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SI Joint Dysfunction (Evaluation Demo)


Follow along as Dr. Peshkin walks through his evaluation of a patient with SI Joint Disfunction including a notable difference in leg length. #MovingInTheRightDirection


Transcript:


So one thing we see with SI joint dysfunction, is leg length discrepancy meaning one leg is shorter or longer compared to the other. And that translates all the way up into the hips. So SI joints connect your your legs to your sacrum, which connects to the spine.



So it's a really important joint. It's really a big joint in the body. But as we can see here with our patient here, Mark, we're looking at as you're seeing, his left leg being tremendously shorter compared to the right leg.



You can see it right from the hips. But I usually do this make sure that there's no angulation, differences in the foot. I take my thumb and look underneath the medial maleoli, and right here as we put them together. We see that the right leg is shorter than the left leg.



The second thing we'll do is walk away up to the person's knee creases just to make sure it- can have you bend your knees for me, slowly?- I'm going to the knee crease here and the knee crease here and then bring your legs down.



And again, I'm showing you there's a little bit off here. Coming up, the SI joint, which is this area right here. I'm going to pull your pants just a little bit right here.



And it's a joint lying right in there. And if I push in here, as you see his right leg go a little bit longer, so you can see how when that joint is restricted, then it's not able to move.



The leg is short but if I push down, it gets longer. And so that's kind of showing me where we want to move his hip today as well. So because this is such a large joint and I do need his body to relax, we're going to be using some hot heat.



And we also want to be careful about the musculature here as well. Typically, when we see people with SI joint dysfunction, we see it kind of start on an ankle or a knee and work its way up.



So we just did a foot scan with Mark and we see that he has a flat foot and his flat foot happens to be worse on the left. So the type of chain we see chain reaction is usually flat foot here.


Then there's usually internal rotation of the knee here, which causes a pelvis to cross here. And then if it goes all the way up the body, we usually see it shoot back over into the shoulder and then upper cervical spine.



That's where the restrictions are normally found, about 90 percent of the patients that we see. So with Mark's situation here, we're going to start correcting that for him by throwing some hot heat on there, warming him up. And we're going to be using something called SOT Blocks to help his pelvis relax in the position we want.



And it's a very simple procedure.