Why It Matters: The Sacroiliac Joint For proper treatment of our body’s structural core, the sacroiliac joint, it is important that we understand how it functions properly. Misconceptions regarding the interrelationship of ligaments and muscles, the shape and movement pattern of the sacroiliac joint, and other factors disguise many complications and contraindications that make treatment challenging. Is The Sacrum a Keystone or is it Suspended? Whether the sacrum functions as keystone or is suspended from the ilia has been debated for well over one hundred years. In the early 1990s Vleeming and ..read more

  Figure 1 Figure 2 Relationship of structural and soft tissue elements To understand how our musculoskeletal system functions, it is important to understand the interplay between soft tissues, such as the ligaments and muscles, and the body’s structural elements, the bones. This relationship is expressed through a principle called tensegrity (Tensional Integrity). Tensegrity is based on a principle discovered by one of Buckminster Fuller’s students, Kenneth Snelson, who named it “floating compression.” It may be described as a triangulated structure composed of stick-like stru ..read more

Hilton’s Law[1] forms the basis of the relationship between the structural elements of our musculoskeletal system; it states that the nerve supplying a joint also supplies both the muscles that move the joint and the skin covering the articular insertion of those muscles. The innervated parts of joints consist mainly of three ligamentous structures; the ligaments that hold the joints together, the capsule that encases the joint, and the synovium which allows smooth movement. As the pelvis moves, the ligaments within the two SIJs and pubic symphysis act to both regulate the muscles to ensure sm ..read more

What is Posture?Do you ever notice when you see people with good posture? They walk erect, their heads lifted, shoulders back, their arms swing evenly, and they move with a simple, efficient gait. Unfortunately, most of us have some structural imbalance that causes us to alter our posture. Many people think that by stiffening their back to stand up straight, they are correcting their posture but the tension in their spine will reflect in other places. In actuality, correct posture is a state of relaxation. Posture is the position in which we hold our bodies while standing, sitting, or lying do ..read more

During normal anatomical standing, with balanced weight bearing, the spine should not be laterally flexed or rotated. The sacral apex should be neutral, evenly spaced between the right and left ischia. The height of the ilia should be even, with no rotation. If I am correct, this pattern may not exist on any back-pain patients. CLARIFYING SIJ MOVEMENT Balanced Movement In normal movement of the spine, most vertebrae move in unison, in the same direction as the ones immediately above and below. But, in normal movement of the pelvis, there is a significant difference; the sacrum and ilium move i ..read more

With joint injury, sprained ligaments initiate a complex chain reaction as the body compensates for the resulting hypermobility. To explain this better, we should consider that ligaments serve two main functions, proprioception and joint stability. Proprioception is a means of sensing the movement pattern of the joint, including direction, speed, and acceleration, and then balance the tension of the muscles to maintain even, smooth movement; this is an essential component of maintaining stability. In a normal joint, at the endpoints of range of motion (ROM), the ligaments not only physically s ..read more

Over the past 30 years, I have researched the literature on the sacroiliac joint (SIJ) and matched it to what I found in my patients. In the early 1990s, the keystone concept of form and force closure was introduced by a group of physiotherapists in Europe[1]. They came upon an idea after finding that “A commercial device used in painting ceilings helped us to conceive the concept of the SIJ functioning as a friction joint. This was, of course, scientific heresy since the main characteristic of a joint is its capacity to function smoothly.” They continued “Twelve years later, there is ample ev ..read more

Understanding a problem may do little good if you can’t do anything about it. For this reason, I am taking the helpful step of writing an informational blog that explains the biomechanics behind the development of the Serola Belt. The primary purpose of a sacroiliac belt (aka pelvic belt or trochanteric belt) is to keep stress off the ligaments within the joint; it does this by keeping the SIJ within normal range of motion (ROM). The more the sacroiliac joint (SIJ) is kept within normal ROM, the less stress is put on the ligaments, the less the muscles tighten, and less pain is experienced. Th ..read more

Unfortunately, any sacroiliac (SI) belt may occasionally cause pain. In most cases, this may be due to several factors that can be alleviated with the right approach; knowing where the pain is and what to do about it. Issue #1: The pain is localized at the SI joint and may be coming directly from the ligaments. This can occur for several reasons such as: Reason #1: Ligament stress can occur when the SI joint is locked at one point in the joint but the rest of it is free to rotate; this causes the free parts to move excessively to make up for the lack of motion in the locked portion, and ..read more

Sometimes we get aches and pain in muscles, and we are not sure what is the best thing we can do to find relief. Should we take medication, stretch, exercise, apply heat or ice, massage, vibration, etc. Basically, we can classify these types of pain relief to one central cause and effect based on reduced circulation. First, we have to understand muscle tone, which is the state of tension in a muscle while at rest. Balanced muscular tone allows greater strength, energy, flexibility, reactivity, and overall health. Conversely, unbalanced tone can reduce all of the above. The question is what do ..read more