♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet. ♪
- Hi, I'm Bob Schrupp, physical therapist
- Brad Heineck, physical therapist.
- And together we are the most famous
physical therapist on the internet, Brad.
- In our opinion of course, Bob.
- Today Brad, we're gonna do three tests to tell
whether or not your S.I. is actually causing your back pain.
- S.I.? - Right.
- Sacro-Iliac.
- Sacro-Iliac, what is it Bob? - Very, quickly
let's show what that is.
All right, this is the back of your spine.
So Brad, show which way. We're oriented like this.
- Right here. Yep. - Yep.
And the pelvis here, you have the sacrum
which is a triangle shaped bone right there on Brad.
And you have the pelvis, or the ilium.
So this is the sacrum and this is the iliac,
and this is this joint right in here,
or this joint right in here
that's giving you trouble.
- And let's, if we move this, if you can see that move
there's a little bit of controversy on-
- [Bob] On whether there's movement or how much movement.
- [Brad] If there is movement. Exactly, so...
- [Bob] So in the medical field, this is not settled yet.
All right so on Brad, Brad's having pain on his right side.
So we're gonna check whether or not it's actually coming
from his Sacro-Iliac or not. Or S.I.
So we're gonna start off the first,
That's what the red tape for is, by the way.
It indicates it's on his right side.
- Okay. - Why don't you lay flat
on your back, Brad. Very simple test,
figure four or Patrick test this is called.
Yep, he's gonna put this one down
and this one across like that.
So he's crossed his leg.
He's making a four here, if you can see that.
And all you do is you push down here
and you hold right here and you push down.
- Not too hard, just gentle - No, just gentle pressure.
And if he gets pain, if he gets his same pain,
if it reproduces his pain on the right side
that's a possibility that's the S.I.
- Right.
The more tests that are positive
the more likely it's gonna be your S.I.
- Right. - All right,
let's go right into the next one Brad.
Next one you're gonna go ahead and
put the leg off the edge here.
Don't fall off the bed.
(Brad makes falling noise) Don't fall off the bed.
- Okay. - Okay.
So this one goes down,
this one goes up like this. Like that, yep.
You can actually hold on it.
- Yep, I got it.
- But I'm gonna actually push down on this one
while I'm pushing on that one too.
So again, gentle pressure.
Same thing, does this reproduce your pain Brad?
Does this make the pain replicated?
- Right, and no it doesn't. - Okay.
Okay. No, it doesn't.
You're not helping me at all.
All right, next one we're gonna do
is we're gonna actually have Brad lay on his side,
like this, and what I'm doing on this one
on the pelvis, I'm gonna push right on the pelvis here.
Okay? So right, show it on here.
So he's right like this,
I'm just gonna go ahead and push right on the pelvis,
right on the flare of here, of the ilium.
Easy one to do.
So we're just gonna go ahead and push.
Pressure on, pressure on. Any pain with that Brad?
- Pain with pressure, yes.
- Okay. So now we got a positive one
- Right there. Right there. - So,
again obviously with all these tests
you're gonna need someone to help ya.
The last one we're gonna do, very simple.
We're actually gonna throw an extra one in there
that we said three tests, this is gonna be four.
Lay flat on your stomach Brad.
On this one we're just gonna go, right,
you know where the belt is. We're gonna push right
on the sacrum itself, right on that triangle.
So I'm just putting a hand here,
pushing another hand on here
and pushing down like that.
- Yeah. And actually it's below the belt.
- Yep, a little. Yep, exactly. I'm not,
I'm putting pressure on my palm is what I'm doing.
So I'm putting pressure right on the sacrum.
Pressure on, pressure off.
Now to be honest, the gold standard of tests
for checking whether or not you have a S.I. problem
is if the doctor themselves actually does an injection
of a anesthetic into the S.I. joint.
- Sure.
- And if that makes it feel better,
greatly relieves your pain,
it's likely there was an S.I. problem.
But if you do these tests,
if you do all four tests and they're all positive
or three of 'em are positive,
there's a pretty good chance you have an S.I. problem.
- The other thing I do wanna mention, Bob, is
S.I. pain can refer down the leg,
but they always say it almost never refers past the knee.
- Right.
- So from here down to here, but if you're getting pain
here all the way down to your foot,
it's probably not- - I'll often see S.I. pain,
even in the groin - Sure.
- Or in the front here. - Right.
- Now one thing you can do just real quickly,
another test, by the way stand up Brad,
is if to see whether or not an S.I. belt would help.
- Sure. - There's these
S.I. belts you can order.
What you do is you actually push on his pelvis, have someone
- Squeeze a little. - This is a little strange.
Pushing right on the pelvis. Like right there.
- Yep. - And we have 'em walk.
And if before, if they were having pain when they walked,
when they were walking, and now they don't
that's a good indicator that that S.I. belt might help.
- Right.
- 'Cause when do you have pain with S.I.?
- Weight bearing typically.
- Usually weight bearing, yep.
And it's usually worse with stairs and running
and you can even feel it sitting when you're
weight bearing on the pelvis with that, so.
- Some impact activities where it puts the weight through.
But the S.I. about just squeezes around.
Let's get Bonaparte in here.
It's just like a two inch belt and it comes around
and you pull. Its Velcro, goes on real easy.
And it just supports that area.
Thank you.
- Yeah thanks, Napoleon.
And remember, we can fix just about anything, but
- Well Bob, it's that broken heart.
We're still working on it.
- Yeah, we're gonna try, you know,
come up with an answer for you.
- Thanks a lot. - Bye.