A particularly pleasant gentleman entered my office recently with left sided low back pain after raking up the pine needles through his own yard. He had spoken to a physiotherapist who had described his problem as “a rotated hip”, which was explained in “one leg being longer than the other”. He had heard that chiropractors commonly treat a problem like his, so he entered my office seeking help.
First of all, I had to clarify that it was not really his hip joint that was causing his problems. The “hip joint” is the ball and socket joint between the bone of his thigh (femur) and a bone in his pelvis (ileum). I continued by telling him that his pain was actually being caused by the “sacroiliac joint”, which is located in the back portion of his pelvis. Health care practitioners and patients alike mistakenly call the “sacroiliac joint” the “hip joint”. In fact, the sacroiliac joint is much different than your hip joint. There is one sacroiliac joint on each side of the back portion of your pelvis, made up of a sacrum bone in the middle (where the bottom of your spine attaches to and your tailbone projects downwards from) and an ileum bone (the large bone you feel at the side of your waistline).
The sacroiliac joint on each side of the pelvis is a very common and often misdiagnosed source of low back pain, which may or may not cause pain or numbness to travel down into the groin or leg (sciatica). This particular gentleman put too much stress on his left sacroiliac joint as he repetitively reached forward and twisted his lower back with each stroke of his rake. Although he was not in any pain prior to raking his lawn, it was likely that the individual mobility of his low back and pelvis joints were not at their full potential to begin with. Therefore, when he challenged these joints by working long and repetitively, they could not handle the stress and inevitably became sore and inflamed.
As for the leg length difference, this is a complicated item to explain accurately so lets see if I can help you understand. The movement within the sacroiliac joints allows the ileum bones at each side of the pelvis to rotate or “tip” forward and backward. This motion occurs when you walk, run, bend forward, bend back, or raise your knee to your chest. In the past, it was thought that the sacroiliac joints did not move at all. However, high quality medical studies have shown that they do move and actually play an important role in actions I just mentioned. One of the sacroiliac joints can become “restricted” or “jammed” in a “rotated forward” or “rotated backward” position when they are injured or even simply become stiff. It is very important that you understand that the sacroiliac joint does not have to be injured or sore for this to occur! As we discussed above, the real “hip joint” is made up of the pelvic bone (ileum) and the thigh bone (femur). Therefore, if the left ileum were rotated forward or backward, it would have a direct effect on the left leg. For example, if this gentleman was lying down and his left sacroiliac joint was jammed or restricted in a position that had the left ileum “rotated forward”, his left leg would appear shorter than the right when you compare the bottom of his heels. The other possibility, and what this gentleman actually had, is when the left ileum is rotated backward. This made his left leg appear longer than the right. I hope this explanation makes sense to you. If it does not or you think you have one leg longer than the other, please drop by my office so I may clarify it for you further.
As far as treatment goes, the task of the chiropractor is to restore the proper positioning and mobility of the sacroiliac joints. He or she does this by performing a series of treatments consisting of “manipulating” or “adjusting” the affected joints. Once this mobility is restored, the remaining treatments are done to maintain it that way until the joint is able to heal fully and naturally.