Snowboarding season is upon us here in Colorado and I can’t tell you how many times I have treated these athletes for sacroiliac joint butt-landing ligament injuries. These ligament failures accompany sacroiliac joint subluxations (misalignments less than dislocations) with attendant pain, stiffness and weakness. Depending upon the patient’s age and general health, immediate, accurate diagnosis and treatment will re-align the sacroiliac joints and heal the ligaments for uncomplicated recovery.
On the other hand, most people with chronic low back-hip-pelvis-leg pain, stiffness and weakness have, at some time in the more distant past, fallen on their butts and experienced the same injuries. Due to the long-term wear and tear of these injuries, these cases are often complicated by more severe ligament laxities, inflammation, cartilage loss and the pain of degenerative osteoarthritis.
I recommend that you take care of your sacroiliac joint ligament injuries and their attendant joint subluxations quickly and effectively. If you are still symptomatic after undergoing reasonable treatment, seek another opinion from a sacroiliac joint injury expert. Left unattended, these injuries can make your life miserable.
Neuromuscular re-education is an attempt to teach your body to move normally through analysis of your abnormal movement and then learning and practicing the normal movement. Theoretically, your normal movement patterns involve specific nerve signals transmitted through specific nerve tracts between your muscles and your brain. By practicing normal movement repeatedly over time, these nerve tracts become reinforced and these normal muscle movement patterns are learned and remembered. It is thought that normal muscle movement patterns are disrupted when nerves or muscles are injured, and normal movement may be regained through Neuromuscular re-education.
I find it is true that abnormal movement results from nerve and muscle injuries and may be relearned. However, it is my clinical experience that certain conditions must be in place for that to occur. Namely, movement-disrupting injuries are more extensive than those to nerves and muscles, and to restore normal movement, these injuries must be healed.
The traumas which injure muscles and nerves will most likely injure your joints too. In most of my cases, joint injury is the primary injury and the nerve and muscle injuries are secondary to (they are caused by) the joint injury. Joint injuries occur from both acute and repetitive stress traumas. Acute traumas abound in contact sports and motor vehicle collisions, where excessive forces sprain your ligaments, strain your muscles and bruise your nerves, and worse. Accompanying these sprains and strains are displacements of your bones from their healthy, neutral alignments within your joint capsules.
Your joints contain bone, cartilage and synovial fluid encapsulated by ligaments, muscles and membranes. Your joints contain nerve endings (mechanoreceptors) which deliver feedback such as information about the alignment of the bones within your joints, joint capsular pressure, ligament, tendon and muscle tension/tone and the position of your limbs in space. When your joints are injured, and therefore misaligned, feedback from these injured joints to your central nervous system becomes abnormal. You’ve heard the expression “garbage in — garbage out”. The control of the nerves associated with those injured joints is disrupted or lost and abnormal motion of the joints ensues.
In this case, treating the abnormal muscles and nerves without realigning the joint and healing the ligament and other soft tissue injuries can only go so far. Based upon my clinical experience, I propose that the injured ligaments, tendons, muscles and nerves will not effectively heal until their associated joints are realigned and are moving normally in the first place.