Explaining S.I.J. Issues Without Using “Rotation” Or “Innominate"

One of the most frequently asked questions I get at Modern Manual Therapy courses is, “How do you explain SIJ dysfunction without using rotation, out of place, etc?

Many clinicians, both novice and experienced are gravitating toward Pain Science Education, but cannot seem to fully commit. This is something you really can’t dabble with. Click here to see 5 Outdated Clincial Explanations and Why You Should Not Use Them.

If you use a modern explanation for neck pain, why can you not do the same for the SIJ? Here are steps that Lorimer Moseley suggests that I use to Stop Thought Viruses

Challenge a concept
Provide an alternative concept
Provide evidence for a new concept

In this case you can use a video or education like in this #GetPT1st SIJ video

After you get them thinking, ask them something like:

How much force do you think your PT/Chiro uses?
Is it less than what is required to move the pelvic and tail bones after all other skin/muscles, etc are removed?
How long does a full body massage last?
Do you think the hour long or more input from a massage lasts longer than a few quick impulses?

The important message here is that without education on self assessment and treatment, regardless of the mechanism (if they’re not buying the neurophysiologic aspect), is that treatment must be reinforced with home movements/education to get lasting effects. The evidence for a new concept may be doing alternative treatments, or self treatments like a repeated loading strategy that enables them to self treat without any passive modality or manual therapy. Even if you have to use a manual therapy treatment, always relate it back to self treatment accomplishing the same effect (reducing alarm in the brain – good input = good output).

One of my final questions is:

If I could show you a way to both assess and treat yourself, so that in many cases, you would not need either myself or any other clinician, would you want to learn that?
Most answer yes, and by then, regardless of the mechanism, most will choose saving $$ and empowerment, probably in that order.

Erson Religioso

Dr. Erson Religioso III, DPT, MS, MTC, CertMDT, CFC, CSCS, FMS, FMT, FAAOMPT, graduated from D’Youville College in 1998 with a dual Bachelor’s of Science and Master’s of Science in Physical Therapy. His interests in Orthopaedics and Manual Therapy lead him to pursue a Doctor of Physical Therapy degree from the University of St. Augustine. Studying under Stanley Paris, Ph.D, PT, internationally known for his manual skills and knowledge of the spine as well as his distinguished faculty, Dr. Religioso earned his DPT and Manual Therapy Certification in 2000. He later became credentialed in Mechanical Diagnosis and Treatment of the Spine in 2000. Erson also operates several websites dedicated to Manual Therapy, www.themanualtherapist.com, www.modernmanualtherapy.com as well as www.edgemobilitysystem.com

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Erson Religioso

Doctor Of Physical Therapy at The Manual Therapist

Dr. Erson Religioso III, DPT, MS, MTC, CertMDT, CFC, CSCS, FMS, FMT, FAAOMPT, graduated from D'Youville College in 1998 with a dual Bachelor's of Science and Master's of Science in Physical Therapy. His interests in Orthopaedics and Manual Therapy lead him to pursue a Doctor of Physical Therapy degree from the University of St. Augustine. Studying under Stanley Paris, Ph.D, PT, internationally known for his manual skills and knowledge of the spine as well as his distinguished faculty, Dr. Religioso earned his DPT and Manual Therapy Certification in 2000. He later became credentialed in Mechanical Diagnosis and Treatment of the Spine in 2000. Erson also operates several websites dedicated to Manual Therapy, www.themanualtherapist.com, www.modernmanualtherapy.com as well as www.edgemobilitysystem.com

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