stool one? Yeah
You can do this on steps because it's different heights. If you got a rail, it can help you do it better
This is a little high for me but it gives you the right idea
so you're gonna go up there, if you're doing it on a stairwell you're gonna hold on to the rail and then you just
lean into it and once again, it should feel like oh, this is a good stretch. It's making that pain feel better
And then when you're done you walk around, it also should feel better
Then you know you're right on, so there you got four different options for SI joint pain that are going to
immediately cause relief, if it's the right one. And then you can also try
basically, if you want to try a belt, an SI belt, you could do that
Oh sure. You can give that go. Just happened to have one Bob
And basically what you're trying to do is you're trying to hold the pelvis together and this is again in those cases where
the hormones are taking place and
If you're pregnant, now Liz she's had a couple children and she has one that she has to watch in addition to that: Alex
I always like that joke. Yeah, that's her husband, by the way, but she tried it you had good success with it, right Liz?
Now you didn't have this one, but she had one that was made for a pregnant woman, right
So it puts force around here and stabilizes those joints
So yeah the way I determine whether or not it might help someone is I actually go up to the person, no Brad
And I actually push on their pelvis and I have them walk
and I know this is kind of a goofy thing to do, but you walk behind someone and
if that gives them relief then there's a good shot that the belt's gonna help
alright, so you get one of these SI belts and you put it on here
And it has to be on the pelvis not too high on the waistline. The pelvis is right here
Starts right here. So it's below the pelvis. Yeah, and you can tighten it up from both sides. You get it nice and snug
Should feel good. And then you wear it throughout the day, and a lot of times, you know
once you get it calmed down it stays calmed down
Yeah, that's the whole idea, you know when things get inflamed
It can be very difficult to get that inflammation to come down. So that's why this can help with that
So a lot of different options and once again, Bob
I really like to tell everyone here, we can fix just about anything throughout the body, except for a broken heart. There you go
But we're working on it, we can give you advice too on, you know, if you're lovelorn and you having trouble finding a date
Well we could, it might not be good advice. It's not good advice, but we could give advice. So thanks for watching