Treatment for Right Posterior Ilium with Upslip Sacroiliac Joint Dysfunction

THIS PATTERN IS EXTREMELY RARE BUT ONE UNNAMED PHYSICAL THERAPIST SEEMS TO DIAGNOSE MANY PATIENTS WITH THIS PATTERN.
This is presented by Dr. Jerry Hesch, DPT of Hesch institute in Aurora, Colorado.
Jerry is a sacroiliac expert. Website: www.HeschInstitute.com
We treat complex injuries via a whole-body approach.
We also provide distance education and workshops.
Please follow us on You Tube and Facebook at "Hesch Institute"

[@keithdavis7595]

I have been suffering with SI pain for the last 3 weeks. The first exercise in this video totally released my SI joint and my pain decreased significantly. Thank you so much for these videos! Not many doctors know a lot about SI problems and solutions, but you do.

[@pam8056]

Thanks for the video - it helps a lot. A year ago I stepped with my R leg very hard down with all my weight into an 8 inch hidden hole in my front yard, causing severe L SI issues. Tons of different exercises later, it got better after a few weeks. All this time I thought it was a downslip, but with your video, I realized now it's an upslip. With a 1 week recent flareup and no relief, I finally found some improvement after doing these exercises.

[@ambert5722]

These exercises have changed my life, thank you for the expertise!!!

[@shadapakap]

I love these self-treatment videos.

[@mcewanschampion]

Thanks Jerry!

[@jillachen7217]

Thank you! God bless you doctor

[@bjohnstoneful]

I just did these exercises and got the pop and HUGE pain relief! Thank you!

[@shaesta7897]

Thnx so much doctor ........very help full technique to correct the pelvis and lumbar too......

[@maheshsirwani4713]

Thanks doc. Really gud information !!

[@robinshepard4571]

Thank you ,

[@patrullagalactica]

Thanks, your video is very informative. Keep going. Bye

[@5solas743]

Amazing! My SIJ was really flared up today. It was so bad that it was hard to stand or walk very long without much tightness and pain. After doing the last exercise shown in this video the pain and stiffness almost completely disappeared! I’m stoked about how much this can help me as I practice it consistently over the next several weeks! Thanks for sharing your knowledge!

[@olwynosullivan7267]

And how is it now?

[@curtssallee9807]

You are very helpful

[@JerryHeschInstitute]

thank you Curts.

[@dazeofmylife6385]

This man is the hand of GOD.

[@MegaMusical10]

I wish you were in GA, 15 years of suffering running from Dr to Dr ....

[@lpfan23]

I used to think my issue was primarily piriformis in the right glute, now I know how that upslip numbs my entire right glute and makes my body compensate all the way up and down. Will try these exercises when I'm home, I already feel a way better understanding (I theorize I had an upslip in my pelvis due to seated positions like working at the office and playing guitar,

[@Mabhonzoo]

I have a hard time trying to explain where the pain is coming from, thanks will try the stretching 🙏🏾

[@IndagatorAD4]

I think you helped me out, thank you. Injured during kickboxing. Picture this: Right leg, low kicking at about mid shin level into mid shin level. My rear right side, where the iliac crest meets the SI joint, was slightly raised more than the left. I noticed as I did these exercises, they were basically recreating my kicking positions in reverse and with a static hold. As I held these positions, my bulge would flatten almost immediately. It also relieves almost all my pain. Even if it’s only for a short time of no discomfort I thank you but, I have faith. 👊😇

[@JerryHeschInstitute]

I am happy to heartbeat is nearly th opposite movement to your injury. Keep healing!

[@oceanosteopathy9305]

Great video I will start looking for this more often, very nice therapeutic exercises for the condition, and it is amazing how people present differently when lying down versus standing, can you do videos on leg length discrepancies and the rotoscoliosis that goes with it? Also on hyperlordosis and spondylolisthesis? Do you have a list of all the 16 pass of joint stress test, do you have a source that you can leave me too? Thanks

[@JerryHeschInstitute]

I have online courses found at www.heschinstitute.com

[@Lisa2010Photography]

Thank you very much for making this video! But can you explain how the self correction steps would be different if there is an upslip but anterior rotation of the right pelvis? Thanks in advance.

[@JerryHeschInstitute]

It is very rare for a combination of an upslip and anterior ilium, it is definitely over-diagnosed. A higher ilium can simply be due to the rotation of the entire pelvis on the hip joints. I use passive motion tests and ligament tests to determine the correct diagnosis. You can search youtube for upslip treatment and for anterior ilium treatment but of course I have no way of knowing if that is what is needed.

[@Pincho75x]

Dr. What excercise would you recommend for someone diagnosed with spondylitis, that affects primarily the left SI joint?

[@nanallen1]

Wow. Thank you. I appreciate how important your knowledge is. And so very few practitioners understand this. It is interesting that years ago neurosurgical team Hansasuta, Tubbs, Oakes ( Univ. of Alabama) found off midline fusion of the filum and dura in the sacrum in 3 out of 27 normal cadavers. I have wondered for years if this is factor in chronically unstable sacrum/pelvis cases - i.e. very difficult to correct. Also, there are the gut malrotation and malattachment phenomena. At least one researcher ( and there aren't many on these gut phenomena) felt that a long, redundant colon is a variation of malrotation issues. 20,000 breaths a day - would this create constant unbalanced stresses on the sacrum?

[@JerryHeschInstitute]

Hi Nan, very interesting study, please share link on the research. I do not know if that scenario would be source of unbalanced stress on sacrum. I apologize for delay of reply the last post last week dod not work and then we were away teaching in Amsterdamn. Hope you are doing well. best regards jerry Hesch

[@nanallen1]

Thank you ! Filling out my paperwork to come to Aurora. Will find research. Blessings.

[@christinagurrola5335]

Thank you Jerry! I want to go seek treatment from you again, my right upslip has been bugging me and I can't seem to find good PT in El Paso. Thank you for the video!

[@jerryheschsr]

Christina Gurrola thank you happy to see you whenever

[@JerryHeschInstitute]

Christina, I will be in Albuquerque October 31-Nov 4, closer. Thursday is a good day Nov 1 if you decide to come to Alb.

[@lh4651]

You need to go see Bridget Scholljegerdes in Las Cruces. She's a great physical therapist working for Southwest Sport and Spine.

[@christinagurrola5335]

@@lh4651 THank you!

[@lahcenmessi2504]

شكرا لك

[@MOHANDE1980]

if you want to fix anterior pelvic tilt , lateral pelvic tilt , pelvic rotation,SI joint ,anterior innominate rotation . in less a month !contacte me.

[@jimdeehan9128]

Genius

[@NelsonBiglar]

Thank you for that. I see that with your foam stretch is somewhat an SOT (sacro occipital) technique no? I fell on my right side butt which did cause a posterior upslip so this video is great. The other part to this is in the retentioning of muscles. Do you have a video that might further explain the possible muscle reatrictions/overworking with a posterior ilium upslip? I may have a slight anterior rotation on left side that adds to my issue but it's more on the right as you've perfectly explained it. I use a left and right foam wedge to help re-torsion the iliums. Thank you so much!

[@jerryheschsr]

Mitch Larouche It is distinct to the SOT in that it is not shaped at a 45-degree angle but rather is flat such that it primarily induces a glide. That is my intent, I find it more effective. Unfortunately I do not have a video on muscle. I wonder if perhaps you might have more going on as the pattern you describe should resolve in three visits. If you ever travel to Denver I am nearby. Feel free to schedule a phone call if helpful.

[@MOHANDE1980]

If you want to fix pelvis rotation or lateral pelvis tilt in less a month contact me

[@isabella3025]

@@MOHANDE1980 email please

[@stuffstuffstuffyay]

Hi doc, I'm wondering if this is what my orthopdic visit yesterday said I was? He talked so fast so I did not catch it..he definitely said posterior, he maybe said illiac, it was a short word...he wrote "Segmental and somatic dysfunction of pelvic region"" on my aftercare notes. Maybe you can tell by the thing he is asking me to do each day before I exercise: to reset pelvis that moves too freely, he had me laying down, bringing one knee up at 90, hands clasped below knee and push hard against itself for 5 secs then release, do it 2 more times with knee further up to chest each time. Lastly, bring knee close to chest for final stretch. Do both sides. He also gave me a sheet of exercises for Sacroliac joint dysfunction. I just want to be sure that your exercises would be helpful rather than perhaps the opposite of helpful haha!

[@km2413]

How often should the exercises be done? I just did the first and 3rd one and seem to feel a little better. The exercises definitely targeted my painful area and felt like a good trigger point massage I feel like mobility was better after doing these.

[@JerryHeschInstitute]

When I have a patient with this problem I have them do it twice a day for three days. The pattern resolves easily.

[@daniluigi]

Hello Jerry, I’m an athletic guy with 12 years doing exercise (lifting weights and some triathlon, training 5-6 days per week). I would also like to add that I work as a data analyst during the last 5 years (being seated at desk for more than 8 hours). I started having low back pain around 2 years ago. Usually pains gets worst after being seated too long or lifting weights. MRI didn’t show any issue at my lower back. 1 year ago my rheumatologist asked for an SI joint tomography and the results were cronic bilateral sacroiliitis. I’ve tried physical therapy, pain killers and antiinflammatory meds from my rheumatologist but nothing really seemed to work. Last week I started trying the first stretch from this video and I’ve experience a 80-90% pain reduction. Some of the effects I experience after the stretch is feeling cold in the SI joint right after the stretch. Do you have an idea what could this be related to? As an athlete, do you recommend this stretch in a daily basis as part of my routine? Any suggestion if I should lift weights again? I appreciate your videos Jerry, it has really helped me a lot!

[@JerryHeschInstitute]

No idea what causes sensation of cold this pattern is remarkably rare but glad it helps you done correcgly for correct mobility impairment it is usually once and done

[@fmach12]

Dr Jerry Unfortunately i haven't had any therapist or doctors giving me significantly relief. Your exercises have made me have hope again since my the pain has decreased for the past two days. And that's thanks to you. The pain i have is on my right side. From all i have researched i have what you have explained. I am not sure though which side i should really doing the exercises. If i am having less pain doing the exercises on the left and having results... Should i do it for the right side as well, in your opinion? I am currently doing it for the left side thinking of the compensation you spoke about.

[@JerryHeschInstitute]

I am sorry this applies to a specific pattern of which there are many so it would be guessing. Where do u live?

[@fmach12]

@@JerryHeschInstitute In Australia.

[@shafinrahman2199]

Hi doctor. Could this be the cause of my left leg appearing shorter? I went to a physiotherapist and he said my right hip is high and rotated backwards while my left hip is low and rotated inwards. He couldn't explain it very well so I'm searching up videos based on those keywords. He gave me a half inch insole to put on my left shoes and called it a day..

[@johnbutera6615]

Dr. Hesch, have you studied Visceral Manipulation? I ask because in treating these dysfunctions I find invariably there are visceral restrictions causing the body to compensate with these accommodations presented here and other mechanics. Just an FYI

[@JerryHeschInstitute]

Hi John. I resolve these patterns and their compensations in 1-2 visits with lasting resolution. While I am familiar with visceral manipulation and have been evaluated by one of the instructors I do not feel compelled to pursue it. Thank you for your inquiry.

[@matthewhawkins106]

Hello there Jerry. Thank you very much for your video presentation, as it was very informative and helpful. In the last few days I have now been experiencing some very sharp awkward twinges on my left hip, most likely above the Illium section of the pelvis, as I have been palpating around the area. At first I though I may have just developed a odd shaped hernia, as they ca be possible. But at present I do believe its feels like a muscle tear or tissue tear. I am going to have it checked out, but after watching your video, I would like to ask you some hints and tips as to get a better estimated diagnosis Sincerely, all the way from Townsville, Queensland, Australia Matthew

[@JerryHeschInstitute]

Matt I would suggest you include a hip screen in your work up. best regards Jerry hesch

[@venmargray8288]

Hello Doctor, are there any doctors in Maryland you can recommend? Thanks

[@JerryHeschInstitute]

Please check patient section hesch institute for list of certified practitioners

[@markwisniewski8141]

Thank you very much for this! Is it typical to have immediate soreness in the SI joint area after performing all 3 you demonstrate here?

[@jerryheschsr]

Mark Wisniewski My treatments are very gentle and soreness is very rare. The pattern described in the video is extremely rare but overdiagnosed based on the standing mobility tests which are dubious and based on clinician bias.

[@markwisniewski8141]

I performed all 3 in a row prior to sleep and woke up feeling much better. I don’t get the QL firing up as much anymore and will work to strengthen and stabilize my right SI joint. Hip still “pops” here and there when stretching etc.

[@quickvr4]

Is this a common condition for golfers?

[@SheyEdlingtonDouglas]

Thank you for your video. I have seen osteopaths, chiropractors, sports therapists. All say my left leg is longer. My pain is on the left lower. I have treatment but nothing helps. Should I treat the right side with what you are demonstrating. I live in UK so no option to visit you. I struggle to get moving in the mornings. It’s getting me down as can’t get this fixed now for 3 years.

[@JerryHeschInstitute]

This is a very rare pattern. It rarely occurs. I have no way of knowing what you need. There are many patterns in the pelvis, hip and spine. I wish I could be more helpful. Sincerely, Jerry hesch

[@nielsmogensen9760]

How World you treat a diagnosed left on Right sacral torsion ?

[@The_Kevinist]

I know this might seem like a silly question but i have a lateral tilt with the left hip up hiking and with a posterior tilt whereas the opposite hip is lower and anteriorly tilted Does your treatment apply to my issue if i just reverse the stretches of your video(doing it on the left leg instead of right?)

[@JerryHeschInstitute]

Chris I base my findings on the passive spring tests that I do. Your presentation could be any number of things so I do not know if reverse engineer it. Check with your healthcare provider and give consideration to coming to Denver for very thorough care.

[@ken-fo5zu]

Which side is pain on? My right side is higher than the left and my sacrum points right and pelvis points left. My chiropractor always says problem on right but my left sacrum is stuck. I have pain on left SI joint. Also have osteoarthritis on left hip. left hip does not bother me as much as the SI joint. Which pattern do I show? Is my chiropractor correct in adjusting left SI joint?

[@JerryHeschInstitute]

I unfortunately do not know specifics regarding your pattern because I do extensive testing including 24 different movement test and I recognize 16 additional movement dysfunctions that are not recognized in thechiropractic model. I nearly always treat both sides.

[@georgeibrahim11]

Dr.Hesch, Every time I lay flat on my back or prone on my face FOR PHYSICAL THERAPY OR MASSAGE, EVEN FOR 10 MIN TO GET A HEAT OR tens..I can't get of the table and I suffer a severe pain for at least the rest of the day of not for few days...can you please advise with your extensive experience what this might be and if you have any solution of it

[@JerryHeschInstitute]

It would require detailed hands on evaluation and imaging for consultation see patient section hesch institute

[@luminouslink777]

I'm stuck in a country with no specialists for SI joints. I have pain in my right SI and Psis area, one spot exactly that causes me not be able to sit or walk for long, just lay, otherwise would get painful spasms in my whole right leg. Was treated as sciatica patient for two months by my chiro keep telling something is wrong with my SI joint. Noone can do this spring test for me. How do I decide if it's an upslip or downslip case?

[@JerryHeschInstitute]

It requires hands on examination performing thorough evaluation including 18 passive spring- recoil tests. These are described in my book found at www.HeschInstitute.com

[@ryguyiskindofaflyguy]

What about self met. It confuses me so much, if lets say the left asis is superior then its in a posteriorly rotated position so you would want to do isometric hold relax hip extension on that side to relax the muscle while doing isometric hip flexion on the contralateral side right?

[@JerryHeschInstitute]

Sound ok per MET theory but pelvis does many things so i do passive motion evaluation to determine appropriate intervention. Being thorough is important to me.

[@JohnM...]

I have bad pain near or on my right ischial tuberosity, and when I lie flat on the floor it feels like something is digging into my SI joint, or "digging into my back", as it where. I don't know what's going on, but nearly 3 years ago, I stomped on a tyre iron trying to change a car tyre with my left foot, bracing with my whole right side. This is what caused all the pain in my lower butt cheek and a painful tfl and piriformis, and half way down my hamstring. I don't know. 🤔

[@JerryHeschInstitute]

John I am sorry to hear of your protractd pain. If you should desire treatment I live very close to Denver. Details can be found at www.HeschInstitute.com

[@AussieGirl235]

Can you please tell me a specific doctor’s name in the US who is knowledgeable on diagnosing the joint rotation. I can go ANYWHERE. I have been living a nightmare dealing with neurosurgeons who have no idea about this condition and I’m getting worse

[@JerryHeschInstitute]

Dr Jerry Hesch (me) in Aurora Colorado www.heschinstitute.com Please see Patient section

[@ryguyiskindofaflyguy]

How do u know which hio to target if one side is rotated anterior and the other one posterior?

[@JerryHeschInstitute]

Based on passive motion testing sorry just saw your question

[@do9291]

so basically just stretch more, genius

[@Marruiz1959]

Sir, i wonder if you can help me? I stood on a swivel computar chair to put something on the of the wardrobe, lost my balance and I felt i was falling backwards in slow motion, i couldn’t stop the fall. I put my right foot on the floor and I twisted my ankle and felt the outside of my foot fracture and so i fell flat back on my back, more to the left. The pain in my back was so bad that I couldn’t move. I eventually used my whole strength to turn my self on my front and crawled to the phone. Well eventually I got up and I went to A+E . My fracture was sorted but my back was not seen to. A couple of months later I developed a pain in my left buttock which got worse day by day. The pain radiated down my leg through my hip and back of my leg and occasionally the inside of my groin. An MRI showed i had grown a bone spur which was pressing badly on my sciatic nerve, also i developed a huge hernia arround the next sciatic nerve. I was operated and had immediate relief of pain. But now I have developed again pain in my left buttock, hip and occasionally groin pain, which goes my leg again but not as debilitating as before. It goes away with panadol and neurofen. I know this time it comes from my left sacro iliac joint. If i fell on that side of my back, is it anteriorly rotated or posteriorly. And which exercises should I do to realign it. I would appreciate your help so much. Thank you.

[@JerryHeschInstitute]

I do not know which was it is rotated without performing detailed hands on evaluation as there are several different types of movement dysfunction. Sorry i just saw your question now I hope you are much better.

[@Beef0121do1]

Is upslip on the left uncom9

[@JerryHeschInstitute]

True upslip with blocked inferior spring micromotion is rare on either side. Visual observation is not part of the Hesch model as there is very little normal vertical excursion although a torsional pattern of pelvis moving with trunk and with hip does create observable asymmetry.

[@anujbhatia3337]

Without an assessment is there a danger to using these techniques?

[@JerryHeschInstitute]

I am unaware of any danger but do not know your condition so i defer to your health care practitioner. See disclosure

[@shaesta7897]

Do you mean by up slip as posterior tileting sir?

[@JerryHeschInstitute]

No they are diffent upslip is up, posterior is an oblique rotation of entire pelvis

[@shaesta7897]

@@JerryHeschInstitute thnx sir

[@ibr0704]

Hi Doc I have a left si joint problem caused by a worng step Since that i have a pain and i discover that it causes me a short left leg with hip imablance When standing i feel my left pelvis uncomfortable I am a radiologist MD from Algeria I appreciate your advices for getting back my balance

[@MOHANDE1980]

if you want to fix anterior pelvic tilt , lateral pelvic tilt , pelvic rotation,SI joint ,anterior innominate rotation . in less a month !contacte me.

[@lightsman100]

With that condition where is usually the referred pain ?

[@JerryHeschInstitute]

It is an extremely rare presentation except for the fact that one therapist seems to give many that movement diagnosis (right side) but does not utilize the load-spring-recoil micromotion tests. If one did have both you could anticipate sharp pain in the region of the PSIS/sacroiliac.

[@lightsman100]

Thanks for the response ! My mris on hip, back and si joint are all look ok with nothing to work with . On the other hand I can feel the difference on the height of si joints when I massage the region . It’s like , it is more ease to find the spot of the bone back .

[@lightsman100]

An one more thing is that it affects my walking . Like the legs have different length , but they don’t

[@JerryHeschInstitute]

Interest re walking screen hips?

[@lightsman100]

@@JerryHeschInstitute sorry, i didnt understand

[@pappupaul9206]

Sir i dont knw im suffring from Si joint dysfuction or not....But my Faber test is positive and wen i do your first exercise in dis video...it hurts really bad in my right buttock area....plzz do reply sir

[@jerryheschsr]

Have you seen a doctor? thorough hands-on testing and imaging is necessary for proper diagnosis. Where do you live? I would need additional information, could be coming from hip, or sacroilic or lumbar spine as all have very similar nerve supply.

[@pappupaul9206]

@@jerryheschsr Actlly sir im from india...n its lockown here due to covid.....let me start from beginning way back in 2008 i had disc bulge l4 l5 s1 level...n SI joints were normal in MRI report....i got relieved aftr few months...n life goes on...but b4 10 days 01.06.21...i lifted a brick...aftrdat icud not move my hip rotation outward by laying..pain iz not so high...around buttock n hip area,wenever i rotate it outside,i cud not understnd it sir plz reply???which exercise to doo...plz help

[@jerryheschsr]

@@pappupaul9206 I am sorry without me performing a very detailed hands-on examination all would be guess work. Please see a doctor.

[@djstevesire]

I could Literally kiss you ! My scoliosis finally unwound! This was the last peice!

[@JerryHeschInstitute]

Digital kiss appreciated!

[@oinkPat]

Wow if I don’t do this every day my body resets itself and then I’m fuckin Quasimodo again

[@JerryHeschInstitute]

Maybe something is missing. If ever in Denver come see me.

[@futur3p3nc1ls4]

I was treated for an upslip on my left side but I am not sure...they would pull my leg once a week... The first one was brutal and years of lower back pain dimished significantly...it goes out of place still but I am able to correct it on my own...how do I know what type of upslip it is

[@jerryheschsr]

Futur3 P3nc1ls you can look for my videos on spring testing and have your physical therapy evaluate you with the spring tests

[@futur3p3nc1ls4]

jerry hesch sr Thanks for replying...I couldn't find spring test in any of your titles but I will keep watching to see if I can find an example. Even before I knew there was some dysfunction I would instinctively pull my knee towards my chest and place downward pressure on my knee at the same time looking for relief...I can feel when it's out of place because I will get a sharp pain on the left side at the SI joint..if I mess with it enough it I will feel a sort of pop and movement and it will be better...when I pull the knee towards my shoulder on the left side I get alot of pressure on the outside of the pelvis and the back and also any external rotation on the same side will cause pain in the groin and flank of the pelvis. The right side is unaffected but there is chronic pain on the left...even once I get it in what I believe is the right place...how do I find a specialist in my area who actually knows what they are looking at rather then keep getting sent to the physical therapist...I am near Austin TX. Thanks...

[@JerryHeschInstitute]

Here are some videos on spring testing. kzbin.info?search_query=hesch+spring+tests I do not know how to advise you to find an expert especially because the spring test model is not what the majority learn and use. If you ever travel to Denver I am nearby. My website is www.HeschInstitute.com. Here is another set of videos that might be relevant kzbin.info?search_query=hesch+downslip Sometimes downslip looks like upslip because muscles hike the entire pelvis on that side, but spring testing and ligament palpation confirm downslip. For a deep exploration I have a book on my website see Store link.

[@JerryHeschInstitute]

When clients travel to see me I see them three days in a row and spend up to 2-hours per visit. i treat but also film self-treatment so they will be independent of health care practitioners and :get off the merry go round".

[@futur3p3nc1ls4]

Jerry Hesch Thank you... I will look at these videos.

[@jerryheschsr]

You are welcome!

[@jerryheschsr]

Sounds good Nan I look forward to working with you.

[@jerryheschsr]

sounds like your Flixzone is a scam how about you stay off my KZbin?

[@jerryheschsr]

You could treat both sides. However, I test passive spring-recoil motion to determine which to treat. This relates to your first question also.

[@dianemaurone7277]

I tied your video and it seemed to help a little do you have any on siactia n or periisformi muscle to try first time on your channel hope to hear from you soon I have been suffering for 6 yrs now