Outline · [ Standard ] · Linear+ Big Medical Mistake, sad...

SIJD - the reason for low back pain, scoliosis, lordosis, lumbar/thorax hypermobility, forward head position, bad posture, headaches, leg length inequality, knee problems, achilles problems and so many others... Very common problem and yet so poorly understod!

(SIJD = sacroiliac joint dysfunction/dislocation/syndrome, rotated pelvis, rotated iliac, pelvis misalignment,... A lot of different names to this!)

After years of search I finally found one professional who knew how to cure my back pain: to correct my SIJ. Before him I met tens of others who did it wrong or didn't know anything at all! I spent thousands of dollars during many years for doctors, physical therapists, pictures, exams, test,...

My problem was anteriorly rotated left iliac bone (SIJD), but all the doctors were totally lost, or few of them diagnosed something wrong on right side of my back where the pain was... That is wrong side!!

After I got rid of my back pains (and many other problems too connected to SIJD) I started to search information about SIJ dysfunction and to interview patients who have the same problems I did.

According to many research and studies almost all people have leg length inequality that causes bad posture, scoliosis and other problems. That is because of misalignments in pelvis -> SIJD. When iliac bone is rotated it causes leg shortening and sacrum to lead forward -> lordosis. That leg length inequality causes pelvis misalignment. Those all cause problems to spine all the way from lumbar to cervical spine!

Here some references:
Richard DonTigny, PT:
"Eight of ten people in the world will have low back pain at one time or another and I firmly believe that most of it is SIJD.”
http://www.kalindra.com/faq.htm

Wolf Schamberger, M.D.
"Patients presenting for cardiac rehabilitation are no different from the general population in that 80 to 85% are out of alignment."
http://www.cacr.ca/news/1998/9812Schamberger.htm

Maciej Dluski :
“The theory of the YUMEIHO method is grounded on the fact, that over 95% of people have had incorrectly positioned pelvis since their birth. Most often it means, that one ilium is placed higher than the other. The limb on the higher ilium side is comparatively shorter.”
http://www.yumeiho.pl/o_terapii_en.html

Lisa Mancuso, M.D., Hugh S Thompson, M.D, George A. Bitting, M.D.
"The sacroiliac joint is a commonly overlooked cause of lower back pain. Recent studies have found that Sacroiliac dysfunction was the cause, or a major component, in a high percentage the cases of mechanical back pain. Dysfunction in the sacroiliac joint not only causes back pain but also may mimic pain seen in lumbar disc herniation or a facet joint with pain referred into the buttock and thigh."
http://www.firstchoicehealthcare.com/assets/docs/012405.pdf

Protonics method:
“In a normal person the spine sits on top of a neutrally positioned sacrum (central portion of the pelvis) and has a slight lordosis (arch forward). When the pelvis is anteriorly rotated the sacrum is tipped forward and the rest of the spine has no choice but to follow suit. Rather than fall over forward, the body compensates for this excessive forward tilting of the lower spine by tilting backward at some point higher up the chain. This creates a large increase in the amount of curvature (lordosis and scoliosis) of the lower back. This deep curvature of the back can result in extreme pain and various problems including muscle spasms, pinched nerves, and possibly damage to the intervertebral discs.”
http://www.protonics.com/How%20Pelvic%20In...oot%20cause.htm

Greg Spindler:
“One side (usually the left) is rotated forward and then the other side is rotated back. This creates the unstable pelvic condition while under weight-bearing stress. As a result, the sacrum is off-center and tipped which initiates a direction for the scoliotic compensation (the curvature) to begin. The bottom line is, not treating the pelvic area puts limits on relieving scoliosis conditions.”
http://www.gregspindler.com/treatingscoliosis.html


Postural Restoration Institute
“The left pelvis is anteriorly tipped and forwardly rotated. This directional, rotational influence on the low back and spine to the right, mandates compulsive compensatory movement in one or more areas of the trunk, upper extremities and cervical-cranial-mandibular muscle. The greatest impact is on rib alignment and position, therefore influencing breathing patterns and ability. It is very possible that respiratory dysfunctions, associated for example with asthma or daily, occupational, repetitive, work positions, can also influence pelvic balance and lead to a compensatory pattern of an anteriorly tipped and forwardly rotated pelvis on the left.”
http://www.posturalrestoration.com/about/science.html

Richard DonTigny, PT:
"Here is the mind blower. In 1982 the American Academy of Orthopaedic Surgeons met in Toronto specifically to address LBP. They established criteria for testing and for the interpretation of those tests. They assumed that the SIJ was so strong as to be immune to injury through minor trauma and paid scant attention to it. They also reported that 'in spite of thorough examination they could establish a firm diagnosis less than 15% of the time.
What they did not seem to realize is that when you use their recommended tests and interpret those test in the recommended manner that you will be compelled to miss the diagnosis over 85% of the time! It's not that they are not an intelligent group, but they just have not considered all of the evidence.“
http://www.kalindra.com/critical.pdf

http://www.spineandsacroiliac.com/images/effect.pdf
http://www.spineandsacroiliac.com/sacrodysfunction.html
http://www.healing.org/only-3.html
http://www.kalindra.com/derosa_montreal.pdf
http://www.kalindra.com/rounds.pdf

And I have collected a lot more great links:
http://personal.inet.fi/koti/faro/Selkasiv...nkkeja.html#eng


This is a common mistake the professionals do: They follow the pain!! That is wrong!

Physical Therapy volume 79 · number 12 · december 1999
http://www.Ptjournal.Org/ptjournal/decembe...v79n12p1134.Cfm
Research report: Measurement of sacroiliac joint dysfunction: a multicenter intertester reliability study
Janet K Freburger and Daniel L Riddle

“for example, a patient with symptoms in the region of the right sij, with a right asis lower than the left asis and a right psis higher than the left psis, would have an anteriorly rotated innomimate on the right. Conversely, a patient with symptoms in the region of the left sij, with a right asis lower than the left asis and a right psis higher than the left psis, would be described as having a posteriorly rotated innominate on the left.“

That last sentence is wrong! If right PSIS is higher it is dislocated ie. in dysfunction regardless where the pain is! But it must not be measured when patient is standing. I have seen patients who have right PSIS higher when standing and left PSIS higher when lying. Because iliac rotation effects to the functional length of a leg, PSISs must be palpated while lying.


Here is other similar:
Physical Therapy . Volume 82 . Number 8 . August 2002
Evaluation of the presence of sacroiliac joint region dysfunction
using a combination of tests: a multicenter intertester
http://www.Udel.Edu/pt/manal/spinecourse/sijlab/riddled.Pdf

Reliability study
Daniel L Riddle, Janet K Freburger, North American Orthopaedic Rehabilitation Research Network

According to table 3:

1. Standing flexion test: my left SIJ lifted, so it was hypermobile!
This test alone should give enough evidence that it was left SIJ dysfunction!

2. Prone knee flexion test: I had the pain on right side and right leg was longer, so this test gives the wrong diagnosis to me: posteriorly rotated right iliac. Wrong!

3. Supine long sitting test: again I had the pain on right side and right leg was longer, so this test gives the wrong diagnosis to me: posteriorly rotated right iliac. Wrong!

4. Sitting PSIS test: this is the worst! I had pain on right side and left PSIS was higher. According to this test I had posteriorly rotated right iliac. Totally wrong result!

And this is why I had wrong diagnosises and bad treatments for many years. It took 10 years to find a professional who knew how to do it wright! All the other PTs and chiropractors did it wrong like in that paper.

The pain is usually on the other side than the reason. That is where the mistake is made! Left SIJ dysfunction -> pain on the right side!

This is why the manual treatment is not helping most of the patients... They do it to the wrong side. They try to dislocate the healthy SIJ!


My opinion is that there is no such thing as posteriorly rotated iliac. It is (always) a misdiagnose because the pain is very often on the other side than the cause. Iliac might only seem to be posteriorly rotated when compared to the other one with no pain. Same thing with legs: One leg seems to be different length than the other leg with almost all the people.

If SIJ is hypermobile it is so because it is dislocated. If PSIS is higher on the other side it is so because iliac has rotated (dislocated) anteriorly on that side, no matter where the pain is! But it must be checked while patient is lying, not standing!

That is why they say right SIJ is usually the problem. That is not true! The pain is usually on the right side! But the reason for pain is on the other side. When left SIJ comes out - the left leg gets shorter - and all the body weight is carried on right side of the pelvis. That’s why it hurts there!

I believe it is so. I have seen and interviewed about 100 back pain patients who have got help same way I did. First some of them got diagnose to wrong side from chiropractors. So those chiropractors tried to dislocate their healthy SI!!

SIJD on pregnant women

"-One of the most interesting side-effects of a misalignment of the pelvic bones is that anecdotally, it often seems associated with malpositions of the baby" "-There is little scientific data to show that pelvic misalignment is associated with malpositions because traditional medicine does not recognize misalignment as a problem or research it, nor do they take the idea of "pelvic misalignment" seriously."
http://www.plus-size-pregnancy.org/pubicpain.htm

Dr. Robert White
"Infant spines should be checked shortly after birth due to the twisting, pulling, and tugging that does on during the labor process. Their spines are extremely vulnerable and misalignment can result in such problems as colic, re-occurring ear infections, and later hyperactivity."
http://www.tcwellness.com/article.php?id=399

"Low back pain was caused in 78 percent of the women by sacroiliac dysfunction, resulting from the sacroiliac fixation test also know as Piedallu's sign. The patient is examined and one posterior superior spine is lower than the other. "
http://www.kalindra.com/arcadi.pdf

Dr. Cheryl McFarland
"Scientific research shows that SI joint dysfunction is the primary cause of pregnancy-related back pain."
http://www.sptimes.com/2004/10/25/Citrus/P...en_can_av.shtml

Kenneth D. Erickson, D.C.
"The most common cause of low back pain during pregnancy is a condition known as “sacroiliac joint dysfunction” or “sacroiliac subluxation”. Subluxation is a Latin term meaning “partial dislocation”. "
http://www.doctorken.com/pregnancy.htm

Read your post with interest as I suffer from SIJD as well. It is quite crippling sometimes. The therapists and chiros don't seem to be able to treat it well and there've been times when I can barely get off the table. I'm usually well, in fact I teach fitness classes, but have had to get subs for my classes for the last 5 weeks because I blew my SI again making the bed! Now...I'm coming along, but I want to do it right. What advice or info can be passed discreetly along to the therapist to enable them to bypass erroneous info? what did your fabulous practitioner do? Are there exercises I can do? What manipulations do you recommend? What about taping? Does taping help? What do you recommend for driving? Driving Aids feature lumbar supports, I don't need lumbar supports, I need something hard for my sit bones because I can feel them slipping ouf of alignment! I've been driving around sitting on cookie sheets lately. Any advice would be greatly appreciated. Robyn in Toronto

SIJD - the reason for low back pain, scoliosis, lordosis, lumbar/thorax hypermobility, forward head position, bad posture, headaches, leg length inequality, knee problems, achilles problems and so many others... Very common problem and yet so poorly understod!

(SIJD = sacroiliac joint dysfunction/dislocation/syndrome, rotated pelvis, rotated iliac, pelvis misalignment,... A lot of different names to this!)

After years of search I finally found one professional who knew how to cure my back pain: to correct my SIJ. Before him I met tens of others who did it wrong or didn't know anything at all! I spent thousands of dollars during many years for doctors, physical therapists, pictures, exams, test,...

My problem was anteriorly rotated left iliac bone (SIJD), but all the doctors were totally lost, or few of them diagnosed something wrong on right side of my back where the pain was... That is wrong side!!

After I got rid of my back pains (and many other problems too connected to SIJD) I started to search information about SIJ dysfunction and to interview patients who have the same problems I did.

According to many research and studies almost all people have leg length inequality that causes bad posture, scoliosis and other problems. That is because of misalignments in pelvis -> SIJD. When iliac bone is rotated it causes leg shortening and sacrum to lead forward -> lordosis. That leg length inequality causes pelvis misalignment. Those all cause problems to spine all the way from lumbar to cervical spine!

Here some references:
Richard DonTigny, PT:
"Eight of ten people in the world will have low back pain at one time or another and I firmly believe that most of it is SIJD.”
http://www.kalindra.com/faq.htm

Wolf Schamberger, M.D.
"Patients presenting for cardiac rehabilitation are no different from the general population in that 80 to 85% are out of alignment."
http://www.cacr.ca/news/1998/9812Schamberger.htm

Maciej Dluski :
“The theory of the YUMEIHO method is grounded on the fact, that over 95% of people have had incorrectly positioned pelvis since their birth. Most often it means, that one ilium is placed higher than the other. The limb on the higher ilium side is comparatively shorter.”
http://www.yumeiho.pl/o_terapii_en.html

Lisa Mancuso, M.D., Hugh S Thompson, M.D, George A. Bitting, M.D.
"The sacroiliac joint is a commonly overlooked cause of lower back pain. Recent studies have found that Sacroiliac dysfunction was the cause, or a major component, in a high percentage the cases of mechanical back pain. Dysfunction in the sacroiliac joint not only causes back pain but also may mimic pain seen in lumbar disc herniation or a facet joint with pain referred into the buttock and thigh."
http://www.firstchoicehealthcare.com/assets/docs/012405.pdf

Protonics method:
“In a normal person the spine sits on top of a neutrally positioned sacrum (central portion of the pelvis) and has a slight lordosis (arch forward).  When the pelvis is anteriorly rotated the sacrum is tipped forward and the rest of the spine has no choice but to follow suit.  Rather than fall over forward, the body compensates for this excessive forward tilting of the lower spine by tilting backward at some point higher up the chain.  This creates a large increase in the amount of curvature (lordosis and scoliosis) of the lower back.  This deep curvature of the back can result in extreme pain and various problems including muscle spasms, pinched nerves, and possibly damage to the intervertebral discs.”
http://www.protonics.com/How%20Pelvic%20In...oot%20cause.htm

Greg Spindler:
“One side (usually the left) is rotated forward and then the other side is rotated back. This creates the unstable pelvic condition while under weight-bearing stress. As a result, the sacrum is off-center and tipped which initiates a direction for the scoliotic compensation (the curvature) to begin. The bottom line is, not treating the pelvic area puts limits on relieving scoliosis conditions.”
http://www.gregspindler.com/treatingscoliosis.html
Postural Restoration Institute
“The left pelvis is anteriorly tipped and forwardly rotated. This directional, rotational influence on the low back and spine to the right, mandates compulsive compensatory movement in one or more areas of the trunk, upper extremities and cervical-cranial-mandibular muscle. The greatest impact is on rib alignment and position, therefore influencing breathing patterns and ability. It is very possible that respiratory dysfunctions, associated for example with asthma or daily, occupational, repetitive, work positions, can also influence pelvic balance and lead to a compensatory pattern of an anteriorly tipped and forwardly rotated pelvis on the left.”
http://www.posturalrestoration.com/about/science.html

Richard DonTigny, PT:
"Here is the mind blower. In 1982 the American Academy of Orthopaedic Surgeons met in Toronto specifically to address LBP. They established criteria for testing and for the interpretation of those tests. They assumed that the SIJ was so strong as to be immune to injury through minor trauma and paid scant attention to it. They also reported that 'in spite of thorough examination they could establish a firm diagnosis less than 15% of the time.
What they did not seem to realize is that when you use their recommended tests and interpret those test in the recommended manner that you will be compelled to miss the diagnosis over 85% of the time! It's not that they are not an intelligent group, but they just have not considered all of the evidence.“
http://www.kalindra.com/critical.pdf

http://www.spineandsacroiliac.com/images/effect.pdf
http://www.spineandsacroiliac.com/sacrodysfunction.html
http://www.healing.org/only-3.html
http://www.kalindra.com/derosa_montreal.pdf
http://www.kalindra.com/rounds.pdf

And I have collected a lot more great links:
http://personal.inet.fi/koti/faro/Selkasiv...nkkeja.html#eng
This is a common mistake the professionals do: They follow the pain!! That is wrong!

Physical Therapy volume 79 · number 12 · december 1999
http://www.Ptjournal.Org/ptjournal/decembe...v79n12p1134.Cfm
Research report: Measurement of sacroiliac joint dysfunction: a multicenter intertester reliability study
Janet K Freburger and Daniel L Riddle

“for example, a patient with symptoms in the region of the right sij, with a right asis lower than the left asis and a right psis higher than the left psis, would have an anteriorly rotated innomimate on the right. Conversely, a patient with symptoms in the region of the left sij, with a right asis lower than the left asis and a right psis higher than the left psis, would be described as having a posteriorly rotated innominate on the left.“

That last sentence is wrong! If right PSIS is higher it is dislocated ie. in dysfunction regardless where the pain is! But it must not be measured when patient is standing. I have seen patients who have right PSIS higher when standing and left PSIS higher when lying. Because iliac rotation effects to the functional length of a leg, PSISs must be palpated while lying.
Here is other similar:
Physical Therapy . Volume 82 . Number 8 . August 2002
Evaluation of the presence of sacroiliac joint region dysfunction
using a combination of tests: a multicenter intertester
http://www.Udel.Edu/pt/manal/spinecourse/sijlab/riddled.Pdf

Reliability study
Daniel L Riddle, Janet K Freburger, North American Orthopaedic Rehabilitation Research Network

According to table 3:

1. Standing flexion test: my left SIJ lifted, so it was hypermobile!
This test alone should give enough evidence that it was left SIJ dysfunction!

2. Prone knee flexion test: I had the pain on right side and right leg was longer, so this test gives the wrong diagnosis to me: posteriorly rotated right iliac. Wrong!

3. Supine long sitting test: again I had the pain on right side and right leg was longer, so this test gives the wrong diagnosis to me: posteriorly rotated right iliac. Wrong!

4. Sitting PSIS test: this is the worst! I had pain on right side and left PSIS was higher. According to this test I had posteriorly rotated right iliac. Totally wrong result!

And this is why I had wrong diagnosises and bad treatments for many years. It took 10 years to find a professional who knew how to do it wright! All the other PTs and chiropractors did it wrong like in that paper.

The pain is usually on the other side than the reason. That is where the mistake is made! Left SIJ dysfunction -> pain on the right side!

This is why the manual treatment is not helping most of the patients... They do it to the wrong side. They try to dislocate the healthy SIJ!
My opinion is that there is no such thing as posteriorly rotated iliac. It is (always) a misdiagnose because the pain is very often on the other side than the cause. Iliac might only seem to be posteriorly rotated when compared to the other one with no pain. Same thing with legs: One leg seems to be different length than the other leg with almost all the people.

If SIJ is hypermobile it is so because it is dislocated. If PSIS is higher on the other side it is so because iliac has rotated (dislocated) anteriorly on that side, no matter where the pain is! But it must be checked while patient is lying, not standing!

That is why they say right SIJ is usually the problem. That is not true! The pain is usually on the right side! But the reason for pain is on the other side. When left SIJ comes out - the left leg gets shorter - and all the body weight is carried on right side of the pelvis. That’s why it hurts there!

I believe it is so. I have seen and interviewed about 100 back pain patients who have got help same way I did. First some of them got diagnose to wrong side from chiropractors. So those chiropractors tried to dislocate their healthy SI!!

Read your post with interest as I suffer from SIJD as well. It is quite crippling sometimes. The therapists and chiros don't seem to be able to treat it well and there've been times when I can barely get off the table. I'm usually well, in fact I teach fitness classes, but have had to get subs for my classes for the last 5 weeks because I jammed my SI again making the bed! Now...I'm coming along, but I want to do it right. What advice or info can be passed discreetly along to the therapist to enable them to bypass erroneous info? what did your fabulous practitioner do? Are there exercises I can do? What manipulations do you recommend? What about taping? Does taping help? What do you recommend for driving? Driving Aids feature lumbar supports, I don't need lumbar supports, I need something hard for my sit bones because I can feel them slipping out of alignment! I've been driving around sitting on cookie sheets lately. Any advice would be greatly appreciated. Robyn in Toronto

I realize it has almost been a year since your post w/ the big medical mistake but i am wondering if you can help or state who it was that you saw to help you with your problem? I have EXACTLY the same symptoms you have: right leg long, left leg short, pain all on the right side (low back) as well as under ribcage (right side), told i have mild Lordosis, left back knee problems (on the short leg side) recently new & really starting to worry me. I get mixed messages on wheter to wear a lift in my shoe. I'm so fearful if i don't find the proper PT to put me back in alignment this is going to lead to some sorta of surgery down the road, either the knee, back... All my x-rays, mri's, cat scan don't show anything unusual and the Orthopedic Dr. insists I get on a good workout program strengthening my Core.

I have seen many Chiros, physical therapists and still havn't gotten better. My leg length difference seems to be getting worse. I recently signed on w/ a CHEK trainer the last 2 months and do and his belief is if I strengthen my transverse abdominals & glutes, this will pull me back into alignment. I struggle sometimes w/ even some of these exercises as i do them at home mainly. I just feel like perhaps after reading your post someone really needs to work on the short leg side (non-pain ) side to pull me back in alignment and then a strengthening program. I feel like i might be strenghtening a bad postural (stuck ) position.......

I have been practicing DonTigny's manual rounds, Traction, knee to the chest muscle energy contraction exercise & have even gone as far as seeing someone who helps teach his workshops. Still after i do these i still feel the leg length discrepancy and the knee to the chest kinda aggravates a pain spot on my low right (SI area ).

Again i am in desperate need of someone who can help me. Perhaps finally look at this w/ a differnet approach and look at the short leg side. I have reviewed many of the links you posted, which are great. Let me know if you can suggest someone, a clinic to see, or a addl reading materials or book to help me.

THANKYOU SO MUCH FOR TAKING THE TIME TO READ THIS!!!!!

I too have had problems with my right hip and leg. I've done a total of 3+/- years of doctors and PT and chiro to find relief. Have had some success but I'm now back where I began. I feel like right leg is totally worthless - no strength - and always in pain. What kind of doctor can I see who will know how to evaluate correctly????

I think there is no answer to that what type of specialists to look for. They all believe on different things and have different skills. Some chiropractors might know, some osteopathians, or others. But only very few of them seems to understand it correctly because they all tell different theory.
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