Unerstand the PIEx SI Joint Gonstead Adjustment
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The pelvis is the foundation of your spine, and the ilium (hip bone) can move in several different directions. In the Gonstead System of Chiropractic, we don’t simply identify that an ilium is “out of place.” Instead, we determine the exact direction it has misaligned so a precise adjustment can be delivered.
There are two primary movement patterns we evaluate when looking at the ilium listing in the sacroiliac (SI) joint.
The first is Anterior Superior (AS) versus Posterior Inferior (PI). Imagine the ilium rotating around the sacroiliac (SI) joint. An AS ilium has rotated forward and upward, while a PI ilium has rotated backward and downward. These opposing positions can alter the mechanics of the pelvis, affect weight distribution, and place abnormal stress on the SI joint, lumbar spine, hips, knees, and surrounding muscles and ligaments.
The second movement pattern is Internal (IN) versus External (EX) rotation. This describes how the ilium rotates toward or away from the center of the body. An IN ilium rotates inward toward the sacrum, while an EX ilium rotates outward. These rotational changes can influence hip motion, walking mechanics, and muscle balance throughout the lower extremity.
In many patients, these movements occur together. Rather than having only a PI or only an EX listing, the ilium may develop a compound listing, such as PIEX, PIIN, ASEX, or ASIN. Each combination represents a unique three-dimensional misalignment of the pelvis. This is why no two patients necessarily receive the same adjustment, even if they have similar symptoms.
At Gohl Clinic of Chiropractic, we use the Gonstead System to identify the exact listing through a comprehensive examination, including patient history, visualization, static and motion palpation, instrumentation, and X-ray analysis when indicated. By determining the precise direction of the subluxation, Dr. Kametz can deliver a specific adjustment designed to restore normal biomechanics rather than simply treating pain.
Our goal is to improve joint function, reduce abnormal stress on the surrounding tissues, and allow your body to heal and move the way it was designed.
In this video, you can see there are two ways to adjust the PIEx ilium. A pull, which emphasizes the Ex listing or a push to emphasize the PI listing. Depending on the patient’s anatomy or flexibiliy, you can do it either way. Here, we can see it was easier for the doctor to take out the slack with the push.