Hip Misalignment & Mechanical Issues

[JJKVI]

I posted a few weeks ago and you recommended an evaluation by a Chiro or PT. My GP wouldn't do so without first doing an X-ray to check for scoliosis... which came back negative. She referred me to a PT.

I have seen the PT 5 times now and we seem to still be in the investigation stage. She has found that my hips are misaligned... hip flexors tight... the quad lumborium (?) and transversus abdominis (?) very tight...pelvis not giving...hips not rotating upon certain movements (marching, kicking back, etc.). Monday during a hamstring stretch with the PT I irritated the SI joint (a new symptom for me.) She feels it is all mechanical although not exactly sure the cause and quite frankly I feel like she's a little unfocused as to the best plan of attack (although like I said she may still be in the investigative stage since I suppose these things are not always clear cut.)

Is this something that Chrios treat? Since it's all soft tissue and mechanical I wasn't sure. I am considering getting a second opinion and I think I will have to demand a referral to a Chiro from my GP. I'm getting the impression she will not suggest it herself. I am sure she will want to do an MRI although neither the PT nor I see anything that suggest a disc problem but I guess you never know. Regardless of whether there is a disc issue I agree with the PT that there are mechanical issues that need to be addressed. For instance, I never realized before that I stand like the Elephant Man.

[JJKVI]

I'm just posting a follow up since I know I hate when I find posts on point but then you never find out what worked! I reached my breaking point after being "diagnosed" with arthritis and referred to a pain management clinic. I say "diagnosed" because the x-rays did not show any arthritis (nothing other than normal changes for my age)... and my pain was not in my joints. It was soft tissue.

Refusing to resort to drugs for a solution, I started asking around re: a chiropractor & kept hearing the same name over & over again from satisfied patients. So, I went and he diagnosed trigger points -- lots of them. They seemed to be everywhere! My groin, around the pelvic area and from my shoulder blades on down to my buttocks. It's been about two months of manual trigger point therapy... which is very painful, I'll be upfront about that. It's right up there with childbirth IMO. But, we've worked them all out except for a couple in the quandratis lumborium (sp? sorry)... which is the very lower back - from the small of your back to top of your pelvis. The trigger points here are deep, old & tough.

I'm not misaligned anymore. And while I'm not ready for deadlifts yet, I am back to running and doing pilates mostly pain free. I hope these last knots can be worked out. I may need to consider trigger point injections, although I haven't discussed this with my Chiro yet. I don't think he does them or is in favor of them. But I definitely feel a lot better than I did before and he's done more for me than any medical dr., PT or medicine has. Hope this helps someone!

[Onoceobi]

In case any of this is helpful :).

I had occasionally disabling lower back pain for nearly twenty years (ruptured disc / lifting injury) before dislocating my sternum (without knowing it) forced me into a hunchback type position. This caused a 7yr nightmare of growing upper body, neck and throat symptoms but completely resolved my lower back pain despite new hip girdle instability. After my sternum was back in place and my 'hunch' (kyphosis) reduced back to 'normal', my lower back pain returned. So your original post of the relationship between the upper back/ paraspinal tightness and your hips issues / lower back pain makes sense to me.

I understand my injury is a rare one and that is why it went undiagnosed for seven years but in that time I came to find that Rolfing or KMI Structural Integration (Anatomy Trains) appears to have the best answers regarding our muskuloskeletal structure - especially with the concept of Tensegrity. I can't have the full treatment yet (awaiting a surgical opinion re manubriosternal instability) but I have had brilliantly transformative whole body results with just two treatments and *far better explanations* for my symptoms then I ever found in all those years of trying Medicine, Physiotherapy, Chiropractic, Osteopathy, Massage and Occupational Therapy.

If a tent isn't standing up straight, you don't adjust the poles (bones), you adjust the guy wires (soft tissue). 'Soft tissue' includes fascia (what KMI specifically works with) but mainstream medicine have traditionally behaved as if it doesn't exist and thus the first ever scientific conference on fascia wasn't held until 2007.

I don't live in the USA so I don't know about insurance but if you find a KMI practitioner then they will probably be covered under Massage Therapy. My two treatments stopped all of my lower back pain and stabilised my unstable hip girdle (it moves quite differently) which has given me a much more stable and stronger structure in 3D gravity (ready for the surgery that will hopefully help toward stabilising my upper body / shoulder girdle). It may work for you.

[mkh9]

Personally I don't trust Chiropractors (sorry to the doctor present).  Frankly after being injured badly twice by two different Ph.D. level PT's I don't trust them much either. I have a similar problem and it is myofasical pain syndrome plus I can't cross my left leg right. I had hip X rays as well as an MRI and they are fine. I had 5 different doctors, pain doc, neurologist, physiatrist, GP, and integrative pain medicine  all say it is muscular. If I were you I would get the MRI just to make sure and rule out any bone structure. The first PT that injured me said I had misaligned pelvis and my  SI was out. These were not true and if you read the literature it is very uncommon except when pregnant to get an SI joint going in and out like they try to tell you. I would go to a good orthopedic surgeon to have the MRI read and ask where to go from there. Tell him/her the comments the PT made and the chiropracter on this site and see what they say. You most likely don't need surgery I would go to the  ortho surgeon just to have them confirm that it isn't a misalignment. You can also get hip Xrays like I did in addition.  I have had this for 1.5 years and finally am healing after starting walk more and more and now i'm up to 1 hour walking. I take flexeril and an NSAID daily plus slow magnesium and am long off of  pain meds even though I do have pain. The leg still won't cross right but I was told to get the pain down first then work on the leg and strenthening. I am doing biofeedback to get my fight or flight symptoms down and correct my breathing and anxiety which is helping (even with the pain) and doing accupunture as well, though I didn't believe in it before I have had some pain relief from it. After the orthopedic surgeon then go from there. I have had so many friends get injured by chiro's. Good luck I know this is hard but hang in there.
mkh9

[JJKVI]

Sure, you can ask... it basically comes down to money. My insurance does not really cover Chiropractic care (after a $500 deduction they pay about $20 per visit).

The PT visits are almost wholly covered when referred by my GP.

My question was whether Chiros treat this type of condition and I ask because 1) everyone I know who goes to a Chiro has a disc issue not one like mine, 2) The GP and PT have basically acted like a Chiro isn't the one I would see for this condition, and 3) I don't want to go and spend money seeing a doctor just to have them tell me this isn't something they treat... go see a PT.

Anyway, I gather from your answer that yes, even if the PT's evaluation is correct this is something a Chiro could treat. Thanks for your help.

[Adam Tanase, D.C.]

If I may be so bold, what's stopping you from picking up the phone and scheduling a chiropractic appointment?

You don't need your MD's permission to speak with a chiropractor... And considering neither MD or PT has solved this problem, why are you banking on their unproductive opinions that it's strictly soft tissue?