Pelvic
dysfunctions are most common cause for
pains in back and legs. Yet doctors
almost never even consider that choise as
a source of problems.
Tom LeBlanc, PT
Symptoms of an Upslip
Do you feel as if you are walking on
uneven ground, even though you know the
floor is level? Does it hurt to sit too
long? Do you sometimes misjudge distance,
while walking through an open door, and
bang your shoulder into the door jamb? Do
you feel off balance and frequently have
to catch yourself to keep from falling?
Have you noticed yourself “running out
of steam” much earlier in the day since
having an accident or a fall? If you
answered yes to any of these questions,
you may be suffering from an upslip.
What is an Upslip?
An upslip, or superior ilium, is a
condition where
one ilium (pelvis bone) is slightly
higher than the ilium on the opposite
side.
http://www
.home-entrepreneurs.com/html/the_upslip.ht
m
"The ilium can be rotated anteriorly or
posteriorly.
There can be an upslip (the most
frequent) or downslip. Often, the
sacrum is also rotated, placing strain on
the facets (the joints of the spine).
Those subluxations can be determined by
clinical examination and reduced with
various manipulations and exercises."
http://www.sidysfuncti
on.com/anatomy.html
http://w
ww.spineandsacroiliac.com/sacrodysfunction
.html
"A chronic
upslip will often present
with tightness in quadratus lumborum,
psoas major, and sacrotuberous ligament."
http://www.amta.com.au/arti
cle1.html
Wayne E. Rasmussen, MS, PT, ATC
"The pelvic ring dysfunction presented two
alignment changes. The left side of
Nichole's pelvis was rotated posterior and
elevated. The elevation is called an 'Up
Slip', where one seat bone was higher than
the other."
http:/
/www.flyingchanges.com/htmls/2002/Jan02The
rapy.html
Upslips and Downslips: Ilio-Sacral Shears
"I want to introduce to you an IS pattern
with which most of you probably are
unfamiliar. The ilium can shear vertically
on the sacrum; this is called an upslip or
downslip. When this occurs is critical,
because shears are nonphysiological
patterns, rather than rotations within the
joint's normal planes of motion. In this
shear, the ilium has ridden superior or
inferior on the sacrum, losing its normal
relationship. Once you know how to assess
for IS shears, they become obvious, and
relatively easy to correct."
http://www.chirow
eb.com/archives/21/03/08.html
"Symmetry in your pelvis is very important
to prevent pain problems and allow all
your muscles to work as effeciently as
possible. Your pelvis has many muscles
that attach to it and it takes a lot of
punishment from our work, sports and
accidents. Subtle asymmetries can create
lasting painful problems.
Common
assymetries are an upslip and/or a
torsion. This is where one
half of the
pelvis shifts up or rotates forward
or backward relative to the other side. It
can happen in varying degrees, from a
subtle muscle imbalance to a severe
accident ramming one bone out of place."
http://healthandposture.com/
?cat=15
Richard DonTigny, PT, Advisory board,
World Congress on Low Back Pain and the
Pelvis (1992-2002)
"Because of the variation of the angles of
the front part of the SIJ and the back
part of the SIJ, after the back part of
the SIJ gets stuck, the front part of the
SIJ can still move up or down. When the
front
part
of the SIJ moves up, the leg on that side
gets shorter and it looks like a posterior
rotation or an upslip, but this can
only happen after it rotates anteriorly.
Many therapists or chiros will try to
correct a 'posterior dysfunction'"
"When the
innominate rotates anteriorly on the
sacrum, when it goes 'out', it subluxates
(partially dislocates) by moving up and
out on the S3 segment so I refer to
it as an S3 subluxation. Because of the
unique variance in the angulations of the
joint surfaces, when the S3 segment
subluxates, the S1 segment is opened
slightly. The thing that has been
overlooked by essentially all
practitioners is that once the S3
subluxation occurs, the innominate may
move up or down at the S1 segment giving
the appearance of many different kinds of
dysfunction."
http://www.kalindra.com/faq.htm<
/a>
Wolf Schamberger, M.D
"Vertebral malrotation, malalignment of
the pelvis because of rotation or upslip,
and sacral torsion can occur in isolation
or in various combinations with each
other."
http://www.cacr
.ca/news/1998/9812Schamberger.htm
"
The most
common subluxation occurs when one ilium
moves upward or downward. If the
situation remains for more than a few
days, the ilium on the other side will
usually move in the opposite direction
because of the instability produced by the
first subluxation. The situation in which
both ilia move either upward or downward
is uncommon, although it does occur and
can often make diagnosis very difficult
unless the physician is aware of its
possibility."
http://www.healing.org/only-3
.html
Dr. Einas Al-Eisa et. all.
Key Points
● Asymmetry in lumbar lateral flexion
and axial rotation effectively
distinguishes between healthy individuals
and patients with unilateral mechanical
LBP.
●
Asymmetry in lumbar movement is
highly associated with pelvic asymmetry in
both asymptomatic and LBP
populations.
http://me.queensu.ca/people/deluz
io/publications/documents/Spine2006.pdf
"
Malalignment of the pelvis and spine
affects 80-90% of adults and is one
of the major causes of pelvic, back and
leg pain."
http://www.boydhealthworks.com/P
roductInfo.aspx?productid=MALALIGNMENTDVD<
/a>
"The Malalignment Syndrome describes a
recently defined syndrome that is present
in many people and which can affect
everyday activities and may result in
injury. It is now recognised that the malalignment
syndrome is frequently a predisposing
factor in sports injuries. It may
also underlie biomechanical problems in
less active members of the population."
http://www.boydhealthworks.com/Produc
tInfo.aspx?productid=0443064717
"
Alternatively, the unstable
sacroiliac joints may become locked in an
abnormal alignment, maintained that way by
resultant muscle spasm producing
pain."
http://ww
w.bonesdoctor.com/sacroiliac_dysfunction.h
tml
Dr. Amaral:
"Sacroiliac pain is due to
subluxation of the joint."
http://w
ww.spineandsacroiliac.com/sacrodysfunction
.html
"Pain in the sacroiliac joint may be a
result of a
subluxation of the joint.
This is a partial dislocation. The bones
are slightly displaced, which stresses the
ligaments that hold it together. It also
puts pressure on the surrounding
structures."
http://www.thestretchinghandbook.c
om/archives/sacroiliac-joint-pain.php
The effect
of sacroiliac dysfunction on the
musculoskeletal system
http://www.s
pineandsacroiliac.com/images/effect.pdf
"Without correction of the
partial
dislocation, the SIJ sprain will likely
become chronic, and subject the lumbar
spine and leg to loads and biomechanical
distortions that could lead to further
injury and pain. "
http://findarticles.com/p/articles
/mi_qa3841/is_200408/ai_n9453071/pg_5
"The symptoms are extensive and can be
different in each individual. Because of
the attachment to the spine and the legs,
complaints may be neck or back pain, hip
pain, muscle spasm, ITT band tightness,
groin strain or even heel pain.A person
may experience this discomfort and think
he/she has injured a muscle or joint when
it is really a result of the distortion of
the pelvic ring"
http://www.boyd
healthworks.com/Newsletter03.aspx
Kim D. Christensen, DC, DACRB, CCSP
Much more common in the pelvis is a
biomechanical source of pelvic unleveling,
with
sacroiliac joint
subluxations. This condition can be
caused by work postures, recreational
habits, or just a broken-down chair at
home. Muscle imbalances are frequently
part of this syndrome, with weakness of
the hip extensor muscles being most
common. Tightness of a psoas muscle, or
shortening of the hamstrings from
excessive sitting can also contribute to
pelvic unleveling. An "antalgic" posture
in response to acute pain and inflammation
of the lower spinal joints often results
in a difference in height of the iliac
crests.
http://www.ccptr.org/KDC/
newpage11.htm
SI
subluxation is a legitimate
syndrome, separate from the type of
low back pain associated with disc
conditions, lumbago, or sciatica. 1-6 In
fact, SI joint dysfunction has been
implicated as a common cause of back pain
in more than 30% of children. 3
Additionally, a study involving the
correction of SI joint dysfunction in
patients presenting to a chiropractic
center over one day found an incidence of
57% for SI joint dysfunction. 7
1. DonTigney RL. A review. Physical
Therapy 1985; 65(1):35-44.
2. Cox HH. Sacro-iliac subluxation as a
cause of backache. Surg, Gynec &
Obstet 1927; 45:637-648.
3. Mierau DR et al. Sacroiliac joint
dysfunction and low back pain in school
aged children. JMPT 1984; 7(2):81-84.
4. Jessen AR. The sacroiliac subluxation.
ACA J of Chiro 1973; 7(s):65-72.
5. Cyriax E. Minor displacements of the
sacro-iliac joints. Br J Phys Med 1934;
9:191-193.
6. Freiberg AH, Vinke TH. Sciatica and the
sacro-iliac joint. J Bone & Foot Surg
1934; 16:126-136.
7. Gemmell HA, Heng BJ. Low force method
of spinal correction and fixation of the
sacroiliac joint. The Amer Chiro 1987;
Nov:28-32.
http://www.ccptr.org/KDC/
newpage21.htm
Rehabilitation prescribed in coordination
with prior chiropractic therapy as a
treatment for
sacroiliac subluxation in female
distance runners. Grimston, S.K.,
Engsberg J.R., Shaw L, Vetane N.W.
Chiropractic Sports Medicine, 1990;4:
2-9.
This is the story of a Canadian research
team that included chiropractic care in
the rehabilitation program of 16 injured
female long distance runners. The runners
recovered quickly and seven of them scored
Òpersonal bestÓ performances under
chiropractic care.
http://www.discoverchiroclinic.com
/pages/disease/sports_performance.htm
Chiropractic effects on athletic ability.
Lauro A. Mouch B. Chiropractic: The
Journal of Chiropractic Research and
Clinical Investigation. 1991; 6:84-87.
Fifty athletes involved in various
activities including football, volleyball,
track, cross-country running,
weightlifting, body building, rugby and
aerobic dancing were tested. They were
divided into two groups.
One group received chiropractic
adjustments, the other served as controls.
Eleven tests were used to measure aspects
of athletic ability including: agility,
balance, kinesthetic perception, power,
and reaction time. After 6 weeks, the
control group and chiropractic group were
examined.
The control group exhibited minor
improvement in eight of the 11 tests (only
two were statistically significant) while
the chiropractic group improved
significantly in all 11 tests (eight were
statistically significant).
In a hand reaction test measuring the
speed of reaction with the hand in
response to a visual stimulus (reaction
time), the control group exhibited less
than a 1% response while the chiropractic
group exhibited more than an 18% response
after 6 weeks. After 12 weeks the
chiropractic group exhibited more than 30%
improvement in reaction time.
For example, a player is right arm-/left
leg-dominant. The compensation pattern
will show up with sacroiliac joint
subluxation with pain on the dominant
side. However, if the hip flexors are
tight on the opposite side, then the
compensation will pull to the nondominant
side, due to a pelvic tilt and/or
rotation. This dramatically affects the
efficiency in athletic performance, even
with just a little compensation. So, the
key becomes to identify compensation
patterns as quickly as possible and
counterbalance them.
h
ttp://www.acupuncturetoday.com/mpacms/at/a
rticle.php?id=31533
"Most manual therapists, however, be they
physical therapists, chiropractors, or
osteopaths, appear to believe that
appreciable motion exists in the SIJ, that
careful clinical testing can isolate SIJ
dysfunction, and that specific treatment
procedures can affect SIJ dysfunction.
Sacroiliac joint dysfunction is variously
termed subluxation, "upslip," "downslip,"
or posterior or, more frequently, anterior
fixed innominate.[2-5]"
[2] Lee D. The Pelvic Girdle. New York,
NY: Churchill Livingstone Inc; 1989. [3]
DonTigny RL. Function and pathomechanics
of the sacroiliac joint: a review. Phys
Ther. 1985;65:35-44. [4] Nyberg R.
Clinical studies of sacroiliac movement.
In: International Federation of
Orthopaedic manipulative Therapists Fifth
International Conference, Vail, Colorado,
June 1992. 1992:A90. Abstract. [5] Grieve
EFM. Mechanical dysfunction of the
sacro-iliac joint. Int Rehabil Med.
1983;5:46-52.
Spinal Manual Therapy: An Introduction to
Soft Tissue Mobilization, Spinal
Manipulation, Therapeutic and Home
Exercise (Paperback)
by Howard W. Makofsky (Author)
On page 191: "Because the iliac upslip
requires additional force to correct, a
manual thrust rather than MET will he
described subsequently."
"Pelvic dysfunction can affect all
athletes, from recreational to elite
athletes, and in all age groups. It is
involved in common conditions such as
incontinence, osteitis pubis and stress
fractures. It is also linked with acute
and chronic low back pain."
h
ttp://www.rmit.edu.au/cgi-bin/news/news.cg
i?v=news&c=Latest_RMIT_Media_Releases&
amp;id=111920019246
Sacroiliac Joint Dysfunction in Athletes
"Next, determine if there is any leg
length discrepancy. One should realize
that true leg length discrepancies will
generally cause asymmetry and pain,
whereas a functional leg length
discrepancy is usually the result of SI
joint and/or pelvic dysfunction. Assess
posture for increased lumbar lordosis,
which can result from sacral torsions."
http://www.sidysfunction.c
om/articles/sacroiliacjointdysfunctioninat
hletes.html
Sports Medicine & Rehabilitation
Doctor Taras V. Kochno MD
"Subluxations for the sacroiliac junctions
are best done by chiropractic or
osteopathic manipulation, and once the
manipulation is successful, functional
range of motion of the gluteal and lumbar
muscles can be restored quickly through
various myofascial release techniques."
http://www.drkoc
hno.com/athletic_assessment.htm
The second most common site of injury is
the low back, sacral, pelvic area. As the
body is restrained with the legs extended,
the impact is absorbed through the
pelvic/sacral areas. Frequently,
subluxation of the sacroiliac joints occur
which directly affect the L4, L5 and S1
vertebral complexes.
http://www.d
rkochno.com/motor_vehicle_accidents.htm 
