Canadian RMT Magazine Spring 2016 Apr. 2016 | Page 18

Human Silly
Putty
Treating Sacroiliac Joint Upslips

A

lthough ‘creep’ is an engineering
term, it also applies to human
tissue…the lumbopelvis in particular. Spinal and sacroiliac
ligaments, joint capsules, facet cartilages
and especially intervertebral discs are
viscoelastic and are somewhat similar to
silly putty. Leave a ball of putty on a table
overnight and by the next morning it’s
deformed into a flattened pancake. So be
it with humans (Fig. 1). We’re taller in the
morning than at bedtime, primarily due
to disc and fascio-ligamentous deformation that occurs throughout the day. Of
course, silly putty is much creepier than
discs, fascia or ligaments but, in time,
gravity combined with injury or overuse,
will deform, and sometimes strain, the
body’s connective tissues. As ligamentous creep turns to strain and the tissue’s
anti-gravity function fails, ligamentous
laxity may affect bony alignment and, if
the brain perceives that as a problem, the
person may experience muscle guarding
or pain.
Contrary to what many docs tell their
patients, most low back and pelvic pain
does not result from a single traumatic

18

By Erik Dalton, Ph.D.
lifting, bending or sports injury, but
rather from cumulative viscoelastic creep
due to lack of rest between loading cycles.
According to Bogduk and Twomey, “After
prolonged strain, spinal ligaments, joint
capsules, and IV discs of the lumbar spine
may creep, and may be liable to injury if
sudden forces are unexpectedly applied
during the vulnerable recovery phase.”1
Prolonged one legged standing is an
oft-overlooked culprit creating ligamentous creep that may be a precursor
to more serious conditions like joint
laxity, lumbopelvic instability, sprains,
and osteoarthritis. To demonstrate the
phenomena of creep, let’s look at the
myo-mechanics of a fairly common
pain-generating disorder called iliosacral
upslip or ‘shear’.
What is an Upslip?
In those presenting with true iliosacral
upslips, joint apposition between the
ilium and sacrum is altered, i.e., “the
sacroiliac grooves ain’t groovin” (Fig.
2). Since these superior shears are more
affected by gravity than other iliosacral
dysfunctions, they have almost a zero

chance of self-correction. During history in-takes, clients often report the
symptoms to be much more painful than
one would expect given the type of injury
they describe. Typically, when we see
this upward shearing force of ilium on
sacrum, the person’s SI joints are lacking
either form or force closure.
In form closure, SI joint stability is
dictated by a series of ridges and complementary depressions that produce fr