Walking, sacroiliac joint dysfunction and hip pain

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I was going to write about insulin this week, but I’ve been noticing something in my practice, and I figured I’d better write about it before it slipped my mind. So my apologies to those of you that are eagerly awaiting the next installment in the endocrinology series.

I should also apologize to all my wonderful SI joint teachers who took the time to really coach me with respect to SI joint dysfunction, (Diane Lee and Linda Joy Lee, Marcy Dayan, Paul Chek, Shayne McDermott, David Ewert, Mark Finch, Tom Myers, and most recently, Richard DonTigny), because it is very probable that you actually did teach me this, and I forgot and have now simply relearned it for myself.

For those of you that are not in the exercise or physiotherapy field and have no idea what and where the sacroiliac joint is, it is the joint between the sacrum, or the triangular bone at the bottom of our spines that the tailbone is a part of, and the pelvis.  People that have SI joint pain frequently point to the "pelvic bump" area in the very low back where the dimples are as the achy spot, and that pain is often one-sided.

For non-exercise people, skip to the next paragraph where I’ll explain this more simply, but for those in the field, what I’ve noticed is that most people that get SI joint pain seem to walk using their hip flexors as the prime movers.  While walking quickly, the pelvis is frequently in anterior tilt and/or there is a distinct forward lean of the trunk, and very often the person with the dysfunction is "pulling" their legs forward rather than "pushing" them. In my practice at least, using the hip flexors to walk seems to be a far more obvious pattern in SIJ dysfunction than a Trendelenburg sign, although the patterns do frequently go together.  I realize that someone in anterior tilt also tends to have poor local stabilizer and poor glute function, but I have found that even when someone has generally improved their pelvic position and been trained to connect to those muscles in other functional patterns such as stand-to-sit-to-stand, unless their faulty motor-recruitment pattern in walking is also corrected, the SIJ pain does not go away due to the constant forces trying to unlock the joint.  So I have put gait to the top of the priority list, and have been spending a lot of time recently teaching people how to walk – and it seems to be helping. Because I frequently see this same faulty walk pattern in those that have had or are about to have hip replacement surgery, I think it is possible that overuse of the hip flexors during gait may pull the femur slightly forward in the acetabulum, potentially creating a wear problem leading to the need for hip replacements. Therefore in my opinion, correcting this faulty gait as soon as it is recognized (possibly in late childhood or adolescence) may go a long way toward not only reducing future pain and suffering, but also reducing the need for hip replacement surgeries. If a study has not already been done on this, I think the idea has potential!

Probably the easiest way to explain this concept is to actually try it and feel it in your body. So, stand up, and pretend that your pelvis is a bucket, and you are pouring water out the front. You should feel like you are sticking your butt out behind you, and you have a big arch in your low back. Now try walking while maintaining this pelvis position. Notice how you have no choice but to use the front of your hips to move your legs? Notice how effortful this is?  Not good.  Hard on your SI joint, hip joints, low back, turns off your local stabilizers and your gluteus maximus, and way over uses the hipflexors and quads.  If you have SI joint or hip pain or if this is how you tend to walk, it may be worth your while to try a different way.

First, stretch your hip flexors gently for a minute or two.  Then, while hanging onto something, try standing as tall as possible on one leg on a small stable stool or a stair, tucking the tail under slightly (hold the bucket level so no water spills out) without squeezing the buttocks, so that the other leg can hang down completely suspended from the hip socket. You should be able to swing the leg like a pendulum with no muscles gripping the leg bone at all – it pretty much moves by itself with no muscle effort.  That is how one’s leg should feel in the swing phase while walking – loose, like it’s hanging, and pretty much moving by itself.  So, now get down from the step and try walking.  The trick is to walk while standing as tall as possible – this will frequently be enough to bring your pelvis to a neutral position.  If you can’t get that "hanging" feeling at the hip joint while you walk, stretch your hip flexors again, stand taller, and tuck your tail under a bit more by using your lower abdominals to gently pull up the pubic bone.  If you are walking correctly, you will not only feel like your legs are floating, but you will also feel that any work that is happening is coming from the back side of the body rather than the front side.

Related Tips
Take your space and improve your posture
Exercise – The fabulous stability ball
Breathe – Are you a chest gripper?
Think – Pain is our body’s alarm system


Lee, Diane The Pelvic Girdle Churchill Livingston, 2004.

Lee, Diane and Lee, Linda Joy An Integrated Approach to the Assessment and Treatment of the Lumbopelvic-Hip Region DVD, 2004

Lee, Diane and Lee, Linda Joy Postpartum Health for Moms – An Educational Package for Restoring Form and Function after Pregnancy CD ROM 2006.

Lee, Diane Assessment Articular Function of the Sacroilac Joint VHS

Lee, Diane Exercises for the Unstable Pelvis VHS

Richardson, C, Hodges P, Hides J. Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain Churchill Livingston 2004.

DonTigny, Richard Pelvic Dynamics and the subluxation of the sacral axis at S3 The DonTigny Method.

Myers, Thomas Body Cubed, A Therapist’s Anatomy Reader “Poise: Psoas-Piriformis Balance” Massage Magazine, March/April 1998.

Myers, Thomas Body Cubed, A Therapist’s Anatomy Reader “Fans of the Hip Joint” Massage Magazine, Jan/Feb 1998.

Myers, Thomas Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists Churchill Livingston, 2001

Chek, Paul CHEK Level 1 Advanced Back Training Chek Institute.

Johnson, Jim The Multifidus Back Pain Solution: Simple Exercises That Target the Muscles That Count New Harbinger Publications Inc. Oakland CA, 2002.

Lee, Diane Understanding your back pain – an excellent article explaining the concept of tensegrity and its importance in stabilizing the pelvis and spine.

DeRosa, C. Functional Anatomy of the Lumbar Spine and Sacroiliac Joint 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Gracovetsky, S. Analysis and Interpretation of Gait in relation to lumbo pelvic function 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Dananberg H. Gait style and its relevance in the management of chronic lower back pain 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Online at www.kalindra.com A fantastic website devoted to sacroiliac dysfunction.

Copyright 2007 Vreni Gurd

www.wellnesstips.ca

42 Comments

  1. Cathy Silvera said,

    April 18, 2008 @ 4:24 pm

    Hi there,

    This particular article, though I did not understand some of the terminologies you use, seems to offer me the hope that there may be an answer to an ongoing pain I have now been experiencing for years! I have seen my doctor, chiropractors, and various massage folk and even been checked for cancer of the colon utilizing an awful xray requiring the ingestion of a white solution whose name I do not now recall…was a few years ago…the cancer specialist gave me the good news that he could see no cancer and suggested that the pain was related to the menstrual cycle – swelling of tissue in the region (lower right area – feels like it goes from the front to the back). Recently I went dancing and that really seems to have caused a negative reaction. I walk just about every evening with my two dogs and do probably 2 miles or so and this does help, especially when I pull myself up tall as you talk about here.

    I have limited funds at this time – newly single mother just getting myself financially stable (one day hopefully!!). Can you suggest anyone I could go to see if this is my problem and if it can be corrected by learning how to walk better, or by doing exercises? I live in Delta, British Columbia, Canada.

    Very much appreciate your newsletters, information and your response some time.

    Cheers and wishes for a great weekend. We are told me may have snow!!

    Cathy Silvera
    P.s. I am in pretty good shape otherwise – just this pain – always hoping there is a final resolution for it – after all I was not born with it! CAS

  2. Vreni said,

    April 21, 2008 @ 11:43 pm

    Hi Cathy,

    I would suggest you see Bill Lyons at Delta Orthopeadic Physiotherapy Clinic, or Diane Lee at Diane Lee and Associates in White Rock. If your problem is bone, joint or muscle related, they can help you. If it is more an internal problem (digestive, menstrual etc.) then perhaps I can help you with your diet etc. I’m guessing by your comment that it is joint and muscle related, but it is not clear.

    Good luck!

  3. Alexandra said,

    May 26, 2008 @ 12:03 am

    I too have the SI joint dysfunction, I live in Oshawa, Ontario, is there someone in the surrounding area that you would suggest I see?
    PS. I am 27 weeks pregnant and worried about what I have to face with this dysfunction during delivery.

  4. Vreni said,

    May 31, 2008 @ 4:46 pm

    Hi Alexandra,

    Sorry to take so very long to get back to you.

    I would recommend Proactive Health in Oakville. They have the real-time ultrasound, which I think is invaluable in helping patients connect to the muscles that matter when it comes to SI joint stability. These physios can probably help you during, and definitely after your pregnancy, deal with your SI joint dysfunction.

    Good luck!

  5. barb dangelo said,

    August 18, 2008 @ 9:07 am

    can you help me find someone who specialises in sacroiliac pain? i live in telford pa 18969 not far from phila. thanks. barb

  6. Barb Head said,

    November 3, 2008 @ 3:35 pm

    I have been experiencing hip/joint pain since I did a bit of jogging in Sept. (I am 69 yrs of age, walk regularly, am not overweight, do yogo) I was hoping that it was an injury from which I could recover quickly, but as the weeks pass, it has not resolved. It has been suggested by my Dr. that I may have sacro iliac problems, so have been wondering what I may do to ease the pain. The chair posture excersize you recommended seemed to allieviate the pain while walking, so I will do it regularly to see if it will help. I was wondering if you could recommend a PT in North Vancouver who may also help. I thank you very much

  7. Vreni said,

    November 3, 2008 @ 9:47 pm

    Hi Barb,

    I would suggest you try the Synergy Clinic on Lonsdale in North Van.

    #300 – 1124 Lonsdale Ave, North Vancouver, BC V7M 2H1
    604-986-2777

    They have an ultrasound to check your core function, which is a bonus, and they would be great at assessing you too.

    If you need further help, you can always see me in Vancouver proper.

  8. Rosalia Robinson said,

    December 20, 2008 @ 3:01 pm

    Can you give me the names of doctors in Calgary that specialize insacroiliac pain?
    Thanks eh!

  9. Mitzi said,

    December 25, 2008 @ 9:00 am

    I’ve suffered with this back pain over 25 years & have recently discovered it was my sacroiliac all along. Though there is some arthritis & compression in 3 of my discs, the main problem has been my sacroiliac out of joint for probably most of my life. I thought I was doomed to live with this forever. I would love to learn how to walk correctly as I know I do not. You don’t happen to have a youtube video showing us how to do that do you? I don’t know what hip flexors are. Though your description is probably really good, with me in your audience I’m afraid I can’t transfer a written description of a physical activity into a mental picture. Would you consider a video and if so, would you let me know if you make one? I know it’s a lot to ask but I’m desperate for pain relief.

    Sincerely,
    Mitzi

  10. Tricia Ward said,

    January 3, 2009 @ 7:03 pm

    Hello,
    I recently have been told that my pelvis is upshifting creating irritation in the SIJoint and getting sciatica both legs. I get horrible pain in the groin area too. Do you know anyone in Milwaukee area who specializes in pelvic instability?
    Thanks
    Trish Ward

  11. Elizabeth Nice said,

    January 20, 2009 @ 12:58 am

    I have been treated for SI dysfunction and hip pain resulting from a fall, for the past two years. I have recieved several cortisone injections and have been in physical therapy the entire time. My SI joint is very unstable and results in a substantial leg length discrepency. The focus by my doctor has been mostly on the spine. I haven’t been able to find a doctor in the Detroit Metro area who specializes with SI dysfunction. Do you have any recommendations? Thank you,
    Elizabeth

  12. Nikki said,

    February 4, 2009 @ 1:20 pm

    Thank you so much for this post! I’m pretty sure this has solved my problem! Such a relief to walk without pain.

    Very gratefully,
    Nikki

  13. Vreni said,

    February 4, 2009 @ 10:35 pm

    Thank YOU so much – you just made my day! So glad the post was helpful! 🙂

  14. Health Business Blog » Blog Archive » Grand Rounds 4:34 at the Health Business Blog said,

    April 8, 2009 @ 11:39 pm

    […] The biggest change since I last hosted GR is the plethora of submissions on wellness. The Fitness Fixer shows us how to stretch mindfully so we don’t just cause new problems. Wellness tips advises: “pretend that your pelvis is a bucket,” to avoid hip pain. […]

  15. Debbie said,

    March 7, 2010 @ 12:13 pm

    I am looking for a physio or someone to help me in the Vancouver area (I live at UJBC area) – I have issues with my sciatic, piriformis, SI joint areas. IS there anyone who specializes in that area? Any info would be appreciated.

  16. Charlene said,

    March 8, 2010 @ 12:56 pm

    Incredible. blog.wellnesstips.ca deserves an award.

  17. Tanya said,

    March 12, 2010 @ 4:28 pm

    Can you please recommended some in Winnipeg, Manitoba? I have been suffering for awhile now and like most have been to chiro/massage etc..
    Thank you

  18. LJ said,

    April 12, 2010 @ 7:31 pm

    Wow, just the article to help confirm whats been going on for me as well. Been walking but the hip pain is so bad just about didn’t make it home. Felt really impressed to stand up straight and tall, one foot in front of the other (slight cross over) and swing the arms. the muscles in the back are sore from top to bottom after doing this but I made it home. Then I stretched out the hip. I picture walking like a model just not as pronounced movement. Been going to doctors, massage, physio and have given up on ever finding out whats going on. How does one get a doctor to see things outside of medication to control pain. Was beginning to think I should have my hips replaced. I am only 37. Life is to short to live in pain. Are there other exercises to strengthen the hips or for hip health?

  19. Vreni said,

    April 12, 2010 @ 11:24 pm

    Hi LJ,

    You may wish to look for a CHEK Practitioner (Level 1 or higher) http://www.chekinstitute.com who can assess you and give you appropriate exercises based on the results of the assessment. In the mean time, if the post rang true with you, perhaps stretch your hipflexors and quads, and work on strengthening your glutes. Bridging from the floor can work quite well. Work on pushing through your feet to lift your hips up, without squeezing your butt cheeks together. You should feel your butt working, particularly at the top of the movement. Hope that helps!

  20. Kim Ferrier said,

    August 6, 2010 @ 10:21 am

    Hi there…I was involved in an automobile accident in March 2008. 2 day’s later, I started experiencing pain in my lower back, referring down my right leg. I thought it was something that would work itself out, and dealt with it for approx 3 weeks, until finally I went to my Family Doctor. He sent me for ex-ray’s and a cat scan, and they came back with a little osteo. I was still getting worse, and it was progressing non stop. I then went for an MRI which showed a slight bulged disc, and some osteo in my facet joints. I then started physio. I was in Physio for approx a year and a half, and did not respond to treatment in all of that time. I was working as a server in a very fast paced restaurant, and still am. For 2 years my Doctor, did not help me in anyway, shape or form…he wouldn’t even look at me when I went to see him, as he thought I was a scam artist. Really I’m not that creative, lol. I finally got a new Doctor, in May of 2010. My very first appointment with her, I told her my symptom’s…which are…constant lower back pain radiating down my legs, in my hips, in my groin. My legs go numb, and feel the same as when you hit your funny bone, right into my toes. I have severe nerve pain running down both sides of my buttocks, and It is excruciating when it puts my sciatica out…which I’ve done many times, even at work. I have trouble wiping myself after a bowel movement, as it is hard for me to twist. I have trouble turning over in bed, and getting in and out of a car. I struggle to put my socks, shoes and underwear on. She told me this was definately not from a slight bulged disc, but from my sacrolilical joints. It can’t be detected in a catscan or MRI. She wants me to start Physio again, but I’m really apprehensive, as I’m really upset that it was so easy for her to diagnose me, and my Doctor and Physio Therapist, didn’t look into it any further. I for 2 years, could not understand, how I was in chronic pain, constantly, from a slight bulged disc. I am in Shelburne Ontario, Canada. I have been really thinking about going to see a Chiropracter, and maybe doing Acupuncture. I thought I would ask your opinion first, before I head down that road. I’m thinking Physio could help me again, as he was treating me for a bulged disc, and not my sacrolilical joints. I have been trying so hard to cope with this, but I’m having a really hard time coping lately, as I am in pain 24/7. Beleive me I am not exaggerating. I cry all the time lately, because I don’t know what to do. All I want is for someone to HELP me. Thankyou for listening, and I look forward to hearing back from you.

    Kim Ferrier….Shelburne, Ontario

  21. sheila sache said,

    August 25, 2010 @ 12:34 pm

    hello, My Mother who is 93 yars old has a torn rotater cuff and is in a lot of pain can you suggest some one she could see?
    Thanks, sheila

  22. atrefless said,

    December 14, 2010 @ 8:46 am

    “If your problem is bone, joint or muscle related, they can help you. If it is more an internal problem (digestive, menstrual etc.) then perhaps I can help you with your diet etc. I’m guessing by your comment that it is joint and muscle related, but it is not clear.”
    How much is realistic?

  23. Lucy said,

    March 16, 2011 @ 9:39 am

    Hi,
    I find your approach very interesting, it’s too bad you don’t live in my area!
    I’m a 45 year old female who’s been suffering with sacroiliac pain for the last 2 yrs.I have pain every single day, is this normal? I use to be very active, I use to train 4 times a week, now if I train once a week without pain, I’m lucky. The pain intensifies 100 times after a workout, so I’ve given up on training! I always took care of myself, through nutrition and exercise, but this pain has taken over my life, I have lost my drive!
    I’ve done acupuncture, massage and physio, I’ve seen osteopaths and I’m currently seeing a chiropractor, he’s using LIGHT LASER THERAPY from MEDITECH, no relief yet, it’s been 5 treatments, have you heard of this treatment?
    I have pain every single day, getting through a full day is exhausting! My MRI results show that my right piriformis muscle is 50% bigger than my left, mild central stenosis L4-L5, mild hyperlordosis of the lumbar spine. An x-ray showed that my tibia is 5 mm shorter on my left leg. I’ve had 2 very large fibroids removed last year, thought that might have helped with my pain, but it didn’t.
    I live in Montreal, Quebec, any recommendations as to who you think can help me here?
    Desperately seeking help!!

  24. Vreni said,

    March 16, 2011 @ 10:22 am

    Hi Lucy,

    If you know you have a leg length discrepancy do make sure that you have a sole lift put on all the shoes you wear, including slippers, or wear a flip flop of the correct height on the short leg at home and in the shower. This needs to be a sole lift, not a heel lift, so your shoes need to be built up. Find a good shoe maker.

    If your pelvis is not level due to an uneven leg length, you will be overly compressing the SI joint on one side, and the spine starts it’s journey out of your sacrum on a tilt, so must correct to upright as it goes up towards your head. This curve in the spine can create problems by squashing one side of the disks. No wonder L4 L5 are not happy!

    If you are in pain, it will be challenging to get out of pain until you deal with the leg length by correcting your shoes. It might be possible to dissipate forces away from the unhappy joints through stabilization and posture correction (but you can’t really fix your posture if you have a short leg as your body will always be compensating. You might succeed in moving the problem somewhere else).

    Look for a physio, CHEK Practitioner, or Integrated Somatic Therapist in your area. I believe Yves Ethier is a CHEK Level 4 Practitioner that works in Montreal. He would probably be able to help you.

    Bottom line though – get a 5mm sole lift in all the shoes you wear on the short leg. You can always start with one or 2 pairs and wear them all the time and get the others done over time. Once you have the lift, you need to be very consistent in wearing them. Out of the house, in the house and hopefully you can find something to wear in the shower too.

    Hope that helps!

  25. Lucy Sanita said,

    March 17, 2011 @ 7:12 pm

    Thank-you so much for your response!

    I am 45 yrs old, what I can’t understand is why did this pain start only 2 yrs ago if I was born with a short leg discrepancy?
    I wore a 5mm heel lift for about 6 months recommended by my orthocist, I stopped wearing it because it didn’t help at all, actually my calf tightened up, I my knee started to hurt. No one ever mentioned a sole lift to me before. I’m actually seeing my podiatrist soon, I have a feeling he is going to recommend an orthotic, what is the difference between a sole lift and an orthotic? Which is better in my case?
    Have you ever heard of Medirech Bioflex Light Laser Therapy?
    I will look up Yves Ethier.

    Thanks again, your feedback is very appreciated!!
    I

  26. Vreni said,

    March 17, 2011 @ 9:51 pm

    Hi Lucy,

    A heel lift will obviously only raise your heel, which would cause a rotation in the pelvis, and tighten up your calf. A full sole lift is what you need, as it will keep your pelvis straight and won’t tighten your calf.

    An orthotic is something that is custom made to correct collapsed arches, for example. A sole lift is not usually put inside the shoe, but rather is built up on the outside of the shoe. Believe me when I say that nobody notices. I have a 15mm leg length discrepancy and no one has ever noticed the difference in my shoes. If you need an orthotic on the shorter leg and not on the longer one, subtract the height of the orthotic from the 5mm, to know how much of a sole lift you need. Usually you can transfer orthotics from shoe to shoe.

    You also probably need a good physio or Yves Ethier to teach you stabilization exercises to control the motion at your joints. This is not sit ups and other usual gym type exercises. It is not about strengtheneing, but rather about teaching your brain how to find the muscles that control the motion at the joint. If your muscles are the light bulb, the problem is not that the bulb has burnt out, but rather that the electricity to the bulb is turned off. So it is brain work, and once you find the right muscles that do the job, to learn how to hold them on lightly for long periods of time.

    No, I’ve never heard of Bioflex Light Laser Therapy so can’t speak to that. That said, it sounds to me like your problem is biomechanical. I don’t see how laser can help, unless it is breaking down scar tissue that is pulling your soft tissue and bones out of alignment.

    Good luck with it all. I know it is a long journey.

  27. Lucy said,

    March 18, 2011 @ 8:14 am

    Hi Vreni,

    Thanks again for your prompt reply! Everything you’ve suggested makes alot of sense.
    I looked up Yves Ethier, he is quite a distance from where I live, but will give him a call anyway, he has quite a bit of experience.
    I was recently referred to Somatic Therapist, he’s a teacher from France, I have an appointment with him today, don’t quite understand what a Somatic Therapist is, but will give him a try, I will try anything to get rid of this pain!
    How long have you been wearing your sole lift? Did you have pain prior to wearing sole lift? I’ve been active all my life, why do you think pain only started 2 yrs. ago? I apologize for asking this question again, but the reason I do is because some therapists I’ve seen don’t think I need any lift at all because they say I would have had this pain all my life.
    It feels good to talk to someone who understands!
    Sincerely,
    Lucy

  28. Vreni said,

    March 18, 2011 @ 10:12 am

    Hi Lucy,

    Somatics may be helpful – also helps with brain reprogramming. Depends a bit on what is going on with you.

    It is possible to have a leg length discrepancy and no pain, if the stabilizer system is working well and is able to dissipate enough force away from the compressed joints.

    I was pain free for much of my life, then had a sore SI joint for about 8 years, not understanding at all why all of a sudden my back hurt considering there were no car accidents or falls or anything that might have set it off. I then learned the stabilization stuff, got out of pain again. Then 3 years ago I learned about my leg length discrepancy. Was happy to understand that there was a reason for my previous pain. I decided to use a sole lift despite being out of pain because I knew that if my pelvis is not level, the constant wear and tear of moving would wear out my SIJ and hip joints unevenly, making me a potential candidate for disk problems or hip surgery later. A sole lift seems an easy preventative measure.

    I suspect that something changed in how you were using your stabilization system which brought on the pain. Getting that system up and running again will be key to your recovery. The sole lift will speed up the process and will help prevent further potential problems.

    Good luck!

  29. Lucy said,

    March 19, 2011 @ 7:19 am

    Hi Vreni,

    Thanks again for all your feedback!
    I’ll will start by adding the sole lift to some of my shoes, but what about running shoes, you can’t add a sole lift to those?
    I will found out which muscles aren’t firing anymore by a professional asap so that I can start working on that too.
    After following your plan, I hope my story will end up like yours, pain free!

    I’ll keep you posted!
    Sincerely,
    Lucy

  30. Vreni said,

    March 19, 2011 @ 11:35 pm

    Yes, most runners you can add a sole lift to. Not ones that have air or gel in them though.

  31. Sheri said,

    January 5, 2012 @ 9:13 am

    I have been suffering with SI Joint pain for a few months now and just been through colon cancer and chemo, so not too sure if this aggravated it or not. Do you know someone in the kitchener area? I have been seeing my chiropractor and a physiotherapist and going to my GP next as this pain is pretty bad. I also have fibromaylgia as well. Thanks for the post and I will try your exercises.

  32. Peggy Hobbs said,

    January 8, 2012 @ 7:20 pm

    I have had problems with sciatica for many years…..it comes and then eventually mostly goes and this past year have had hip pains and hip replacement surgery in October. All seems to be going well as far as recovery,my range of motion is good and other indicators as well but I still am having difficulty walking properly and for the most part still use a walker. I don’t really think it is all related to my hip and after reading about the sacroiliac think this is the biggest part of my problem. One other thing that has happened is that occasionally if I move the wrong way something pops in my groin area……it is quite audible and I can feel something? moving, whether it be a ligament, muscle whatever and is very painful initially and then tender for a couple of days.
    I don’t have any problem doing most of the exercises other than the one they call the “clam” which is lying on your side with a pillow between your legs, feet together and raising the leg (operated hip side) as far as possible. This one I find very painful and it seems to be bothering my back and not my hip. My GP, my surgeon, my physio do not seem to be concerned about the fact something is moving around in the pelvis, groin area but I am!
    Is there somebody in the Richmond, B. C. area that you could recommend that specializes in treatment of the sacroiliac. (I’m not very keen on the idea of a chiropractor!)

  33. Bobbi said,

    January 16, 2012 @ 1:28 pm

    I am an athletic person or should I sayI was. Eight months ago I fell off an exercise ball flat on my back and after tons of medications for pain, an epidermal and an MRI I am now in physio being treated for herniated discs. I was doing much better but I am now injured again. The physio therapists have been adjusting my sacrum and si joint almost every other day and I do have a leg length difference which I had treated with orthotics but eventually decided against because of foot pain. I am not able to bend over to put my shoes and socks on and rolling over in bed is painful. I believe I have SI dysfunction….what steps do I take to get on the path to wellness again. I would appreciate anyinformation I could pass on to my physiotherapist.

  34. PS said,

    May 19, 2013 @ 6:50 pm

    Does anyone know of any orthopedic surgeon in Ontario or anywhere in Canada who can diagnose and treat debilitating si joint dysfunction?
    Does anyone know if minimally invasive si joint fixation or fusion are surgical procedures done in Ontario or anywhere in Canada, along with piriformis release surgery?
    It’s so so hard to find medical care for this horrible condition. Most doctors including orthopedic surgeons don’t seem to have a clue and patients end up in the chronic pain unit having injections and radio abelation when this is a problem that in many cases can be fixed. Surgery in the U.S. is 60,000 and up not to mention the difficulty with post operative follow up. See the web-site mysijd.com created by a Canadian who had to go to the U.S. for treatment.

  35. Vreni said,

    May 19, 2013 @ 11:44 pm

    I would be quite surprised if you got lasting relief from surgery. I would suggest seeing Laurie McLaughlin, and follow her recommendations. http://www.mdprohealth.com/about.htm

    Best of luck. I do think there is a solution to your pain, and do not be surprised if the area that is being treated or focused on is not close to where your pain is. It is possible that the area that hurts is the victim of a problem elsewhere. Please keep an open mind.

  36. Don Tracey said,

    February 2, 2014 @ 2:48 pm

    My sister suggested this liitle trick for those with lower back stiffness:

    Stoop slightly (bend at the knees a bit) while keeping your back posture as erect as you can. Set feet into pigeon-toed posistion. Slowly unstoop, leaving your feet pigeon-toed, and notice the muscle stretching going on in your lower back while you slowly try to stand fully erect. Your pains should be alleviated somewhat and walking/standing erect should be easier after the exercise …

    Thank you for your continued wellness tips.

    Don

  37. Allison Diller said,

    March 31, 2015 @ 2:05 pm

    I am 27 weeks pregnamcy with severe hip pain that sometimes bounces from hip to hip. Mostly into left hip. I have about a 1 inch leg length discrepency that was only addressed with an orthotic per podiatrist. I was told as I child I do have a leg length discrepency but the podiatrist said no, however, another physician confirmed that my whole left side is lower- shoulder, knee, etc. she said get a sole lift ASAP. I have tried physical therapy, acupuntire and massage but nothing fixes he problem. I didn’t have this wih my first pregnancy but I was working out a lot more and feel was a bit stronger to endure. This pregnamcy has been drastically different and painful. What else should I do? Your input is appreciated.

  38. Vreni said,

    March 31, 2015 @ 2:11 pm

    If you are in the Vancouver area, come see us for lessons on finding your pelvic floor muscles, or find a physio that can help you stabilize your pelvis. You will need your muscles to support your pelvis, as you are releasing hormones that are loosening your ligaments. Try not to squeeze your butt cheeks together – that might be what is causing you your hip pain. Use your “stop the pee” muscles instead.

    I trust you are now always wearing your sole lift. At home make sure you are never barefoot as if you are on and off your sole lift your brain can’t regulate your system.

    I hope that helps!

    Vreni

  39. catherine said,

    June 4, 2015 @ 8:58 am

    Hi, I’ve had SI joint issues for years now. It started during pregnancy but was never able to get back to normal activity and no pain levels. I’m in Ottawa Ontario in Canada. Do you have any practitioners to recommend. I’ve tried numerous physio’s but haven’t had full success.

    Thanks.

  40. Vreni said,

    June 4, 2015 @ 10:45 am

    Hi Catherine,

    Perhaps try an osteopath? Google Ottawa and osteopath and see who comes up. They would be able to help you.

    Another option would be to find a Barral trained practitioner – hopefully someone that has done both the visceral and the neural streams (VM1 through VM4, and NM1 through NM3). http://www.barralinstitute.com/therapist/index.php

    I am sure you can be pain free. I am sorry your journey has been challenging! I figure if you have not yet found the solution, you may not yet have found the cause, which is why it can be helpful to try a different kind of therapy. Reducing adhesions or restrictions in the organs (which hang from your spine and pelvis) as well as within the nervous system itself may help a lot.

    Joints and muscles are slaves to organs, nerves and blood. If a nerve or organ is snagged and can’t move as well as it should, muscles will tighten to protect the area, and joints will be pulled out of alignment. So looking for and resolving these issues can make a big difference.

    Best of luck to you!

  41. Brandon said,

    June 14, 2017 @ 12:00 am

    Hi,

    Great article and I’d really appreciate a referral in the Calgary area. My left SIJ is in pain. Feel off center all the time with a long right leg. Pain in left neck and left knee. This must be coming from my pelvis. If you can point me in the right direction to a skillful, knowledgeable therapist that would be great because I need only the best. I’ve seen too many people that have not helped me.

    Thanks so much,

    Brandon

  42. Vreni said,

    August 25, 2019 @ 12:24 pm

    Hi Brandon,
    I am so sorry – I only saw your comment now, more than 2 years after you asked your question. Trying to sift through the spam to get to real comments is a full-time job. If you still have pain, I would google, Michael Lindee or Beth Backman in Calgary. They are massage therapists that have completed their 5th year of course material in osteopathic manual therapy, so I am thinking they would be able to help you.

    All my best, and once again I am really sorry this did not get to you when you needed it.

    Vreni

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