Hi,

I am not sure as to exactly what you seek, but the Cibulka article speaks directly to SI dys with the others also related.

Ed

This article contains some cases with SIJD. 

  DonTigny, RL: Sacroiliac 201; Dysfunction and Management: A biomechanical solution.  Journal of Prolotherapy 3:644-652, 2011   Available in full text from https://www.researchgate.net

This is a recent email regarding my website at www.thelowback.com

Dear Richard Dontigny, P.T.,

Three hours ago, I tried the direct correction with the Impulse adjusting instrument. I alternated both sides 4 times each. It took that many times until the legs didn't shorten anymore. I am now completely out of pain. This is amazing. I have been in almost constant pain since 1999. Now after doing your correction, all my pains are completely gone. It took 30 minutes for the pain to completely disappear.

Here is a description of my usual pain: left hamstring tightness, right iliolumbar ligament pain, left sacrotuberous pain, base of skull pain, shoulder blade pain, left foot pronation, epididymitis pain, left round ligament pain, left groin pain, left calf pain, headache pain, a shorter than normal walking stride, and right long dorsal ligament pain. I have had these pains since 1999, with most of them being constant all day long. I even have left eye twitches when I am really out of alignment.

Since the correction three hours ago, I have no discomfort anywhere.

I have palpated my sacral base, since the correction. I noticed it went into sacral nutation. From reading about SIJD, this seems to be the more stable position. Is this correct?  Can the sacral base go too far into nutation when the innominates go into posterior rotation during correction? You mentioned the ilia ridge that prevents over correction of the posterior innominate rotation. Does this ridge also protect the sacral base from over correction?

Thank you very much for taking the time to write to me. I bet the health care care costs of our nation would be much cheaper, if the medical profession would adopt methods like yours, that are safe, reliable, effective, and simple to perform.

How many chiropractors would need to attend, if I had one of your instructors come to my area to teach a seminar?

There are around 200 chiropractic technique systems. They all teach to adjust the innominates into anterior rotation. I figure all P.T and osteopathic technique systems teach the same absurd thinking. I also had the same absurd thinking for years too, and that was making my pain worse. Your information along with the information from Joseph Shaw, M.D. are the only ones that I have seen that teach to correct into posterior rotation.

Thanks again for answering my questions.

Sincerely,

T.J,,  D.C.

Thanks....  What would be a suitable journal to publish any work on SIJ??

the journal International Musculoskeletal Medicine.

the journal International Musculoskeletal Medicine.

I am surprised a patient is self correcting a "nutated scarum", as I have never read any evidence that clinicians are reliable in finding any positional faults or that there is any validity in bony palpation and positional faults.  How is this patient palpating their own sacrum? I guess in lumbar rotation? Would that not lead to some false sense of tension, irrepsective of the lack of clinical reasoning associated witht this. Would be keen to know if there are some good trials that support this patients sensational story?

Regarding palpation of the sacrum. The sacrum only nutates in response to innominate movement. First, you must know what you are looking for. In the long straddle position the sacrum is flexed laterally toward the side of loading where it rotates on a force-dependent oblique axis to drive counter rotation of the trunk in order to decrease loading forces to the femoral head. If you are seated, palpate the tip of your sacrum and then translate the  left leg anteriorly and the right leg posteriorly to cause the pelvis to move into asymmetry as in the long straddle position.  The sacrum can easily be palpated as it flexes laterally toward either side.  Much more on http://www.thelowback.com.  How it works, why it hurts and how to fix it. and http://www.greatseminarsonline.com for CEUs for professionals.

Also see:

Tingren J, Soinila S. Reversible pelvic asymmetry. J Manipulative Physiol Ther. 2006; 29(7):561-5.

Thanks for this answer, i am just a little confused how a patient (in your example) is somehow doing this effectively ,  you say you must know what you are looking for, how does this apply to a chronic back pain patient? You have also posted a patient story using an instrument for this technique, is there any research other than anecdotal stories to support this?

This was from a competent chiropractor who has investigated his own body for some time for the source of his problem.  I am not familiar with the piece of equipment that he used although it is simple enough to correct this joint without any equipment.  This is all available on http://www.thelowback.com.  How it works, why it hurts and how to fix it. 

I discovered and published on the sacral axis in 2007 and dysfunction at this axis is prevalent just distal to the PSIS and easily self-corrected with a posterior innominate rotation.

1.  DonTigny, RL:  A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology: the implications for lumbopelvic function and dysfunction.  In Vleeming A, Mooney V, Stoeckart R (eds): Movement, Stability & Lumbopelvic Pain: Integration of research and therapy. Churchill Livingstone (Elsevier). Edinburgh, 2007, pp 265-279

2.  Gracovetsky S: Stability or controlled instability.  In Vleeming A, Mooney V, Stoeckart R (eds) Movement, Stability & Lumbopelvic Pain: Integration of research and therapy. Churchill Livingstone (Elsevier), Edinburgh, 2007, pp 279-293

3.  DonTigny, RL: Sacroiliac 101; Form and Function; A biomechanical study.  Journal of Prolotherapy  3:561-567, 2011    Available in full text from  https://www.researchgate.net

4.  DonTigny, RL: Sacroiliac 201; Dysfunction and Management: A biomechanical solution.  Journal of Prolotherapy 3:644-652, 2011   Available in full text from https://www.researchgate.net

5.  . DonTigny, RL:  Measuring PSIS movement. Clinical Management 10:43-44, 1990