It’s always fascinating to hear how patients describe what’s bothering them. When one patient with instability of her SI joint said her “leg feels disconnected,” this one stuck with us. Why? Because this is an acutely accurate description of what it feels like, so we thought we’d dissect this description a bit today.
What Is the SI Joint?
The sacroiliac (SI) joint is located where the sacrum (aka tail bone) and the back of the hip (at the largest part of the hip bone called the ilium) meet. There is a three-joint system located here known as the pelvic ring, and the SI joints (there are two of them as the image to the left shows) are part of this ring. The two SI joints live in the back of the pelvic ring while a single joint called the symphysis pubis lives at the front. The three joints work together to manage the forces that move up the leg and into the spine. Strong ligaments surround and support the joints.
What Can Make Your Leg Feel Disconnected
So what exactly causes the leg to feel disconnected? The hip joint is the connection point between the leg and the rest of the body. The femur in the leg and the acetabulum in the pelvis create the hip joint. So if the left SI joint, for example, in the back and the symphysis pubis joint in the front become unstable due to loose supporting ligaments, then the left leg, which is connected between the two joints, is likely to also feel a bit disconnected. Likewise, if the right SI joint were unstable, then the right leg might feel disconnected.
How This Patient’s “Disconnected” Leg Was Fixed
Despite “leg feels disconnected” sensation, we were able to successfully treat this patient’s “disconnected” leg feeling by addressing the SI joint. We did this by injecting growth factors derived from her platelets as well as a proliferant. This helped the ligaments tighten up. For the patient, she had been wearing a stabilizing SI belt all the time. After her treatment, she no longer had to wear the belt to perform normal activities. She is a skier and reported that this is the only time she now feels the need to wear her SI belt.
What About Steroids for a Painful SI Joint?
We say just don’t do it! While you may enjoy some temporary relief with an SI joint steroid injection, it’s only addressing the symptom, not the real problem, which is the instability due to the loose ligaments. Not to mention, the introduction of steroids is only creating more problems that you will no doubt have to deal with down the road. We’ve dedicated a whole blog to problems with steroid injections in the SI joint, which you can read here.
Treating the Symphysis Pubis Is Also Important
Treating the symphysis pubis joint at the front of the pelvic ring is just as important as treating the SI joint, yet many physicians who offer prolotherapy (or ligament injections) don’t know to treat that area. This particular patient did not want to treat her symphysis pubis instability a few years ago when we treated her SI joint, but as running is the next challenge she’d like to conquer, she is now ready to take that step to try to get even better control of her pelvic-ring instability.
Every good doctor knows that if you let the patient talk and just listen, he or she will tell you exactly what’s wrong. Sometimes, such as in the case of this disconnected leg, what’s wrong is much more accurate than the patient even realizes!