When to Educate and Why SI Joint Dysfunction Is a Myth

Peter does not educate during the history. He reflects and asks questions, then uses the examination to expose the person to feared movements, such as bending or sitting, while calming their breathing and guarding. When the expected harm does not come, that violation of expectations opens the conversation about a broader understanding of pain. He stresses that this is doing therapy, not talk therapy, and that passive treatments clutter the approach. On the pelvis, he explains that the degree of ligament laxity in pregnancy does not correlate with pain or disability. A prior history of pain, sensitization, poor sleep, stress and low mood are stronger predictors. His group has also found that joint hypermobility in young people does not predict disabling back pain. He describes a woman with a fused pelvis who still tested positive on the active straight leg raise, and a CT scan showing no sacroiliac movement during so-called torsion tests. Clinical tests reflect sensitivity and guarding, not instability.