ORTHOTICS AND THE SACRO ILIAC JOINT .
2019 UPDATED ARTICLE
By Dr Les Bailey, back and joint pain centre, caterham.
A highly experienced Physical therapist , based in caterham,specialising in orthotics for over 30 years.
Dr Les Bailey is author of the best selling book, “the layman’s guide to foot and heel pain “which sold over 35,000 copies .
Dr Les Bailey ,has featured in the national media and TV ,for his work with orthotics.
My first experience with sacro-iliac pain and orthotics , was when I originally had orthotics prescribed for plantar fasciitis ,some 30 plus years ago. This was long before I adopted orthotics as a speciality myself.
I used to stand all day and night, treating patients at my Osteopathy clinic ( Then in Milton Keynes) ) ,so my pronated feet got a bad time ,daily.
I was also an active Muay Thai fighter, and I had developed plantar fasciitis , awoken prematurely in my life, by running high mileage on pronated feet.
The one thing I noticed ,when I got my orthotics, was , aside from the plantar fasciitis clearing, that the treatment my colleague did on my sacro iliac Joint , weekly, was no longer needed . And I can safely say , that in over 30 years my pelvis/sacro iliac joint has never needed treatment again .
I began to study orthotic prescription, and my earliest pairs were made for patients who had a long history of sacro iliac /pelvis issues , usually on and off constantly.
I noticed , that like myself, they all displayed either pronation on standing, (dropped arches upon weight bearing) or rolled into pronation on walking (weak sub-talar joint) .
With accurate orthotic prescription, their problems ceased in this area, and I lost my regular patients ! (quite happily , I add).
The issue is, that , quite unequivocally, foot posture rules the sacro iliac‘s inherent stability.
One may , quite rightly, ask “how so?“, as ,for a layman, unfamiliar with biomechanics, this seems a trifle far fetched?
If we look at the human structure , as we do a building, the worse thing that can occur, is collapsed foundations. This causes major issues all the way up the building . The same happens in the human body .
The feet lean inward into pronation, which causes the knees to kink inward , which places pressure into the hip joints. This then puts pressure into the pelvis, which literally squeezes either side of the sacro iliac joint . The sacro iliac joint is where the pelvis joins the sacrum , a joint which was believed, until recently, by orthopaedic doctors, to be immovable. The osteopaths and chiropractors argued that, in fact , they moved them daily in their practices .
It transpired we were right , and there is a micro amount of movement between the sacrum and the pelvis meeting , now agreed by orthopaedic physicians.
This means that the faulty and pronated feet, exert pressure all the way up to this joint, squeezing the sacrum within its tiny area of movement, and making it “wriggle” to attempt to settle, thus irritating the dermatomes of the sacral nerves !
This then causes , what lay people call “sciatica”, but is, in fact, irritation of the S1 dermatome. Conversely, it can also cause irritation to any of the sacral dermatomes, not just S1 (although this is the most common dermatome affected).
However, the issue does not end there . One has to look at what sits on the sacrum too . Yes, it’s the spine, reliant on the sacrum as a nice stable and level base on which to stand.
Now , imagine the sacrum twisted by the pressure caused by the foot pronation ,or instability.
I say ,colloquially, that the spine ends up as twisted as a bed spring ! Thus issues are created up the spine at higher levels , even as far up as the cervical area (neck).
Then we look at what sits upon the neck …. the jaw.
There was a very eminent orthodontist in the USA who did the most intricate work . He refused to begin working, until the patient had prescription orthotics. His correct reasoning was that if the patient went on to get orthotics later, his millimetre precision work would then be inaccurate .
This illustrates the far reaching effects of faulty foot biomechanics .
I hasten to add a word of advice around this topic, chiefly, that not all sacro iliac pain is biomechanics related, and the cases one has where sacro iliac pain is a “one off”, eg from lifting awkwardly, or some such activity ,acutely injuring the sacro iliac area, does not in itself indicate faulty foot structure.
Biomechanical fault , causing sacro iliac issues, presents itself as long standing aching , often with intermittent attacks of pain of varying levels.
I hope you have enjoyed this article, and it has been easy to read .
Take a look around our website ,where you will find links to many hundreds of happy patient testimonials , a large proportion of which concern our prescription orthotics . ( after all, self- praise is no praise, so we let the past patients tell you of our effectiveness, and even the most aggressive detractor cannot argue with that !)
Bless you all .
Dr Les Bailey ,
Back and joint pain centre,
175 coulsdon rd,
Tel 01883341949 or 07801418080.
Email firstname.lastname@example.org. Uk