Physical Therapy Update

On Friday, I was congratulating myself for the successful completion of one week with my new physical therapist. Then he informed me that he had taken it easy on me the first week and intended to increase the intensity next week. I spent much of the afternoon “freaking out” about that and today I am trying to approach the situation from a calmer, and perhaps even more professional, perspective.

The pictures below show a healthy lumbar spine and pelvis. Needless to say, mine don’t look like that. Kaulitzki Sebastian kaulitzki


I generally express my complaint as “pain in my right sacroiliac joint caused by a ‘wonky’ pelvis.



A more appropriate description would say that I am dealing with right sacroiliac pain as the result of anterior rotation of the right innominate.

I have been living with this pain since Friday, September 13, 1996 when I fell crossing Franklin St. at the intersection with Shaffer St.

That fall and the subsequent pain changed the course of my life. It took more than 10 years for me to get a referral to a physician who could listen to my description and say, “I know what that is. It is your sacroiliac joint.”

While waiting for the correct diagnosis, I spent plenty of time with orthopedic surgeons, who replaced both of my knees and assured me that all of the pain in my back was the result of spinal stenosis. When I begged for a referral to an interventional pain management specialist, my knee surgeon responded with, “Ann, get a life.”

Once I finally got to the pain management physicians, we worked our way through several factors that contributed to my back pain. There was a problem with my left kidney that was surgically corrected in 2009. I got some relief from the pain of stenosis through a 2011 back surgery. The sacroiliac joint pain has been treated with ablation of the sacral nerves and with steroid injections. The limited relief from these is not long lasting.

At the start of July 2016, I was on the phone with my pain management physician pleading for steroid injections. Once on the procedure table, I asked him for a referral to a physical therapist who could really help me with my “wonky pelvis.”  I think that this guy is the one, finally. So, I am ready for whatever he wants to try.

I am sure that someone will ask why anterior rotation should be so painful. Clearly, it places stress on a joint that is not supposed to move that much. I expect that there are some arthritic changes in the sacroiliac joint.

There are  numerous muscles that attach to  each aspect of the pelvic bone. The rotation causes problems for each of these muscles (the glutes, hamstrings, quads, the adductors, and the abductors and of course the hip flexors that objected so strenuously to my deep water work). The imbalance also impacts the corresponding muscles on the other side of the body.

There are also numerous nerves that run around and through the pelvis. Most people my age have experienced at least one “bout” of sciatica. My bout has lasted for 20 years.

I believe that relief is possible and that even if the pain continues, I will have increased mobility if the right innominate can be returned to a neutral position.

I need to be able to get into the deep water without my hip flexors going into spasm. I need the cardiovascular boost and the metabolic boost. I need the “feel good”chemicals that my brain makes when I push through the wall. Without them I am a really grumpy old woman.

I am gonna do my physical therapy homework. I think this therapist is on the right track and he will get nothing but my best. He has no idea how I am driven. He has no idea how I am persistent.

He will get an idea.



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