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Last updated: 7-28-11


The Upslip

 by Tom LeBlanc, PT

Symptoms of an Upslip
Do you feel as if you are walking on uneven ground, even though you know the floor is level? Does it hurt to sit too long? Do you sometimes misjudge distance, while walking through an open door, and bang your shoulder into the door jamb? Do you feel off balance and frequently have to catch yourself to keep from falling? Have you noticed yourself “running out of steam” much earlier in the day since having an accident or a fall? If you answered yes to any of these questions, you may be suffering from an upslip.

What is an Upslip?
An upslip, or superior ilium, is a condition where one ilium (pelvis bone) is slightly higher than the ilium on the opposite side.

Two things happen to your anatomy when you have an upslip condition:

1.     The sacrum (the base upon which the lumbar vertebrae are stacked) becomes unleveled.

2.     A functional short leg is formed because, as the ilium moves upward, it takes the leg along with it.

Anatomical changes involving the sacrum usually result in a variety of symptoms appearing in the lower back.

A functional short leg leads to balance problems. When one leg is shorter than the other one, it feels as if you are walking with one shoe on and one shoe off. This is what gives you the feeling of walking on uneven ground. This unevenness can cause you to run into door jambs as you leave or enter a room.

Other Indicators
Because the sitting bones (ischial tuberosities) are also uneven, people who suffer from an upslip condition typically experience sacroiliac pain while sitting, usually on the affected side, but in a small percentage of cases, on the opposite side.

Fatigue, early in the day, is another indicator of an upslip condition. An early “fatigue point” could mean that a person is working harder, to maintain balance, because of an upslip.

Brain and muscle work together to produce the effort needed to maintain one’s balance. Because balance is a function of the autonomic nervous system, people aren’t consciously aware of the processes involved.

When you have one leg that’s shorter than the other your brain, at a subconscious level, works overtime sending an abnormally large number of signals, along neural pathways, to numerous muscles that are involved in maintaining your balance while standing, walking and performing normal daily activities.

Those muscles expend more energy because they’re working harder, continuously, to make those minute adjustments that help you to maintain your balance. As a result, the upslip sufferer gets tired much earlier in the day.

To demonstrate how much energy is consumed in maintaining your balance, sit on a large balance ball and, without leaning against or holding on to anything, lift your feet off the floor (Have someone standing by to catch you.) Do this for several minutes. It won’t be long before you feel yourself becoming tired.

What Causes an Upslip?
Any force that pushes the leg or pelvis upward can cause an upslip. Typical causes of upslips are motor vehicle accidents, or falling onto one knee or onto one buttock.

An ilium can be shifted upward when the back muscles pull against it. This can happen while you’re bending, twisting and lifting. If you bend forward, rotate to your right, then lift a heavy object, the left ilium bone could shift upward, giving you a painful upslip on the left side.

Correcting an Upslip 
Physical therapists, skilled in manual therapy, are able to quickly assess your condition by observing your bony landmarks. They’ll look for an elevated ilium bone while you’re standing, sitting and lying in the supine (on your back) position. A functionally short leg will be apparent on the side of the elevated ilium.

While in the prone (on your stomach) position, an elevated ischial tuberosity will also be evident on the elevated ilium side. The physical therapist very gently rocks or pulls the functionally short leg to pull the elevated ilium back into its proper position. After making the correction they must then look for two possible secondary dysfunctions (pubic subluxation or posterior ilium) and correct these problems, too, if they are found to exist.

Usually, the correction is permanent, but, sometimes, the problem will mysteriously return for no apparent reason. When that happens, your physical therapist will look at the things you do or the ways in which you move that might place stresses on the pelvis that cause the condition to return.

If you suffer from any of the symptoms listed above, talk with your doctor. After he conducts a preliminary exam he may refer you to a physical therapist that’s skilled in manual therapy, to correct the condition. You may want to call physical therapists in your area and ask them if they are familiar with upslips.


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Tom LeBlanc PT has been a physical therapist for over 30 years. His experience includes working in all of the above caregiving environments. He is currently developing a FREE teleseminar on Caregiver Secrets. He also hosts Home Entrepreneurs News, a site dedicated to helping entrepreneurs and business seekers find the business that is right for them. One of his “featured Businesses” is detailed in his article, Become a Personal Caregiver.



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