Expert: Scott F. Gillman, DC, DACBSP - 11/4/2009

Question
QUESTION: I wrote you a few weeks ago regarding a bad adjustment to my SI joint.  I decided to go to a new chiropractor.  He has adjusted me via side manipulation and the stiffness in my back has decreased.  He says that there is more mobility in my joint.  It has been three adjustments and I feel about 40% better than I did.  MY Si joint still aches, not as bad though, stretching is easier, I am still a little stiff in my lower back and it still hurts to sit for prolonged periods.  The new chiropractor wants to see me every three weeks now.  Can the chiropractor tell when you are back in alignment?  If I am in alignment, how long will it take to start feeling better?  Thanks again for all of your help.  Unfortunately, this chiropractor is not specialized in the graston technique, so I haven't had any soft tissue work.

ANSWER: Nicole,

It's not about "alignment."  It's about soft tissue lesions, e.g. scar tissue, adhesions, tendon degeneration.  And, it's about general pelvic joint function, e.g. does your pelvis (SI joints) move smoothly and freely and with the ability to become stable when you want it.  Too bad your new DC hasn't gone through the Graston Technique program.   Ask him to examine for soft tissue lesions at these locations: insertion zone of the thoracolumbar fascia and the zone of the iliolumbar ligament.  If he feels that they are sensitive or have a fibrous or plucky feel, then do simple transverse friction (vis. Cyriax or Hammer texts...he'll know what this is).   Don't forget about stability exercises (see McGill's papers...).

'Glad you're getting better.

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Do you think I should schedule an appointment ASAP for this inspection or should I wait and ask him in 3 weeks? Would I be able to feel for damage?  The muscles connecting to the SI joint are definitely tender still.  Is that a sign?  With the right treatment, how long does this damage take to heal?  Thanks again for all of your time and advice.

Answer
Nicole,

First off, you're not dying from anything so there's no rush.  Don't worry.  It's all up to you as to when you want to get things checked out.   The objective is to get the right treatment, and I know that this is not always easy.   Even I have a hard time finding DC's that are well skilled to work on me!   If you don't want to wait, I'm sure your new chiro' will be happy to tend to you.   You should still bug him to do the Graston Technique course, and also to look up the "FAKTR-PM" (functional and kinetic treatment with pain provoation and motion) course.  

'Best,

Dr. G