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--- title: SI Joint visibility: public --- # Si [systematicawesome.jacobcole.net > ChronicPain.jacobcole.net > si.jacobcole.net | sijointpain.jacobcole.net • backpain.jacobcole.net](http://backpain.jacobcole.net) Tags:, connectordoc, curatedList [started by jacob@ideaflow.io](mailto:jacob@ideaflow.io) Contribute to the list at top! SI (Sacroiliac) Joint Pain Tricks, tools, and resources for working with SI (Sacroiliac) Joint Pain, in the lower back. - [SI (Sacroiliac) joint dysfunction (specific type of lower back pain)](#si-sacroiliac-joint-dysfunction-specific-type-of-lower-back-pain) - [Great physical therapists for SI issues](#great-physical-therapists-for-si-issues) - [PT/ osteopathic model of the sacrum](#pt-osteopathic-model-of-the-sacrum) - [Exercises to correct #t](#exercises-to-correct-t) - [Exercises to stabilize #t](#exercises-to-stabilize-t) - [Misc](#misc) [See also: ChronicPain.jacobcole.net for extensive resources. And qigong.garden](http://qigong.garden/) (related) ----- ## The Magic Bullet! For self-releasing the SI Joint. I now do this 12 min in the morning and 12 min before I go to bed daily and it shifted my life from constant pain / seeing a chiro or osteopath 3x/week to being self-sufficient. Works well on other types of low back pain, as well, and scoliosis. [*Releasing Low Back Pain and SI Joint via Svaroopa-Inspired Yoga (Video) * https://www.youtube.com/watch?v=CjsnDJnLlQQ&feature=youtu.be](https://www.youtube.com/watch?v=CjsnDJnLlQQ&feature=youtu.be) [More: Online and live classes: https://svaroopa.org/](https://svaroopa.org/) ### SI Stability Routine 2024 Additions - [Kobang Qigong Eight Psychic Horse Stance](https://www.youtube.com/watch?v=hnDF1umar-I&embeds_referring_euri=https%3A%2F%2Fbeacons.ai%2F&source_ve_path=OTY3MTQ&feature=emb_imp_woyt) (5 min daily) <> Chair Pose - [OR https://www.energyhealing.ai/](https://www.energyhealing.ai/) Albert Chen Horse Stance Standing Meditation (40 min daily) - Albert chen’s basic intro class https://www.youtube.com/watch?v=jmqb5ehMxDc&feature=youtu.be Bionic Energy Training Introduction #qigongclass - - - Qigong-inspired side plank and dying bug hold position poses (1 min, 1 min, 2 min, 1 min) ### More on SI (Sacroiliac) joint dysfunction (specific type of lower back pain) JM, JC #### Great physical therapists for SI issues Alison McLean – San Diego [Janet Perrino, Meenal Mujumdar - ACMEE Pelvic Wellness](https://www.acmeepelvicwellness.com/about-meenal) – Bay Area South Bay #### PT/ osteopathic model of the sacrum [Explanation of Left on Left Forward Sacral torsion, left on right backward sacral torsion, etc](https://hal.bim.msu.edu/CMEonLine/Pelvis/Biomechanics/page_12.html) #### Exercises to correct #t add hip hike correction exercise and pushing on knee to correct uneven ilia [Right on Left Backward Sacral Torsion](https://drive.google.com/file/d/1uodY7bFXIUeGMAMZKhpC2Yfi8UAB7wIZ/view?usp=sharing) [Left on Left Forward Sacral Torsion](https://drive.google.com/file/d/1O7R6oj4vpa7i-4cBIlOnb4D3X_N1XaAO/view?usp=sharing) #### Exercises to stabilize #t Cat-Cow yoga Bird-Dog yoga Planks #### Stretches Yoga with Adriene on YouTube has a lot of great deep stretch videos for hips + lower back that impact SI inflammation, especially these two: https://www.youtube.com/watch?v=XeXz8fIZDCE https://www.youtube.com/watch?v=phuS5VLQy8c ## PRP / Prolotherapy injections to stimulate ligament growth Great doctors: [Donna Alderman www.prolotherapy.com](http://www.prolotherapy.com/) Oakland, LA. PRP/Prolotheraphy Takes platelets injects into ligaments Dr. Bjorn Eek – Burlingame. Prolotherapy ### Misc Tags:, chiropractor, Ron, Schmidt, Action, Chiropractic, santacruz Ron Schmidt <actionchiro1@sbcglobal.net> What is the technique where you punch my spine at different locations called? After my self adjustment, what all was left that you adjusted? I had L EX and R PIE-X Best, J -- Ron Schmidt <actionchiro1@sbcglobal.net> What you are recalling as punching is more of a pushing on each vertebrae, which is a stability test . The technique is called ABC Advanced biostructural correction. : Beau Jansen <beau@santacruzcore.com>, Janet Perrino <jperrino@physiofitpt.com>, RIBS DOC Anja Huq <ribsdocanja@gmail.com>, Ron Schmidt <actionchiro1@sbcglobal.net> personal trainer, Physical therapist, chiropractor in Palo Alto, and chiropractor in santa cruz "jperrino@physiofitpt.com" <jperrino@physiofitpt.com>, ["ribsdocanja@gmail.com" <ribsdocanja@gmail.com](mailto:ribsdocanja@gmail.com)> I’d love to connect you with Dr. Anja Huq at Revitalize Integrated Body Systems, my thoughtful, warm, and skilled chiropractor, who favors gentle adjustments, precise movements, and making stabilizing exercises a lifestyle. Dr. Anja, Janet Perrino at Physiofit is perhaps the single physical therapist with the most complete understanding of how to work with SI joint issues I’ve met. She also has a wonderful combination of intellectual curiosity and physical skill. Today Dr. Anja and I took a stab a translating between chiropractic and PT understanding of SI misalignment issues. (If you see the first below link in the forwarded message, it explains terminology like “L on L forward sacral torsion” and “L on R backwards sacral torsion”.) Do you think you could help us work on translating chiropractic language into these terms? For instance, today I had a “P-L sacrum on the left” according to chiropractic terminology. What would this be in PT language? Please feel free to ask questions here if you don’t know offhand. More generally, at the end of this, it would be great if we could figure out how to self adjust me out of the state I was in today with Dr Anja: Palpation revealed: “PI ilium on right” — right psis low, asis high “P-L sacrum on the left” — sacrum rot left March test revealed: Upper joint of the SI, near sacral base, moving OK on the left, lower joint (a ways above ILA?),sacrum restricted Right side ilium restricted on both the top and bottom. I attempted the L on L forward sacral torsion adjustment you gave me, which didn’t seem to work completely (or possibly at all). We then performed the Webster technique adjustment and corrected it. Janet, would you be willing to help us figure which state I was in according to physical therapy terminology? Again, please feel free to ask anything that would be helpful. Thank you so much, both of you. J P.S. Also, I’ve attached the self adjustment manuals for L on L and R on L to the thread for reference [Left on Left Forward Sacral Torsion.jpg](https://drive.google.com/file/d/1O7R6oj4vpa7i-4cBIlOnb4D3X_N1XaAO/view?usp=sharing) [Right on Left Backward Sacral Torsion.jpg](https://drive.google.com/file/d/1uodY7bFXIUeGMAMZKhpC2Yfi8UAB7wIZ/view?usp=sharing) Mirror image these exercises for right on right or left on right respectively ------------------------- On Mon, Feb 24, 2020 at 5:21 PM Jacob Cole <jacobcole4000@gmail.com> wrote: Looking primarily at this first link, and ignoring the L5 adaptive versus non-adaptive, could you help me translate “Left on right backward sacral torsion, ” “left on left” forward sacral torsion, etc. into Chiropractic speak? Also, for your reference, I have attached the exercises for self correction of R on L backward sacral torsion and L on L forward sacral torsion. One open question I have (Not necessarily for you, but just sharing it anyway here) is: is there no such thing as “Left on right” FORWARD sacral torsion? How about “left on left” BACKWARD sacral torsion? ————— [Home |Principles of Manual Medicine| MSUCOM](https://hal.bim.msu.edu/CMEonLine/Pelvis/Biomechanics/page_12.html) Left on Right Posterior Sacral Torsion L5 Adaptive Left on Right Posterior Sacral Torsion L5 Adaptive A posterior or backward torsion of the sacrum to the left on the right oblique axis (LOR) results from an inability of the left sacral base to move into anterior nutation (sacral flexion) with extension of the lumbar spine. In the neutral position, the sacrum is side bent right and rotated left. When lumbar extension is introduced, asymmetry increases. When lumbar flexion is introduced, symmetry improves. In the neutral position, when the sacrum is side bent right and rotated left, L5 is considered to be adaptive when it rotates to the right and sidebends to the left (Click here to see an image of left on right sacral torsion with the patient in the neutral position). In the backward bent position, when the sacrum is more side bent right and rotated left, L5 is considered to be adaptive when it rotates to the left and sidebends to the left (Click here to see an image of left on right sacral torsion with the patient in the backward bent position). Click here to visualize left on right sacral torsion with the patient moving from neutral to the backward bent position. Left on Left Anterior Sacral Torsion L5 Adaptive #SIAdjustment A anterior or forward torsion of the sacrum to the left on the left oblique axis (LOL) results from an inability of the right sacral base to move into posterior nutation (sacral extension) with flexion of the lumbar spine. In the neutral position, the sacrum is side bent right and rotated left. When lumbar flexion is introduced, asymmetry increases. When lumbar extension is introduced, symmetry improves. In the neutral position, when the sacrum is side bent right and rotated left, L5 is considered to be adaptive when it rotates in the opposite direction of the rotated sacrum (i.e., rotates to the right) (Click here to see an image of left on left sacral torsion with the patient in the neutral position). In the forward bent position, when the sacrum is more side bent right and rotated left, L5 is considered to be adaptive when it follows the sacral base postion (i.e., rotates to the left) (Click here to see an image of left on left sacral torsion with the patient in the forward bent position). Click here to visualize right on left sacral torsion with the patient moving from neutral to the backward bent position. [Explanation of a Nutated Sacral Torsion (SIJ), Right on Right oblique axis (R ON R) or a L on L - YouTube](https://www.youtube.com/watch?v=uDQhj7Dbu00) [Seated forward flexion test for sacroiliac joint dysfunction (SIJ) - sacral torsion assessment - YouTube](https://www.youtube.com/watch?v=KF92Z7P81iQ) [How to correct a Sacroiliac R-on-R sacral torsion using the Sims position - YouTube](https://www.youtube.com/watch?v=36k4x5zyWq4&list=PLTyMpdMrxx9N3frsOHowuwWafQqgxdDDT) [How to assess motion of the Sacroiliac Joint - Hip extension test - YouTube](https://www.youtube.com/watch?v=l3IwCem7WIg) Tags:, SILog https://fadavispt.mhmedical.com/content.aspx?bookid=2154§ionid=164750771 [Explanation of a Nutated Sacral Torsion (SIJ), Right on Right oblique axis (R ON R) or a L on L - YouTube](https://www.youtube.com/watch?v=uDQhj7Dbu00) --- (Oh, also, before I attempted the L on L forward sacral torsion adjustment, I used the muscle energy technique to even out my ilia) --- Janet Perrino<jperrino@physiofitpt.com> Feb 25, 2020, 6:25 PM to me Thanks for opening up the discussion. When I saw you last. Your pelvis was in alignment but not your sacrum. You had a left on left forward sacral torsion. In regards to the pelvis or ilium (IS joint)- it can be either posteriorly rotated or anteriorly rotated. You can also have an up slip but it is rare and EXTREMELY painful to bear weight and walk. Posterior rotation: on palpation the affected side PSIS is inferior and the ASIS is superior in relation to the non-affected side Anterior rotation: on palpation the affected side PSIS is superior and the ASIS is inferior in relation to the non-affected side. Also stiff in spring to ilial posterior rotation. I do a few tests to determine which side is affected (since no one test alone is reliable): 1) Standing forward bend for ilium (IS joint)- the affected side moves first and furthest. cranially 2) Gillet or standing march for ilium (IS)- the affected PSIS does not drop below S2 or does not move caudally. 3) Usually the extensor hallucus longus (big toe extensor) is weak on the affected side. 4) Ilial spring test: stiff and possibly painful For Testing the sacrum or SI joint I do: 1) Seated flexion test: affected side moves first and and further cranially 3) Sit slump -for a backward sacral torsion (BST) the obliquity gets worse with extension and for forward sacral torsion (FST) the obliquity gets worse with flexion or slump 4) lumbo-sacral spring test: usually painful and stiff with a BST and springy/ not painful with FST. 5) sacral spring for mobility In regards to the sacrum (SI joint)- there are many possible dysfunctions. Sacral nutation or flexion- both sacral sulci deep and both ILA shallow, gait usually normal Sacral counter nutation or extension- both sacral sulci shallow and both ILA deep, gait usually normal but uncomfortable. Left on left FST: L sacral sulci and ILA shallow (posterior), + seated flexion on right, sit-slump left ILA more shallow with flexion or slump, sacral spring-decreased R extension via the L ILA. Right on right FST: R sacral sulci and ILA shallow (posterior), + seated flexion on left, sit-slump right ILA more shallow, sacral spring-decreased extension via right ILA, lumbar spring negative Left on right BST: L sacral sulci and ILA shallow, + seated flexion left, sit-slump L ILA more shallow with extension, sacral spring- decreased flexion via left sacral base, lumbar spring + Right on left BST: R sacral sulci and ILA shallow, + seated flexion right, sit-slump R ILA more shallow with extension, sacral spring- decreased flexion via right sacral base, lumbar spring + It is possible to have unilateral sacral flexion or extension but it is not as common. Also usually gait (walking) is normal with FST but antalgic (pain and decreased weight on one side) with BST. For treating these dysfunctions I use muscle energy techniques specifically for the dysfunction. They are gentle and use your muscles to re-align. I am not saying chiropractic manipulations are wrong, they are just not in my tool box. You also can not correct yourself with drop table or direct manipulations. You can corrrect yourself with muscle energy techniques. The hard part is for you to determine what direction you are out of alignment to use the right technique. Hope this helps. Warm Regards, Janet Perrino MPT, Physical Therapist, Certified Kinesiotaping and Graston practitioner PhysioFit Physical Therapy and Wellness 1000 Fremont Ave., 108 Los Altos, Ca 94024 Suite 108 Los Altos, CA 94024 650-947-8500 [www.physiofitpt.com](http://www.physiofitpt.com/) [Like us on Facebook](https://www.facebook.com/pages/PhysioFit-Physical-Therapy-and-Wellness/29360164987?ref=br_tf) [Find us on Yelp](http://www.yelp.com/biz/physiofit-physical-therapy-and-wellness-los-altos) [Follow us on YouTube](https://www.youtube.com/channel/UCcYn_IxkpaCicrPvqMjWVmQ) --- Jacob Cole<jacobcole4000@gmail.com> Feb 26, 2020, 10:09 AM to Janet Which side would you describe as the “affected“ side with the way I presented last time? Would you describe my left sacroiliac joint as “stuck“? Would you say that my right or left ilium is affected? Thank you so much for the thorough answer, and responding further soon – actually walking into an appointment with Dr. Anja right now! --- When I saw you last visit, your ilium was in alignment. According to your visit with Shalini, your left ilium was anteriorly rotated. When I saw you, only your sacrum was out of alignment- all testing lead to left on left forward sacral torsion as I described in the note. Your left sacral sulci and ILA were shallow which was worse with flexion in sit-slump testing, lumbo- sacral spring negative, sacral spring showed decreased extension via left ILA, your gait normal. Warm Regards, Janet Perrino MPT, Physical Therapist, Certified Kinesiotaping and Graston practioner PhysioFit Physical Therapy and Wellness 1000 Fremont Ave., 108 Los Altos, Ca 94024 Suite 108 Los Altos, CA 94024 650-947-8500 [www.physiofitpt.com](http://www.physiofitpt.com/) --- Janet Perrino<jperrino@physiofitpt.com> Feb 26, 2020, 4:50 PM to me P.S- "stuck" is not the term I use. Your sacrum did not extend well or rotate toward the right along the left obilque axis when I pushed on the left ILA. Warm Regards, # Other ways people fixed back pain Had hip injury post dynamic kettlebell- core wasnt integrated Psoas release Re knitting core Relearn how to walk with walked hips Ket Hip hook while anime -> breathwork -> yoga practices spinal activation/flexible Segmented mat vertebrae