Amy:
I feel a little "101" here, but what is the bullet point implications here - I kinda assumed fused = no movement anywhere.  The SIJ might not move much but lose that micromotion and some macromotions get effected. What is that lateral marco motion used for, is probably a better way to ask my  question.
 
Jerry Hesch
Amy, just after I posted it I scrolled through my You tube videos and made the discovery some time ago, just did not recall! So there is another video on same topic with CT scan evidence. Yes fused left sij means no movement in the left SIJ. I do believe that every biomechanical expert would be very surprised to see that a one-sided SIJ fusion significantly restricts pelvic side-glide mobility. Pelvic side glide is not thought to be a pure motion in the sij, but rather very minuimal sij motion and more motion of the lumbar spine and of the hip joints.  Place your hand on the sacrum and try to glide it left and right, tell me what you find. lie the person on their left side and compress the right ilium and spring test it. What do you feel? I will  explain.

Jerry Hesch
The lateral micromotion is a functional motion during gait, lateral weight shift, etc. It of course becomes a macromotion during such movements. The test for this motion is very relevant as some clients have it restricted, yet it is treatable with Hesch Method and it is a preventive model. Side-glided pelvis' even if subtle alter weight bearing throughout the kinetic chain, especially the lower extremities, and of course as you know; will create a distal compensation such as at the occipitoatlantal joint, which in time becomes symptomatic and non responsive to "adjusting the upper cervical spine". Does that answer your question. Micromotion is such a fundamental property of joints like the SIJ, so very relevant to test if one is using terminology such as "joint". Otherwise one is talking about the bony pelvis as it moves on the hips, which is NOT sij motion, despite the popularity thereof. I believed such for many years, but could not ignore the burgeoning research.
 

In response to an inquiry re pelvic/sij alignment.
Derek,
I have seen x-rays of "aligned" clients who had surgery and they were not aligned at the symphysis pubis joint and not aligned in the transverse plane.  Tops of iliac crests appear to be symmetrical. a huge problem is the fact that the body can cause asymmetry of the pelvis from joints in the spine, hip, knee, the 26 bones in foot and ankle, all the musculature, even asymmetry of shoulders can pulll on a muscle that connects the shoulder to the ilium; latissimus dorsi. 

Research on x-rays covered in my torsion chapter briefly, positional artifact can affect some of the alignment. Some clients have a developmental asymmetry of the hemipelvis and this can be readily discerned. I am much more concerned about maximizing joint function than "alignment". Asymmetry, visual malalignment guides me to do passive joint testing to confirm or negate possibilities. 

Several pelvic asymmetries look very similar, so the passive mobility testing and ligament testing is crucial to discern.  Further there are advanced patterns that are not taught to Physical Therapists, that PT's cannot find with the traditional testing. It is what it is. It is far more comnplex than what is being propounded, but fortunately for the majority, the presentation is fairly typical such as the Most Common Pattern.  If interested in more you can find more at the Hesch Institute web site.  Snake oil or purple kool aide $$$ dunno but we can be much more thorough in testing and treating and much more honest in the information we give to desperate clients.  It is a choice we (as clinicians) can make.

Actual Email reply to an inquiry re "SIJD" with sciatica, PN and muscle weakness.
February 26,2012 
 
Dear  XXXXXX

    You have been on my concern list having read some of your posts, though I do not do any form of aggressive marketing to the group, as most already have health care providers, though if I  had a magic wand, would screen a few, XXXXXXX is also on my worry list, and I worry about some who slowly sip the kool aide and end up getting an sijd fusion for a problem that comes from somewhere else. The marketing can be unintentional and very subtle. The name of the group should be changed to something that encompasses the entire spectrum of co-factors; especially the lumbar spine and hip, and gynecological...My philosophy, "Conservative care, put patient first," and above all “DO NO HARM.” Like I told my recent client, “people need information.” That is what I do as much as I do highly skilled manual therapy to the whole body, because injuries affect the WHOLE BODY. When one has complex sijd with a lumbar or thoracic spine as primary, or when the signs of sijd are simple false negatives, not the real cause, you can present as such. SIJD is a diagnosis of exclusion after the thoracic spine (rare disc herniation there) and thoroughly ruled out lumbar pathology, disc herniation, stenosis with impingement, radiculopathy, etc, then thoroughly clear the hips, and gynecology, you can go on and screen for sijd.

     I  perform very thorough whole-body evaluations including all of the above and my sij eval is much more thorough that the current standard, has been for 25+ years. The current tests are really not the “gold standard” that is being marketed. If ever in Las Vegas and you want an evaluation plus or minus treatment my work is complete within 1, 2, or 3 visits, going much further than standard PT and working very hard to make patients independent of me able to  manage the sijd but of course need continued strengthening via formal PT or some program at home. You can read about it in the patient section at  www.HeschInstitute.com
then: FOR PATIENTS

     If I knew more about your condition, I could be more helpful, but the only way to do that is to invest a reasonable amount of time, I read the records you send and call you afterwards. This typically is accomplished in 30 minutes sometimes 45, rarely more. So a phone consult is done before we ever schedule a visit, and sometimes it does not need to go any further. I have helped a few in this manner and sometimes help means encouraging a specific workup that has not been done, and last week I discouraged someone from coming to see me because I know that his problem is neurosurgical/pathology that is beyond my advanced skill set. Sometimes the eval can be useful when a change of perspective is needed, as people do tend to “marry the diagnosis” and sometimes that will not and cannot satisfy in the long run. I do know the limits of my knowledge, a very important perspective all clinicians should embrace (when to refer, when this paradigm is not the correct one, etc.).

     I hope this is helpful. Best advice; think outside the sijd box.

     I do know that some do benefit from surgical stabilization, but dislike the failures of the marketing process, attracting some with WRONG DIAGNOSIS.

Best  Regards,
Jerry Hesch