3 Steps to Permanent Relief for SI Joint and Pelvic Pain
Today we are going to cover the 3 steps topermanent relief for pelvic and SI joint pain. Now what is SI joint painé The SI joint, ifyou do have SI joint pain, is pain on either side of the tailbone where the tailbone connectsto the pelvis. So this is a drawing of the pelvis. This is your tailbone. This isyour lumbar spine or your lower back, the bones in your lower back called vertebraesitting on top of your tailbone. Then on either side of that you have your right hip or yourleft hip if we are looking at a person from the front. When we see somebody with SI jointpain, they will typically have pain on that given side. 70% of the time, it is on theright side. Don't ask me why that is but
70% of the time we know it is on the right. You canalso get shooting groin pain, buttocks pain and symptoms down the outside of the leg thatis affected. It might be pain, numbness, tingling, burning. Typically, that personsuffers from a heaviness as well. It can also cause some incontinence and leaking issuesas along to effect sexual performance as well. It can be absolutely devastating ifthe pelvic problem is bad enough. Fortunately, most people just have pain on one side. Sowhat can you do about ité That person who has SI joint problems typically has troublerolling over in bed, getting in and out of a car, crossing one leg over the other. Usuallythey have trouble sitting for long periods
of time especially if it is on a couch or a softsurface. So it can be absolutely devastating. Now what are the steps to permanent relieffor thaté Number 1 is this. Most people when we seethem if they are going to try exercises on their own and they only have a little bitof SI joint pain or pelvic pain, they are doing stretches. Yes, there is a very basic stretchwhich most people show me on Day 1. It is a piriformis stretch which is where you grabthe knee and pull it up and across to the opposite shoulder. It will give the personwho suffers pelvic or SI joint problems and pain temporary relief. However, long termwe don't want to stretch. We want to
strengthen or stabilize. Why is thaté Whensomebody has an SI joint problem, so the center of gravity of your entire body is inthe center of your pelvis. That needs to move the right way and it needs to be stable whenyou are doing day to day activities. If it is not stable enough, what will happen is thejoint will move so far that it becomes stuck. So if we are looking at the tailbone, we havethe tailbone and we have the pelvis and you get a normal gliding day to day. If morestress, more force is put through the pelvis than the pelvis itself can handle, that SIjoint can handle, what will happen is you actually become stuck. Now that creates allsorts of problems for the muscle around it.
What most people do is try to stretch theirway out of it. The problem is not stretching and it is not flexibility. It is actuallya stability issue. If we want to stabilize, we need to do strengthening exercises. If you go on ourYouTube channel, on the Madden PT official YouTube channel, there is a tutorialcalled Top 3 Exercises for SI Joint and Pelvic Stability. They are very low grade, kindergartenlevelexercises where you can at least begin stabilizing the muscles that controlyour 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 problemsé Number oneis standing with the weight shifted. So if I'm standing like this with my weight shiftedside to side for long periods of time, what that does is over years and years and yearsit 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 stretchedthe ligament but it is not a muscle. It is different than a muscle. There are littlehabits that we do. If I stand like this and let's say I weigh 175 pounds and if I'm standinglike this, I have 150 pounds on one side and 25 pounds on the other. Where if I'm standingbalanced, I have 87 Â½ pounds on each
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Knee Osteoarthritis Part 2 Symptoms Evaluation
(light rock music intro) Welcome back to The Art of Medicine. The diagnosis of osteoarthritis depends on carefulanalysis of your condition. Let's take a look at the common symptoms and how we evaluate your pain. Symptoms for osteoarthritis are three. Pain, swelling and stiffness.
They can all either bepresent at the same time or you can see each one individually in different degrees. The pain can either bebecause of particles flaking off and irritatingthe lining of the joint or increased pressure within the bone. Similarly, the stiffness can be because of fluid inside thejoint or it can just be
because of increased pressure in the bone because of not havingas much cushion there. Osteoarthritis is nothingmore than wearing away that gristle on the end of the bone and instead of havingseven to 10 millimeters of tread, you may have threeto four millimeters of tread. And the swelling caneither be because of fluid, which is an irritation tothe lining of the joint,
or it can be just because of thickening of the lining of the joint, both of which will cause limited motion. The common symptoms with osteoarthritis are more functional. They're difficulty with walking, ascending or descending stairs, particularly descendingstairs where you put
more force across the kneecap area, kneeling, bending,squatting, where again you're loading and compressingthe joint at its extreme, and driving often times where you have to hold that knee in one particular spot. The symptoms of osteoarthritis often times are made worse any time the knee is held in one position orcompressed in one position
for an extended period of time. All of these decrease the amount of motion across the knee and decreasethe amount of lubrication. On physical exam forosteoarthritis we're really trying to evaluate the nature of thepain, swelling and stiffness. We are looking forseveral specific findings. We're looking to see whereyou're pain is located, if your knee is swollen,