Today we are going to cover the 3 steps to permanent relief for pelvic and SI joint pain.
Now what is SI joint pain? The SI joint, if you do have SI joint pain, is pain on either
side of the tailbone where the tailbone connects to the pelvis. So this is a drawing of
the pelvis. This is your tailbone. This is your lumbar spine or your lower back, the
bones in your lower back called vertebrae sitting on top of your tailbone. Then on either
side of that you have your right hip or your left hip if we are looking at a person from the
front. When we see somebody with SI joint pain, they will typically have pain on that
given side. 70% of the time, it is on the right side. Don’t ask me why that is but
70% of the time we know it is on the right. You can also get shooting groin pain, buttocks pain
and symptoms down the outside of the leg that is affected. It might be pain, numbness,
tingling, burning. Typically, that person suffers from a heaviness as well. It can also
cause some incontinence and leaking issues as along to effect sexual performance as
well. It can be absolutely devastating if the pelvic problem is bad enough. Fortunately,
most people just have pain on one side. So what can you do about it? That person
who has SI joint problems typically has trouble rolling over in bed, getting in and out of
a car, crossing one leg over the other. Usually they have trouble sitting for long periods
of time especially if it is on a couch or a soft surface. So it can be absolutely devastating.
Now what are the steps to permanent relief for that?
Number 1 is this. Most people when we see them if they are going to try exercises on
their own and they only have a little bit of SI joint pain or pelvic pain, they are doing
stretches. Yes, there is a very basic stretch which most people show me on Day 1. It is
a piriformis stretch which is where you grab the knee and pull it up and across to the
opposite shoulder. It will give the person who suffers pelvic or SI joint problems and
pain temporary relief. However, long term we don’t want to stretch. We want to
strengthen or stabilize. Why is that? When somebody has an SI joint problem, so the
center of gravity of your entire body is in the center of your pelvis. That needs to move
the right way and it needs to be stable when you are doing day to day activities. If it is
not stable enough, what will happen is the joint will move so far that it becomes stuck.
So if we are looking at the tailbone, we have the tailbone and we have the pelvis and
you get a normal gliding day to day. If more stress, more force is put through the pelvis
than the pelvis itself can handle, that SI joint can handle, what will happen is you
actually become stuck. Now that creates all sorts of problems for the muscle around it.
What most people do is try to stretch their way out of it. The problem is not stretching
and it is not flexibility. It is actually a stability issue. If we want to stabilize, we need to
do strengthening exercises. If you go on our YouTube channel, on the Madden PT
official YouTube channel, there is a video called Top 3 Exercises for SI Joint and Pelvic
Stability. They are very low grade, kindergarten-level exercises where you can at least
begin stabilizing the muscles that control your pelvis. But we don’t want to stretch,
we want to think stabilize.
Step #2 is we want to take a look at our habits. So what are some habits that lead to
pelvic instability and problems? Number one is standing with the weight shifted. So if
I'm standing like this with my weight shifted side to side for long periods of time, what
that does is over years and years and years it weakens the ligaments which are tissue
that hold joints together that we can't control. Think about somebody with an ankle
sprain. They sprained a ligament. They stretched the ligament but it is not a muscle. It
is different than a muscle. There are little habits that we do. If I stand like this and let's
say I weigh 175 pounds and if I'm standing like this, I have 150 pounds on one side and
25 pounds on the other. Where if I'm standing balanced, I have 87 ½ pounds on each
leg. Really quick math there. We want to take a look at our habits. Other habits that
cause problems are sitting on a couch or laying on a couch in an awkward position or a
side lying position. The way that we sleep. If you sleep on your stomach and you have
one leg raised higher than your other as you are sleeping on your stomach, that can
cause problems. Crossing one leg over another whether it is at the ankle or it is at the
knee for long periods of time. That can cause problems. Sitting on one leg which I
know especially for office workers a lot of women will sit on one leg as they are working.
Well if you work 8 hours a day, let's say you do it half the time, so that is 4 hours a day.
There is 5 work days a week so that is 20 hours a week. There are 50 work weeks a
year with your 2 weeks of vacation. That is 1,000 that you have spent stretching the
ligaments in your pelvis. That can create very big problems. Also common amongst
women is pregnancy. When the woman gets ready for delivery whether it is a natural
delivery or a C-section, there is a baby that is going to pass through the birth canal or
the pelvis which is right there. The body releases hormones called Relaxin that make
those ligaments really, really lax. Not such a big deal at one pregnancy but can be a
really, really big deal with the 2nd, 3rd or more pregnancies because when that woman
delivers typically now she has a toddler at home to take care of who she is carrying and
lifting and holding off to one side. So that creates uneven wear and tear within the
pelvis. That can lead to long term problems. I mean 30, 40 or 50 years down the road
it can create problems there. Also common amongst women is shaving. If the woman
which we will see often with pelvic pain, if she holds one leg up and she leans forward
while she is shaving one leg, that can typically create problems. Create some pelvic
pain and SI joint pain as well. So we want to take a look at the habits. The biggest
violator for men is they will tend to sit on a wallet on one side. So if they are like
a heavy machine operator or a truck driver or do something where they are sitting for
1 or 2 hour drives between jobs and they have a wallet that they are sitting on regardless of
how thick it is, that can create some pelvic and SI joint problems as well. So you want to take a look at that.
The third thing that we are going to address is this. What does successful treatment
look like? And what can you do about it? So successful treatment for SI joint and pelvic
pain is this: it is hands-on PT. So the very first thing when I see somebody in the clinic
and they have SI joint or pelvic pain is there pelvis isn’t moving the way that it is
supposed to. Very difficult for me to unlock that or for me to get their pelvis to move the
right way without doing some sort of hands-on treatment. So hands-on treatment is the
first component to move the pelvis in the way that it is supposed to. The second
component of that is to do exercises as we covered up here, that strengthen and
stabilize the pelvis and SI joint so this injury isn’t constantly happening to them
over and over and over again. So we have hands-on PT plus strengthening exercises. The relief
can be quite quick with SI joint pain. Many times we will have those little miracle cures
where somebody comes in and the same day they walk out leaving 50 to 75% better
and we just need to strengthen them from there on out. They do really, really well with physical therapy.
Now if you are not in Central Pennsylvania, how do you find a good Physical Therapist?
This is the answer that I give for the questions that we get from all over the world on
how to do this. So whether you are in Australia, whether you are in Ireland, whether
you are in India or Canada or the Western United States, here is what we say: find the
best hands-on PT in your area. Here is how to do it. Call in to schedule an
appointment. When you do, ask does the therapist do a Grade V lumbopelvic
mobilization? If they don’t or if there is a stutter or hesitation, just call the next therapy
office and keep moving. You want to find one who does the good hands-on PT. Now
statistically 1 in 10 Physical Therapists or worldwide, 1 in 10 Physiotherapists will
do the type of hands-on PT that is necessary and that the research show is the most
successful for SI joint and pelvic pain. Also another bonus item that you are going to
want to look for is keep an eye on your inbox and over the next 3 days, 4 days, you are
going to get an offer for a free report on SI joint and pelvic pain. We particularly at our
clinic have done a lot of research here and this is something that we specialize in and
frankly I think we are pretty good at treating and helping people with pelvic pain. So
watch for the offer for the free report.