Most people who visit a Greenville chiropractor are familiar with a side posture chiropractic adjustment intended to correct or mobilize the sacroiliac (SI) joint. Side posture adjusting is one of the most common types of a chiropractic adjustment performed. However, the science and research behind this adjustment do not support the assumption that the side posture adjustment is actually capable of mobilizing and thus adjusting the SI at all.
This is a rather advanced topic but bare with me and you will end up understanding more about the SI joint than practically any MD and most doctors of chiropractic in Greenville and the rest of the country.
The primary function of the SI joint is to transfer load from the upper body to the lower body. This is evident when you look at the design of the SI joint.
No, you don’t. What you are hearing is called a cavitation. A cavitation is a formation of gas bubbles in the liquid in the joint space. Cavitation (popping) is NOT NOT NOT an indicator of a successful adjustment. You or your chiropractor didn’t get anything to “GO” anywhere. The sounds happen when there is a distraction or mobilization of the joint that creates an air bubble in the joint. Anyone can get a joint to cavitate.
Cavitation does sometimes happen during a chiropractic adjustment but not always. It does also sometimes happen during injuries. An adjustment is accomplished by diagnosing the improper position of a bone or bones and using a quick low amplitude force to change the bone or bones position. As we see above this is not something that can really be accurately measured or changed with any significance when considering the SI joint. MRI VIDEO LINK
What you are hearing is likely the joints between the L5-S1 facet joint between the L5 vertebra and the sacrum. Remember the L5-S1 facet joint is designed to move the SI joint is not!
It is very difficult to identify TRUE SI joint dysfunction. The gold standard to accurately diagnose pain originating from SI joint is to inject the joint with an anti-inflammatory and see if the pain reduces. If the pain reduces then you know that the SI joint was the source of the pain. However, there are a number of other lumbar and pelvic problems that can cause pain that feels like SI joint pain.
Unfortunately, the orthopedic tests being used to identify SI joint dysfunction are never accurate at determining if a patient will respond to an SI joint injection. Even if they could identify that you have SI joint dysfunction, it’s clear that the significant limitations of motion in the joint suggest that an adjustment to the SI joint, if possible, is not going to fix the problem.
First, if your chiropractor thinks the problem is likely TOO MUCH motion with true SI joint problems. This is often caused by postural distortions that improperly load the SI joints, which would lead to the SI joint not being stable. When this happens you need a structurally focused chiropractor to correct the structure of the spine and pelvis so that the SI joint is equally loaded and balanced. The traditional chiropractic side posture adjustment, if it, in fact, does what most chiropractors think it does, would make the joint more mobile, which is not what the SI joint is designed to do.
Please understand this is not an attack on chiropractic or other chiropractors. The point of this blog is to educate the public and other chiropractors about the SI joint. I am just as guilty as every other Greenville chiropractor of doing a side posture chiropractic adjustment and thinking I was doing something that I now know I wasn’t. For more information please see this YouTube video where Dr. Deed Harrison explains the SI joint in GREAT DETAIL.
4320 E 10th St Ste G, Greenville, NC, 27858