Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 I would check the opposite SI for fixations and try some core stabilization exercises as well as some one-legged squats and lunges to target the G max. Robins, DC On 10/10/06, anngoldeeen <anngoldeen@...> wrote: Hi all! I am stumped with a patient who has a chronic left SI problem lasting almost one year- just seen first time yesterday. She has had TONS of chiropractic care. The joint moves well to motion palpation but hurts to push on it, SLR, Fabere. The muscles on that side are all weaker. Hip motion is also normal with pain in abduction only. I was thinking she would be a good candidate for polotherapy. More banging on her SI probably won't make a difference. What say you? Ann Goldeen, Astoria -- Robins, DC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 Hi Ann, At the risk of sounding really off the wall.....have you checked her cranium? This last weekend I had the opportunity to have an nasal-specific adjustment from the master, Dr. Bob Pfieffer with astounding results. Not only did my cranium - over the next 2 hours - adjust (involvoing the r lambda, the R parietal, the r temporal (twice), the l tmj (in three phases) and the occiput but about 2/3 of the way through all of those changes, my sacrum breathed right out of a lttle r torque that I'd noticed for at least 2 years!. It loosened and then settled right into its little nest quite nicely ---not to mention all by itself. Thanks, Bob! Might check that. Sunny Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C Eugene, Oregon, 97401 541- 344- 0509; Fx; 541- 344- 0955 From: "anngoldeeen" <anngoldeen@...>< >Subject: stubborn SI problemDate: Tue, 10 Oct 2006 12:42:21 -0700 Hi all! I am stumped with a patient who has a chronic left SI problem lasting almost one year- just seen first time yesterday. She has had TONS of chiropractic care. The joint moves well to motion palpation but hurts to push on it, SLR, Fabere. The muscles on that side are all weaker. Hip motion is also normal with pain in abduction only. I was thinking she would be a good candidate for polotherapy. More banging on her SI probably won't make a difference. What say you? Ann Goldeen, Astoria Be seen and heard with Windows Live Messenger and Microsoft LifeCams Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 Anne, before prolotherapy try rehabilitating the hip/si. Focus on Strengthening the musculature surrounding hip joint. Stretching and Massage included. Keep adjusting the hip/SI to maintain motion of the joint. When the musculature attains some strength it will probably hold SI adjustment much better and cause her much less discomfort. You are correct that simply adjusting the SI alone will probably not change things, but in conjunction with the above it may. I'd only use Prolotherapy as a last resort and only if there is a very precise tendonous area of involvement. If there is, try TFM, Graston etc. before prolo. Of course these are only my humble utterances and opinons. Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204 stubborn SI problem Hi all! I am stumped with a patient who has a chronic left SI problem lasting almost one year- just seen first time yesterday. She has had TONS of chiropractic care. The joint moves well to motion palpation but hurts to push on it, SLR, Fabere. The muscles on that side are all weaker. Hip motion is also normal with pain in abduction only. I was thinking she would be a good candidate for polotherapy. More banging on her SI probably won't make a difference. What say you? Ann Goldeen, Astoria Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 You might consider hypermobility and brace the pelvis with a non-elastic intertrochanteric belt (ala SpinePower) 24/7 for a couple weeks, and do trunk stability exercises with the belt on. Wearing it all the time is a bitch but effective if needed. Try the Chair test to determine necessity. Remember good quality protein, Vit-C, Glucosamine and other nutritional support. Seitz, DC Tuality Physicians 730-D SE Oak Street Hillsboro, OR 97123 (503)640-3724 From: [mailto: ] On Behalf Of anngoldeeen Sent: Tuesday, October 10, 2006 12:42 PM Subject: stubborn SI problem Hi all! I am stumped with a patient who has a chronic left SI problem lasting almost one year- just seen first time yesterday. She has had TONS of chiropractic care. The joint moves well to motion palpation but hurts to push on it, SLR, Fabere. The muscles on that side are all weaker. Hip motion is also normal with pain in abduction only. I was thinking she would be a good candidate for polotherapy. More banging on her SI probably won't make a difference. What say you? Ann Goldeen, Astoria Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 Don't forget to check the pubic bone.... > > Anne, before prolotherapy try rehabilitating the hip/si. Focus on Strengthening the musculature surrounding hip joint. Stretching and Massage included. Keep adjusting the hip/SI to maintain motion of the joint. When the musculature attains some strength it will probably hold SI adjustment much better and cause her much less discomfort. You are correct that simply adjusting the SI alone will probably not change things, but in conjunction with the above it may. > > I'd only use Prolotherapy as a last resort and only if there is a very precise tendonous area of involvement. If there is, try TFM, Graston etc. before prolo. > > Of course these are only my humble utterances and opinons. > > > Dr. ph Medlin D.C. > Spine Tree Chiropractic > 1627 NE Alberta St. #6 > Portland, OR 97211 > Ph: 503-788-6800 > c: 503-889-6204 > stubborn SI problem > > > Hi all! I am stumped with a patient who has a chronic left SI problem lasting almost one year- just seen first time yesterday. She has had TONS of chiropractic care. The joint moves well to motion palpation but hurts to push on it, SLR, Fabere. The muscles on that side are all weaker. Hip motion is also normal with pain in abduction only. I was thinking she would be a good candidate for polotherapy. More banging on her SI probably won't make a difference. What say you? Ann Goldeen, Astoria > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 Hi Ann, I like 's approach. To discriminate hypermobility in supine patient, test active SLRs both singly and with both legs at the same time. If pain at CC on any of these, brace the pelvis with lateral-medial bilateral pressure on the illia, and have patient repeat the provocative motion. If pain improves, hypermobility is likely. Try SI belt, if that doesn't work, send her to Dave Milroy, DC, ND in ville for prolotherapy injection. My 2 cents...hope it helps. W. Snell, D.C. Hawthorne Wellness Center 3942 SE Hawthorne Blvd. Portland, OR 97214 Ph. 503-235-5484 Fax 503-235-3956 drpsnell.chiroweb.com >From: " anngoldeeen " <anngoldeen@...> >< > >Subject: stubborn SI problem >Date: Tue, 10 Oct 2006 12:42:21 -0700 > >Hi all! I am stumped with a patient who has a chronic left SI problem >lasting almost one year- just seen first time yesterday. She has had TONS >of chiropractic care. The joint moves well to motion palpation but hurts >to push on it, SLR, Fabere. The muscles on that side are all >weaker. Hip motion is also normal with pain in abduction only. I was >thinking she would be a good candidate for polotherapy. More banging on her >SI probably won't make a difference. What say you? Ann Goldeen, Astoria Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 Hi Ann: Have you considered the possibility of a sprain of the weight bearing portion of the SI? What was the mechanism of the original injury? She could have swelling inside the joint that will just get worse with osseous adjusting. Try blocking her supine (SOT cat II) and see if it makes a difference. Trochanter belt may help if it is an SI sprain, locate it to hold the SI's together just above the trochanters. Muscles should test stronger with support to the SI if it is a sprain. I had one of these and used to lay supine on the floor with an ice pack under the affected SI, kind of blocking myself with ice and pushing the joint together. Ask Sunny about Cat II - she is the SOT pro. Rod stubborn SI problem Hi all! I am stumped with a patient who has a chronic left SI problem lasting almost one year- just seen first time yesterday. She has had TONS of chiropractic care. The joint moves well to motion palpation but hurts to push on it, SLR, Fabere. The muscles on that side are all weaker. Hip motion is also normal with pain in abduction only. I was thinking she would be a good candidate for polotherapy. More banging on her SI probably won't make a difference. What say you? Ann Goldeen, Astoria Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 Interesting responses, Prolo is great, as a last resort, use Graston or something similar first, the goal is to restart first stage healing of tendons and ligaments, with a controlled amount of bruising, mild inflammation, it hurts, but it works. The core stab ideas are also critical. I've been writing on this topic- Chronic SI joint- in several of my last Dynamic Chiro articles, here are links and attachments. Sacro-Iliac Revisited, the Importance of Ligamentous Integrity July 2, 2005 http://www.chiroweb.com/archives/23/14/10.html (this one is basically about a Graston or prolo model for looking at SI0 (this one is another approach to SI, from a PT in Montana, I like his self correction exercises, and some of his basic correction procedures Sacroiliac Joint Correction - A Different Model December 17, 2005, Volume 23, Issue 26, MH#39 http://www.chiroweb.com/archives/23/26/09.html (here is my latest, an overview of SI instability, the various tests and procedures I use) http://www.chiroweb.com/columnist/heller/ Sacroiliac Instability: An Overview Marc Marc Heller, DC mheller@... www.MarcHellerDC.com Rod wrote: > > Hi Ann: > > Have you considered the possibility of a sprain of the weight bearing > portion of the SI? What was the mechanism of the original injury? She > could have swelling inside the joint that will just get worse with > osseous adjusting. Try blocking her supine (SOT cat II) and see if it > makes a difference. Trochanter belt may help if it is an SI sprain, > locate it to hold the SI's together just above the trochanters. > Muscles should test stronger with support to the SI if it is a sprain. > I had one of these and used to lay supine on the floor with an ice > pack under the affected SI, kind of blocking myself with ice and > pushing the joint together. Ask Sunny about Cat II - she is the SOT pro. > > Rod > > * stubborn SI problem > > Hi all! I am stumped with a patient who has a chronic left SI > problem lasting almost one year- just seen first time yesterday. > She has had TONS of chiropractic care. The joint moves well to > motion palpation but hurts to push on it, SLR, Fabere. > The muscles on that side are all weaker. Hip motion is also > normal with pain in abduction only. I was thinking she would be a > good candidate for polotherapy. More banging on her SI probably > won't make a difference. What say you? Ann Goldeen, Astoria > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2006 Report Share Posted October 10, 2006 Mark,, Great article,,Dan Beeson -----* stubborn SI problem >> >> Hi all! I am stumped with a patient who has a chronic left SI >> problem lasting almost one year- just seen first time yesterday. >> She has had TONS of chiropractic care. The joint moves well to >> motion palpation but hurts to push on it, SLR, Fabere. >> The muscles on that side are all weaker. Hip motion is also >> normal with pain in abduction only. I was thinking she would be a >> good candidate for polotherapy. More banging on her SI probably >> won't make a difference. What say you? Ann Goldeen, Astoria >> >> > > >OregonDCs rules: >1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated. >2. Always sign your e-mails with your first and last name. >3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2006 Report Share Posted October 11, 2006 Even if Hypermobility is the issue, which there seems to be a component of that, muscle strength in that area needs to be increased to help support the joint and counteract the hypermobility. Simply bracing by itself will not address the entire problem. Dr. ph Medlin D.C. Spine Tree Chiropractic 1627 NE Alberta St. #6 Portland, OR 97211 Ph: 503-788-6800 c: 503-889-6204 stubborn SI problem >>Date: Tue, 10 Oct 2006 12:42:21 -0700 >> >>Hi all! I am stumped with a patient who has a chronic left SI problem >>lasting almost one year- just seen first time yesterday. She has had TONS >>of chiropractic care. The joint moves well to motion palpation but hurts >>to push on it, SLR, Fabere. The muscles on that side are all >>weaker. Hip motion is also normal with pain in abduction only. I was >>thinking she would be a good candidate for polotherapy. More banging on >>her >>SI probably won't make a difference. What say you? Ann Goldeen, Astoria > > > > > OregonDCs rules: > 1. Keep correspondence professional; the purpose of the listserve is to > foster communication and collegiality. No personal attacks on listserve > members will be tolerated. > 2. Always sign your e-mails with your first and last name. > 3. The listserve is not secure; your e-mail could end up anywhere. > However, it is against the rules of the listserve to copy, print, forward, > or otherwise distribute correspondence written by another member without > his or her consent, unless all personal identifiers have been removed. > Quote Link to comment Share on other sites More sharing options...
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