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
Arthritis of the Big Toe Joint Hallux Rigidus Treatment Ideas from Podiatrist Larry Huppin
Today I'm talking about arthritis of the bigtoe joint. This is also called hallux rigidus. So essentially what this is, it's arthritisof this joint here. So if you look at a normal step what should happen as we walk is thisjoint bends 60 to 80 degrees. You can imagine, if this joint wears out, which is what arthritisis, how painful that can be. So as you walk forward now, you can no longer bend this joint. Now let's look over at this picture here.So this is what that joint should look like with that cartilage in that joint a hundredtimes smoother than glass. As it starts to wear out, this cartilage gets thinner andthinner to the point where down here we have
hallux rigidus or that there is no cartilageleft and essentially there is no motion left in this joint, or if there is motion it'sjust a few degrees that leads to pain. So when we look at trying to treat this probleminitially, our goal is to eliminate the pain so that people can walk pain free and do theactivities they want to do. In most cases if it is early on, meaning thereis not bad arthritis, we want to do something to enhance the motion in that joint. In thatsituation we might use either a prefabricated or a customer orthotic to try and bring thisbone down a little bit more because whenwe do that, that helps the motion in this joint.But over time if this joint gets bad enough
that it really starts to get quite worn outand there's very little cartilage left, that isn't going to eliminate pain. In order to eliminate pain we have to do somethingto stop motion and there's several ways to do that. First of all, we still want to useeither a prefabricated or custom orthotic to transfer pressure off of this area andget more pressure back here. Custom orthotics tend to work better because they conform closerto the arch but there's also some good overthecounter devices that can work. Actually if you goto our website and do a search for hallux rigidus or big toe arthritis, you'll finda list of overthecounter devices that might
help you. The second thing that we might do is do someshoe changes. You can buy shoes, either athletic shoes or dress shoes or walking shoes thatare rigid on the front. This is called a rocker sole. You can see I cannot really bend thatsole. So as this person starts to walk forward in this type of shoe, the shoe rocks you throughthe step and the toe joint does not have to move. That can be very effective at eliminatingmotion in that joint and eliminating pain. You could also purchase what's called a turftoe plate. It's a rigid plate that goes inside a shoe in order to stop motion. There's evenwomen's dress shoes on the market that come
with platforms, for example. Those have rigidsoles on them. So we'd like to do all of this before consideringsurgery. There are surgical options that can also be done. If it gets too bad where yougot real arthritis in that joint, usually you're considering a fusion of that joint.Usually it's actually a fairly effective surgery, most patients do very well, but we alwaysconsider surgery a very last resort. So if you have pain in your big toe joint, don'tlive with it. It can only get worse. Often we catch it early enough, we can prevent furtherdamage or at least slow the potential for damage. Later on if there is quite a bit ofdamage of the joint, we can still do a lot
to eliminate your pain. So if you're in ourarea, make an appointment to see us. If you're not in our area find a podiatrist that specializesin biomechanics and orthotic therapy. They can usually help you a lot.
How to Best Treat Foot Arthritis with Seattle Podiatrist Larry Huppin
Hi. So today we're going to talk about arthritison top of the foot or what's called midfoot arthritis. That's arthritis in these jointsthrough here. This is the second most common cause that we see causing pain on the topof the foot. The first one is a condition called dorsal compression syndrome, whichjust means that the foot is collapsing down and all these bones get pressed together toomuch but there's no actual damage to the joint. For information on that problem, go to ourwebsite and do a search for quot;dorsal compression syndromequot; or quot;top of foot pain.quot; However, today we're going to talk about arthritisin these joints. So longterm, this foot flattening
out too much can start to damage these joints.As the foot goes down, all these bones get pressed together. Initially it just causespain, but over time, it starts to wear away the cartilage on the inside of these joints,and that can cause a lot of pain. So after that occurs, almost any motion in this areawill start to cause pain. Also, a lot of times people will see a bump, a bone occurring ontop of the foot associated with that arthritis. When we look at treating it, our first goalis to avoid surgery and still eliminate a 100% of the pain. You really should look atsurgery as only the very, very last resort. And in most cases, in fact, in almost allcases, we can treat this without doing surgery.
Our goal here is to limit motion in thesejoints, so what we're going to do is put something under the arch of the foot. We're going totake an orthotic device, put it underneath there, and we're going to try and use thatto stop the motion in that joint. For that to work the best, we want that orthotic toconform extremely close to the arch of the foot. It's called a total contact orthotic.Again, you can look up quot;total contact orthoticquot; on our website. That type of orthotic doesthe best job of limiting motion in this area. If that's not enough, we can actually do someshoe modifications where we put what's called the rocker on the bottom of your shoe to limitthe motion in that foot. This is a big orthotic
that we might use in a men's dress shoe orin anybody's athletic shoe. For women's dress shoes, we can use much, much smaller devices,as we aren't going to a flat or a heel, but the key is that still conforms very closeto the arch of the foot. So if you think you might have arthritis inyour midfoot, what you want to do first is find a podiatrist in your area who specializesin orthotics and biomechanics. If you're in our area, go to our website and you can findcontact information there. If you're not in our area, look for someone who has that specialty. If you want to try and treat this yourself,go to our website and do a search for quot;selftreatment
for midfoot arthritisquot; or quot;selftreatmentfor foot arthritisquot; and you'll find all kinds of hints there, we'll recommend some overthecounterarch supports you can try instead of the custom ones. We'll recommend some types of shoesyou can use and a number of different things you can do initially to try and treat thisproblem.