A couple of weeks ago, my advanced program class at Lauterstein-Conway Massage School did our final exam for the orthopedic massage training. We were assigned a partner in the class, and our job was to interview them, observe, palpate, check range-of-motion, and do special tests if needed to identify the tissues involved.
Then we treated them, and they did the same for us.
My partner, James, did a great job of reassessing my pelvic alignment, first done back on June 22 by our teacher, Jan Hutchinson, PT/LMT. I’ve been wearing a sacroiliac belt around my hips much of the time since then. My hips feel tighter, and my walk has changed for the better. I rarely feel much discomfort at the left SI joint any more.
But I’m still not there. I still had a slight lateral tilt, an anterior tilt, with the left innominate having more of an anterior tilt than the right, and the pubis was also tilted. James watched me walk and could see that it affects my gait.
James applied what we’ve learned in the class. Since the bones are supported by the muscles, we learned techniques to length and shorten muscles to move bones into better alignment.
By the end of his treatment, he retested me. Everything was aligned. No tilts! Good job, James!
But it didn’t stay in place. It usually takes lots of repetition for the body to hold itself differently. But at least my body got to sense what it’s like to be aligned albeit temporarily, and that will only speed the healing process.
It’s going to take more treatments like that to literally retrain muscles and fascia into holding it. I’m hoping James will trade sessions with me, and I can work on his neck issues, which I have some experience with.
A couple of days ago, I had a session with Jan Hutchinson, who gave me some exercises and also taped me up with kinesiotape. Jan told me that because of my age (62) and the duration of my pelvic alignment issues (19 years), it might take 1.5 to 2 years to really keep my pelvis aligned. It takes time for ligaments to shrink, and aging (specifically the decline in collagen and elastin, components of connective tissue, that starts around 40) slows down the healing process even more.
She advised me to continue wearing the sacroiliac belt when I’m doing massage and bodywork, working out, and doing anything even a little bit strenuous, as well as when sleeping because of changing positions when unconscious and possibly stretching the very ligaments I’m trying to shorten.
I’m inclined to be positive: I am active, and my connective tissues are being used. My diet is healthy – and what I mean by that is I eat very little processed, packaged food, no grains, no dairy, and very little sugar. It’s a nourishing Paleo diet. I take good quality supplements targeted to my needs. One of my friends teasingly said I look like I’m 40! (I don’t see it, but I am definitely active and strong for my age and size.)
Jan gave me three exercises to do as often as I can: anterior/posterior pelvic tilts, side-bending lateral tilts aka hip hiking, and transverse pelvic tilts.
She advised that any time I feel that the SI joint might be out of place, to stand, place my foot out in front or to the side, and drag it back into place, while keeping my pelvis level.
She recommended the book Body Learning: An Introduction to the Alexander Technique by Michael Gelb and gave me a couple of technical articles to read.
The kinesiotape goes up the spinal erectors on both sides and across the top of the sacrum and iliums, as well as an asterisk-shape over my left SI joint.
The kinesiotaping seems to perform myofascial release. I felt its effect for a couple of hours and then my body seems to have adapted. I don’t notice it now except when I go to scratch an itch and remember it’s there.
The Well: bodymindheartspirit 
I am 44 woman and dealing with SI pain for a little over a year. I am exhausted of trying tons of things that do not provide relief. I am currently trying prolotherapy (8 months), but it seems like it is not working. I live in Illinois. It seems a big portion of your recovery was due to finding the right PT. Do you have any advice about how to find a good one? Many thanks, Mayfe
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Mayfe, look for a PT with a lot of experience who has continued their learning after finishing PT school. They need to be curious, and therefore always learning, and to be a problem-solver. Maybe even a PT teacher! The PT who helped me was also trained in orthopedic massage (and taught it) and used its evaluation techniques to tell me what was causing my pain, AND she put an SI belt on me, which immediately made me feel stronger and more stable. She was also honest with me about stretched-out ligaments being slow to shorten, and said that I would need to wear an SI belt nearly 24/7 for 2 years to get my pelvis stable again without the belt. No one wants to hear that! However, I was very motivated to heal this old injury. It actually took 1.5 years. Wishing you the best in your healing journey.
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Please post pictures of the exercises you were advised to do? I want to make sure I am doing the right ones. I just stumbled across your website while looking for relief for my constant pain in my SI joint area. I have so much Internal clicking and popping that is quite painful. I’m buying a belt today hoping I can help myself out.
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I don’t remember the exercises, Tina. It’s been a few years, and they did their jobs. You can probably find some good SI joint exercises on YouTube — just be aware that your awareness is the judge of what helps. You’re the expert when learning without an expert present.
I do remember what made my SI joint pain worse: asymmetrical movements, like a lot of yoga poses (lunge, triangle, for example) and bending and twisting to get groceries out of the car. If you have a habit of standing with more weight on one leg than the other, shift to carrying your weight evenly on both legs.
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Thank you so much for your fast reply. I am referring to the pelvic tilt exercises. I searched them and a few different ones popped up. When I lay on my back my left leg is higher and when I stand my left leg is longer. I’ve had X-ray MRI, gone to a podiatrist (for heel lifts that made me worse), two different rounds of physical therapy and it gets slightly better but it doesn’t go away. I’m ordering the belt today and looking for a physical therapist that specializes in orthopedics. I have painful clicking in my pelvic area when I raise my hands over my head and stretch or when doing side planks…well several activities too numerous to tell…I’ve come
to the conclusion that a lot of PT don’t understand the pelvic area/SI joint. I’ve had these issues for 20 years.
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I hope you find a very experienced PT with orthopedic training who thoroughly understands the pelvis. That’s who I was lucky enough to find. If you can’t find such a PT, you may be able to find someone with orthopedic massage or clinical rehabilitative massage training and experience. Both are taught by Whitney Lowe.
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I have suffered from intermittent bouts of SI induced back pain for over 30 years. The SI exercises on Bob and Brad’s You Tube channel, especially the chair exercise has been life changing. When I feel the pain returning I repeat the stretches and I am good again usually for months. Thank you for sharing your advice. I also have Morton’s feet so the connectedness is eye opening. Paul Brown
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