Jerry Hesch Allow me to go oblique. If you find a competent manual therapist ask them to do a complete evaluation of the foot and ankle joints, knee, hip, T-spine, rib cage, cervical and shoulder girdle in addition to whatever lumbar and "SIJ" eval they do. Here is a very interesting example.
Jerry Hesch I recently consulted on a SIJ case that chose not to go the surgical route and was nearing the end of her rehab, utilizing a team approach. She was unstable in the knee and ankle!
Jerry Hesch I told her: "This is a one in 500. Your talus (big bone in ankle) is stuck posteriorly, very rare, not even on the radar of most manual therapists. Your distal femur (top knee bone) is stuck in posterior glide also. I demonstrated her lack of balance with a surprise push and unilateral standing on that leg versus right. A one-time fix at knee and 2x at ankle. Stable now. Bingo that is a part of the problem.
Jerry Hesch In summary, i suggest that the body works as an integrated whole and, a real hands-on whole body evaluation is important especially when full progress is not happening over time. Yes, stability of the left ankle and left knee contributed to left sided "instability". this one would have been another SI fusion failure if she had gone that route. Stability in the
left SIj is a sum total of the stability in the left foot and ankle, the left knee, the left hip, the left SIJ, the left symphysis pubis, the left lumbar spine and trunk and shoulder girdle (see the latissimus dorsi muscle that connects pelvis and shoulder) and ROSITA THE MUSICIAN gimme a drum roll...THE SIJ ON THE OTHER SIDE!!!.
Jerry Hesch I recently consulted on a SIJ case that chose not to go the surgical route and was nearing the end of her rehab, utilizing a team approach. She was unstable in the knee and ankle!
Jerry Hesch I told her: "This is a one in 500. Your talus (big bone in ankle) is stuck posteriorly, very rare, not even on the radar of most manual therapists. Your distal femur (top knee bone) is stuck in posterior glide also. I demonstrated her lack of balance with a surprise push and unilateral standing on that leg versus right. A one-time fix at knee and 2x at ankle. Stable now. Bingo that is a part of the problem.
Jerry Hesch In summary, i suggest that the body works as an integrated whole and, a real hands-on whole body evaluation is important especially when full progress is not happening over time. Yes, stability of the left ankle and left knee contributed to left sided "instability". this one would have been another SI fusion failure if she had gone that route. Stability in the
left SIj is a sum total of the stability in the left foot and ankle, the left knee, the left hip, the left SIJ, the left symphysis pubis, the left lumbar spine and trunk and shoulder girdle (see the latissimus dorsi muscle that connects pelvis and shoulder) and ROSITA THE MUSICIAN gimme a drum roll...THE SIJ ON THE OTHER SIDE!!!.
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