How to mobilise a tight sacroiliac joint with the Backpod
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- čas přidán 28. 07. 2012
- The flat plate of bone which is your sacrum glides along the sacroiliac joints in your pelvis - or it's supposed to. For a variety of reasons that glide can jam up and stay stuck. Here's how you free it up again.
The Backpod can be used to free up a tight sacroiliac (SI) joint problem such as can commonly occur during or after pregnancy or from a fall onto the low back or tailbone. The impact can often leave the sacrum ‘jammed up’ along the SI joints and not moving.
This leaves the tailbone more exposed to impact/pressure when sitting down and can create ongoing pain from the repeated banging on the tip of the tailbone. This type of TAILBONE PAIN (also called coccydynia) doesn’t respond to purely local treatment of the tailbone itself but clears when the SI movement is restored to normal.
The extremely tough mix of capsule, ligaments and fascia around immobile SI joints means that good results from mobilisation and manipulation techniques often don’t last, because the surrounding shortened collagen just tightens them up again. The Backpod is ideal for quietly stretching this so the SI joints can stay free.
HOW TO USE THE BACKPOD: The patient lies on their back on the floor, thighs vertical, shins horizontal, ankles crossed and heel supported on the edge of a table or chair. The Backpod is positioned lengthwise under the sacrum and the patient relaxes onto it for several minutes, once daily. This uses their own lower body weight to stretch the tight SI joints.
It can still take weeks before the SI joint movement frees up reasonably, and often they are tight enough to also need the greater force of specific therapist mobilisation or manipulation techniques. The Backpod is then the ideal follow-up, to stretch things further so they stay free.
CLINICAL CAUTION: The Backpod should be used to stretch only tight or frozen sacroiliac joints. Stretching already excessively moving SI joint problems will make them worse.
The best test to clinically distinguish between the two is Andry Vleeming’s test for SI hypermobility. Briefly, the patient lies on their back and actively lifts one straight leg as high as they can. This is then repeated with the patient’s friend or therapist manually pushing both sides of the patient’s pelvis together (i.e., artificially compressing and stabilising the SI joints).
If the leg raise is then clearly higher and without pain, it indicates an unstable, excessively moving sacroiliac joint. This should not be manipulated or mobilised, with the Backpod or any other technique. These problems are best treated by support muscle strengthening and stabilisation belts - see a physio (PT).
SACROILIAC PAIN DURING AND AFTER PREGNANCY is common. Usually it is explained as arising from excessively moving (i.e. hypermobile) and strained SI joints, due to the loosening and softening effect on the ligaments of hormones released during pregnancy to allow the sacrum to hinge open fully to let the baby come through the pelvic basin.
This surely happens, however it doesn’t explain SI pain just on one side, since all the ligaments are presumably loosening equally. Unpublished New Zealand research and extensive clinical experience suggests that one-sided SI pain appearing partway through pregnancy is more usually from a tight or immobile SI joint.
These patients generally have a history of a fall or impact on the low back, pelvis or tailbone, presumably leaving the legacy of an adhesed and immobile SI joint. The interpretation is that as the pregnancy continues, and the surrounding ligaments get looser, the adhesed SI joint becomes relatively tighter and then painful.
These problems generally respond well and quickly to mobilising the tight sacrum with manual physiotherapy (PT) techniques, or simply by lying on the Backpod. This rather validates the model, as the patient is no longer sore - even though the pregnancy is continuing and the baby is getting bigger - so the pain can’t just be coming from the stresses and strains of pregnancy.
If SI or tailbone pain persists months after the baby is born it is then usually coming from SI joint immobility after the ligaments have tightened up again after the birth. The Backpod is equally effective in this situation to gently mobilise the tight SI hinges as described above.
For more detail see the sacroiliac section on the OTHER CONDTIONS page of the Backpod's website www.backpod.co.nz
Steve August; New Zealand physiotherapist with 35 years' experience.
Thank you for this! I don't have a backpod at the moment but I've been doing this with tightly rolled socks as you suggested and it has already made a huge difference to my pain levels! I've had bad SI joint pain since the start of my pregnancy over two years ago now and I am so grateful to finally find some relief.
Well done on thinking for yourself. SI tightness is really quite common after pregnancy. (Also during it, though usually it's assumed that the pain is because the SI joints are moving too much due to the hormone release. I just don't find this to be the case, most times.) If the socks are helping, the Backpod should help more. It's just that much stronger, and SI joints are tough, and yours has been frozen for two years, and you may definitely need that extra oomph.
As well, try and talk, bargain or bribe someone into doing some massage on you at home - the muscles around the tight SIs and low back will be tight also. They need something to let their fingers slide - massage wax is best but any sort of oil will do.
Then, kneel on the end of a firm bed, plinth, couch, etc. - feet shoulder width apart, and just off the edge of whatever it is you're kneeling on. Make sure you're stable - wriggle your feet up to the edge of it so they lock onto it a bit. Put a pillow behind your knees, and sit down on it.
Then tuck another pillow into your waist and curl forward over it. This puts the strong muscles down your back onto stretch. Your massage buddy then works up and down the big erector spinae muscles along your back, over the harder, lumpier gristle over your sacrum and SIs, and lower down onto your buttocks, for about 10 minutes.
It works really well to loosen up spasm and scarring. It should help your low back a lot. Probably do it once a week for a few weeks.
Cheers, Steve August.
Thank you so much for sharing this!!
Thanks a lot!
Hi Steve you have no idea how much of a help this was, thank you very much. Will we purchasing Backpod as soon as it can be delivered to my country. ATM no one can deliver
Hello and thankyou for sharing this video. For sacral malalignment, which modality would you best prefer to resolve the problem? Chiro or osteopath? Thank you
Is it useful for Ankylosing spondylitis?
I want one right now. I think I've needed one for 20+ years. Take my money (as long as it doesn't take a whole lot of my money because I'm not wealthy)! Gimme!!
The tennis ball isn't quite right. I have some ideas though. Is there a suggestion box? Or an idea collab. section?
The backpod is so expensive (especially for a hunk of plastic) - I won't buy one. But what I do have is a serrated knife and a yoga block that I sculpted into a domed egg shape. Muahaha
The Backpod moves the sacrum in an up - down direction. But what if the distance between the sacrum and the iliac ( hip bone) needs to be increased to the side, and not in an up -down direction? Thus I would question how useful the Backpod would be in increasing the distance to the side.
Hi Donald. It'll do that too. Think of the SI joint between the sacrum and the ilium like two bricks side by side and touching each other. They're supposed to slide past each other - that would be normal SI joint movement. For a variety of reasons, the SI joint (s) can seize up solid. So if that's the case, you want to free them up back to normal movement.
However, the bricks are held in place by all the collagen making up the ligaments, joint capsules and facia around them. This is a morass of massively tough stuff - collagen is stronger by weight than steel wire. So when the joints haven't moved for a while, this collagen shortens and tightens down around them, and holds them bound and frozen.
That's what you're stretching on the Backpod. Anything that stretches the collagen allows the joints to start moving more. That's why the Backpod helps.
Sure, there are lots of specific hands-on techniques, including manipulation, to glide the SI joints in various directions. Sometimes they need to free in a particular direction and often it's just a general loosening they need. But remember these things are TOUGH. I find a lot of the techniques aren't wrong, but they're just not practically effective because they're not strong enough - like trying to push a brick with a feather.
That's why the Backpod helps heaps. It's only a general stretch, but it's strong enough (your lower body weight pressing down on the Backpod) and long enough (5-15 minutes stretch) to actually stretch the collagen. You need that stretch held over time to stretch collagen - at least a few minutes, just like a yoga pose. No hands-on technique does this - your fingers would give out. If you don't stretch the collagen, then any freeing up from a technique just gets lost fast as the collagen rebound freezes up the joints again. (That's why you get that ridiculous chiro cliché of banging the joints free every few days, then the collagen just freezing them up again.)
Have a look at the Backpod's user guide instructions for SI joints - pages 25 & 26. There's a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. There's a test on that for HYPERmobile SI joints which you'd better have a look at. SI joints can go both ways. Cheers, Steve August.
I feel pressure in that area wierd sensation, injured it back in October lifting heavy servers. went hiking few days ago and man I started to feel it. any suggestions whats going on?
@60 Seconds or So lol what? No servers are the huge metal rectangle boxes with circuitry.
60 Seconds or So lmaoooo.
The backpod gave me diahrea
never badmouth the pod
Did you eat it?
Not for ingesting
Your not supposed to eat it !!!!!!!