Pelvic and Disc Problems

 
 

 

The pelvis is a bony ring that is the link between our spine and our hip joints/legs, plus acts as a cup to support the contents of our abdomen(belly). There are 2 joints called the sacro-iliac (SI) joints at the back of the pelvis (approx where the back pockets are in a pair of jeans) which are where the spine/sacrum ‘fits into’ the pelvis. At the front of the pelvis there is a joint between the 2 halves of the pelvis which doesn’t move much, called the symphysis pubis. There are 2 hips joints where the rounded ends of the upper legs fit into cups formed by the pelvis (strong, stable joints prone to osteoarthritis).

The 2 sides of the pelvis can ‘twist’ in opposite directions with 1 side rotating back and the other side rotating forward (ie. twisting the 2 halves of a ring in opposite directions). Most of the the movement happens through the sacro-iliac joints. When the pelvis rotates back it creates tension on that side in the lower buttock, hamstring and calf (back of the leg). The side rotating forward creates tension in that upper buttock and corresponding quadriceps (upper front of the leg). This is why in most cases, when a person tears a hamstring or calf muscle it is on the side of the pelvis which is rotating backwards.  When the pelvis rotates backwards, it also causes the pelvis to drop down on that side which can often be seen if you look at yourself in the mirror without clothes.

Of course the pelvis can rotate/twist sideways as well, which mis-aligns the hip joints and the base of the spine also contributing to buttock and hip discomfort. 

 


Instability of the pelvis

The sacro-iliac joints join the spine (sacrum/sacro) into the pelvis (iliac) and therefore have to be strong and stable in oreder to support the weight of the upper body. The SI joints can be strained and the ligaments overstretched (like overstretching a rubber band) after which the joint can become too loose and unstable. Many injuries such as: falling onto the pelvis, a sudden slip forward with a foot, over lifting  /overloading, child birth etc. can overstretch the SI joint.

Because of this instability the buttock muscles contract to try and stabilise the pelvis. Often people with chronic pelvic instability can feel this tension as a tight band across the back of their pelvis. Because they can't put too much pressure through the unstable SI joint, they lean sideways away form the joint. This creates alternating tensions up the spine and can often appear symptomatically in the form of tension between the shoulder blades, upper neck pain and headaches, arm pain/tingling and jaw tension with teeth grinding at night. 

Compensating for this instability requires a lot of energy so people often notice a big improvement in how they feel and function once the unstable SI joint has been re-aligned and stabilised. This misalignment and instability of the SI joint also places strain on the nerves passing through the area and can affect the signals sent down by the brain. The sideways shift of the spine also disrupts the relationship between the spine and the nervous system and can affect how well the nervous system is working which can lead to dysfunction in the areas that these nerves control.

My focus is to re-align the SI joints and lower lumbar spine (plus hips and knees if contributing) and re-balance the region, allowing the area to heal and create stability. If the pelvis is always twisted then the SI ligaments are always under strain and are not able to heal.

People with this type of "breakdown" should avoid twisting though the pelvis such as: not crossing the legs, not sleeping on their side with the top leg dropping over the bottom leg (should have knees on top of each other), not bending and twisting especially when digging, mopping sweeping etc. and not slouching in hard chairs.

 

strain of saco-iliac joint

strain of saco-iliac joint


Progression of disc bulge to herniation   (images on right are viewed from above)

Progression of disc bulge to herniation

(images on right are viewed from above)

Disc Problems

Between each bone/vertebrae of the spine there is a spongy pad called a disc. They are shock absorbers that allow movement. The discs are made of a tough fibrous material (similar to the tendons attaching to muscles) that wraps around the soft gel-like center. The disc is attached to the vertebrae above and the vertebrae below, so it is not possible to slip a disc - they don't move!  If the disc is stressed and larger forces are placed on the disc asymmetrically , it can deteriorate and a disc bulge can form. This is when the soft 'jelly-like' material in the center pushes out through the tough outer fibrous material causing them to tear from the inside out. As the outer layers of the disc thin, it causes the disc to bulge out towards the spinal cord and nerves located behind the disc. When/If the bulge gets big enough, it can press on the nerves or spinal cord and produce symptoms such as sharp/electric like pain down a leg (usually) or arm, numbness / pins and needles, loss of ability to move a limb properly and in severe cases loss of bowel and/or bladder function.

The bottom 3 discs are the most common to get a disc bulge, due to the increased weight through them, but they do occur in the lower neck as well. People often equate "sciatica" (pain down the back of the leg) with disc bulges, but the pain from a disc bulge can go into any part of the leg following the path of the nerve with the pressure on it. People can have a disc bulge in their back and feel no symptoms if the bulge isn't large enough (yet) to press on the nerves. Although it is possible to cause a disc bulge due to one specific accident or one over-lifting episode, many disc bulges are produced by repetitive stresses and long-term uneven loading of the disc due to spinal misalignments and poor posture.

My focus is to very gently re-align the affected joint, release muscular tensions placing unbalanced or increased pressure on the area and align the surrounding joints and spine to remove pressure from the affected area. Disc repair is slow due to the poor blood supply to the disc and constant pressure through the disc when sitting and standing. People need to lie down as much as possible when a disc gets damages to take the pressure of it and allow it to heal. When the pressure is placed back on the disc it causes it to tear internally again. Sitting places the greatest load on the disc (especially if the posture is poor), followed by standing.