hey everybody it's doctor Jo and mr.
spiderbear, and today I'm going to show you my top seven treatments for SI joint pain.
so let's get started.
so the first thing that I like to dowith SI joint pain is to do some muscle energy techniques and that's MET forshort.
and basically what you're doing is you're using your muscles to geteverything back into place.
so if your SI joint is out of place, this is what youwould want to do.
now don't ask me which one is out because I can't tell withoutgetting to evaluate you, you need to have your doctor or physical therapist tellyou what side is rotated.
if it's an anterior rotation or if it's a posteriorrotation.
so what you're gonna do is if it's let's say a posterior rotation onmy left leg here, then you're gonna bring your left leg up and then you're goingto put your hands on your leg here.
you're gonna have the other one down.
youcan put a little roll underneath if you want to as a target, but you don't haveto.
and so what you're gonna do basically is use your hip flexors on this side, your hamstrings on the other side to kind of rotate it back into place.
so ifI'm this way, I'm using those hip flexors to rotate it back.
so I'm gonna put myhands here and what I'm doing is I'm pushing up this way and pushing downinto the floor here at the same time.
I'm pushing as hard as I comfortably can forabout five seconds.
so you're not going anywhere you're pushing into your handsand down into the floor for about that five seconds hard as you comfortably canand relax.
so again make sure you know which way it's rotated because you onlywant to do the one side that's rotating.
you don't want to alternate back andforth.
that's why it's really important for this one to know, so if you don'tknow go ahead and skip this one and then go on to the other one.
so you want to dothat three to five times for five seconds pushing as hard as youcomfortably can up this way down that way.
so then the next one is what we calla shotgun technique.
so with the shotguns, you're gonna start off with getting abelt or a strap, but you want it to be something tight.
so this is notthose resistive bands.
you want it to be something that doesn't give.
andyou're just going to take that belt and put it on your thighs just above yourknee.
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alright so once you get thison, you're going to get back into this position.
and now you're pushing out intothe belt.
so it's almost like you're opening up like a clamshell orbutterfly.
so I'm pushing out this way with both legs.
so it's almost like I'mtrying to drop them flat and I'm pushing into that belt as hard as I comfortably can.
again for about that five seconds and then relax.
now sometimes if your SI jointis out of alignment a little bit, you might feel a little pop with thisshotgun technique.
as long as it's a pop and then it goes away, that's probablyjust that joint popping back into place.
so that's completely normal.
so againpushing out this way both sides push push push hard as you comfortably canfor about that five seconds, and do that 3 to 5 times.
so then the second part ofthe shotgun technique is now we're just going to go the other way.
so now whenyou're squeezing in, you can use a basketball, soccer ball, something againfirm and solid.
if you don't have something like this, you can use a pillow, but you want it to be pretty big where your knees are kind of still aboutshoulder width apart.
the exact distance doesn't have to be that much, but youdon't want to use like a little lacrosse ball or tennis ball, you want to besomething fairly big.
and so now this time you're pushing into the ball you'resqueezing that same thing that five seconds hard as you comfortably can.
most of time when I do this with people the the squeezing in is the one where theyfeel a pop if they're going to feel it.
you're not always going to feel it, butif you do, you a lot of times because this isopening up that joint now and I'm pushing in it's fanning that pelvic areaout, and sometimes you get a little pop.
completely normalas long as maybe it's just a little bit of pain and then it goes awayimmediately.
so again five seconds, big push as hardas you comfortably can, and then relax.
and do that three to five times.
so thenthe next one you're gonna lie on your side with the side that's uncomfortableup on top.
so now let's say it's on my right side just so I can look at youwhile I'm talking.
so I'm going to lie down kind of get in a comfortableposition.
I might prop up throughout this just so I can see you a little bitbetter, but make sure you're comfortable.
so if you need to lie all the way down, make sure you're comfortable while you're doing it.
so this is kind of aweird technique, but it usually works pretty well.
so you're gonna feel backbehind you where your SI joint is where that SI joint is.
it's basically wherethe spine are that sacrum comes into the pelvis or that ilium, so sacroiliac joint.
and is it's usually if you look at someone's back where they it looks likethey have little dimples on the low part of their back, that's where that SI jointis.
you can usually feel it it's kind of a little knot back there and that's whatI want you to take your thumb and just push into that joint.
so you're going togive it a little pressure there like you're just trying to push it inwards.
sowhile you're pushing inwards you're going to take that top leg bring thathip up kind of into flexion and drop it on the floor in front of you.
you can dothis on the bed too if you can't get down on the floor that's fine.
you can dothese on your bed, or on a couch, so after you come into this position you're gonnacome up, kick the leg out behind you, and then drop down.
now the key is try to bepushing into that SI joint the whole time.
and so by doing this movement againsometimes it helps it just kind of pop back into place.
so just repeat this acouple times .
so now I'm going to come up and then bring that knee up and bring itdown.
so just nice smooth motions but always kind of come up, kick it out, andthen drop it down.
don't just come back and forth like this because that's goingto irritate your IT band.
so make sure when youcome back up you're lifting up bending up that knee, dropping down, up, kick outbehind you, and then come back down.
so I would just say you know maybe do aboutfive of these.
you don't have to you know go too crazy with it.
you can do five maybe two sets of five a couple times a day throughout the dayjust to kind of give that thing nice and loosened up.
so then the next one isgoing to be a hip flexor stretch.
I usually like doing a hip flexor stretchkind of in the lunge position.
if you're stretching out your hip flexors becausesometimes it's tight on one side and then weak on the other side, so you wantto get them nice and stretched out.
so when you get into the lunge positionfor the hip flexor stretch, I like putting a pillow underneath my knee justbecause it protects it a little bit.
so especially if you're on a harder surfacemake sure you put something under there.
so the the side you want to stretch isgoing to be the one that's down.
so that my left side is the one that I want tostretch that for that hip flexor.
put your other foot a little bit further outin front of you, and the goal with this to get the best stretch is keep yourupper body straight.
so I'm not bending forward like this.
I'm getting no stretchin my hip flexor right now because it's still kind of straight through there, soI want to keep this upright and then launch my whole body forward.
and Ishould feel that stretch right through there.
so if that hip flexor is tight andit's pulling on that joint to rotate it forward, then I'm getting it nice andstretched out.
so since this is a stretch, you want to hold that stretch for thirtySeconds, come back, and do that a total of three times.
now you can do both sides, you probably really want to focus on the side that's tight, but I always like tostretch both sides if you can just to keep everything balanced.
so then afteryou stretch out the hip flexors, then you want to stretch out the hamstrings inthe back because it's the same thing, if you have a tight hamstring on one sideis going to then be pulling it into that posterior rotation.
so there's a wholebunch of different ways to stretch your hamstrings, I'm going to show youstanding up.
so for the hamstring stretch standing up, I like it because it'sreally easy to do.
you can do it anywhere.
just take the side that you want tostretch and kind of prop it out in front of you.
just prop up your heel like this.
now if you have a little bit of balance issues make sure you're holding on tosomething while you're stretching so you can focuson the stretch and not your balance.
making sure you're bending at your hipsand try and keep your back fairly straight because if I'm just curlingdown like this, I'm not really getting much of a hamstring stretch.
I want tokeep that back straight and kind of hinge and my hips to get that stretch.
yeah I'm getting much more of a stretch here than when I was going all the waydown touching my toes.
so again since this is a stretch, you want to hold itfor 30 seconds.
you should feel it kind of through here and then do that a totalof three times.
so again switching both sides just to kind of keep yourselfbalanced three times on each side.
I like to alternate back and forth.
if you wannado them all on one side you can.
so to finish up I'm going to show you a coupleexercises once you kind of get everything nice and stretched out, hopefully get it back into alignment, you really want to then do some exercises.
sothe first one of the exercises is a hip hike.
and so with hip hikes it's kind ofjust how it sounds.
you can do it on a step to give you more of a hike, but whenyou're starting off I think it's better just to do it standing on the floorbecause with the step you're going to get more of a motion.
so really whatyou're doing is just trying to hike up your hip.
so I usually just put my legslightly out in front of me and then what I'm doing is I'm just hiking thathip.
so this one's coming up, but I'm also working this one.
so you're reallyworking both sides in different ways.
this is an open chain kind of bringingit up here working that side, and this is a closed chain.
so I've heard people kindof argue the hip hikes what side are you working, I really think you're workingboth sides.
so this one is really important to do both sides each waybecause it's an open chain closed chain.
so just hiking up and coming back downjust like that.
so it's not bending over to hike it up, you're using these musclesto hike that hip up.
so again make sure you're switching sides because it'sworking those hips in different ways.
so I'm just trying to lift that hip up, I'mhiking it up.
and so these are a little tough to master, so I would just startoff with five on each side do that a couple times.
and then you can slowly progress from there.
and so the last one is going to bea deep squat.
so it's an exercise but it's kind of finishing off with astretch too.
so if you're still out of alignment sometimes a really deep squatkind of helps get you back into alignment as well.
so this one if youhave something solid to hold on to a lot of times with a deep squat that's thebest way to do is kind of hold on to something.
so spread your feet outshoulder-width apart, maybe a little bit more than shoulder width apart.
so a deepsquat is really kind of like when you see a baby squat.
babies do the perfectsquat.
that's how you're supposed to squat.
for some reason as we grow up weforget how to do it, but as babies you know when you kind of see them down likethis, so that's kind of a deep squat.
but see how my knees are still not goingpast my toes.
so if I'm squatting down like this, that's a really bad way tosquat.
you really want to sink that bottom back.
this is really tough forsome people, so you might not be able to get into that deep squat.
that's okaythis is just another technique to use, but again when you're coming down youwant those knees to still be behind the toes.
so I'm squatting but if I hadsomething to hold on to I could kind of balance a little bit.
I can do it alittle bit that's just because I practice these things every day with mypatients, so I can do them a little bit easier, but if you're doing it the firsttime this might be a little bit tough.
but again that's gonna sometimes helpkind of reset it and then when you come back up you're really working all thosemuscles as well.
so it's tough.
you might not be able to do it, but it is an optionif you can.
so there you have it those were my top seven treatments for SIjoint pain.
yes it was.
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