Hip OA related Sacral/Pelvic Torsion - Susan Westlake book

Nexus7

Hi all,

I am a 51 year old male diagnosed with moderate OA in my right hip. I recently purchased Susan Westlake's book, 'HIP Osteoarthritis CAN be Cured: Treating OA with Physical Therapy'. While I am of course keeping my mind open to whether this is a condition that can really be cured, after reading the first half of the book I can see that my condition/symptoms do seem to match what Susan herself suffered from in the book. My right leg does now seem 'longer' than the left and my right foot does want to point 'outwards' to the right rather than stay straight. After doing some of the self-diagnosis steps in the book it seems that I may also have a sacral or pelvic torsion of the sacrum which could also be now contributing to my discomfort/conditions. I am guessing that this has been caused by the OA or has actually contributed to the OA. My OA was most likely triggered by a physical injury 4-5 years ago in my right hip.

I wanted to ask whether anyone with Hip OA has successfully managed to use this book to help with their condition if they also self-diagnosed a sacral torsion. Ideally I would like to find a therapist or even a class where they specialise in rectifying a condition such as this.

Any help appreciated!

R

stickywicket

Hi,

I'm fairly sure this person used to come on here, some years back, advocating hanging from a trapeze (upside down, I think!) to cure hip OA. It never caught on😁

She may well have / have had mild OA in her hip and I can see that a twisted spine might be a cause in some cases though not most. But there is no cure for OA. Once it's there, it's there. Some people manage it very well and can keep going for years with a duff hip. My husband kept up his golf, hiking and gardening, the latter even though his were bone on bone. @jonr on here seems to do very well with regular exercising, diet and supplements.

You write " My right leg does now seem 'longer' than the left and my right foot does want to point 'outwards' to the right rather than stay straight. " Well, yes. If your hip joint is deteriorating that might well happen. But does that imply 'sacral torsion'? I suggest you enlist the help of a good musculoskeletal physiotherapist. If they agree with Ms Westlake then maybe it's true for you. But do beware of people who have answers (especially ones that require your money) to any form of arthritis. If they were right, would we be here?

jamieA

Hi @Nexus7

I don't know if this is of any help as I can't comment on the book. When I was in my early 30's I dislocated my right sacroiliac joint when I twisted round to catch a heavy item that was falling. I remember being told by the medic that one of the tell tale symptoms of his diagnosis was that one leg appeared shorter than the other when I was lying on the treatment couch. I was sent to a chiropractor/osteopath for 'manipulation' to sort it. This consisted of about 15 minutes of what I'd describe as all in wrestling but it did sort it.

Nexus7

Hi @stickywicket

Thanks for your comments. Yes, I do think I saw a comment from Susan on one of the forums. I appreciate that her views are going to be controversial as it does fly in the face of most conventional wisdom around OA. But I'm willing to give it a shot as long there is some science in there. And I must admit it sounds plausible that muscle imbalances can develop which cause the sacrum to twist which then has knock on effects on OA, pain, stiffness, etc... Now that probably won't solve my OA and magically regenerate my cartilage but it might well ease my pain/stiffness which to be honest is all I really care about :-)

Did your husband eventually have his hip operation? or how long has he managed with the diagnosis by himself?

Thanks for the advice about a muscoskeletal physiotherapist. If you happen to know one in London please feel free to share!

Cheers

R

Nexus7

Hi @jamieA

Thanks for your advice. Yes, I guess a chiropractor/osteopath might be able to help. But I have a 'feeling' that my sacral torsion is a result of a muscle imbalance which has developed over time and so probably is not going to be something they can just 'click' back into place. I sense that I need to work out which strengthening exercises I need precisely to rebalance the two sides of the spine so that it pulls everything back into a straight alignment...

Anyway, thanks for sharing your experience. Do you have OA of some kind now?

Cheers

R

jamieA

Hi @Nexus7

I've got inflammatory arthritis - psoriatic arthritis(PsA). That in turn has led to OA in my knees. It's nothing to do with the dislocated sacroiliac joint I had 30 odd years ago but PsA does affect the sacroiliac joints - in fact they did an MRI scan of my sacroiliac joints in 2020 as part of the diagnosis.

Nexus7

Hi @jamieA

I see... I don't really know much about PsA. Did you find anything that is working for you in terms of managing the symptoms for both the PsA and OA?

Cheers

R

jamieA

Hi @Nexus7

I'm on 3 different drugs for my PsA - sulfasalazine, methotrexate and the biologic adalimumab injection. That's keeping the PsA in check most of the time. I was told last year I need my left knee replaced and I'm waiting on an orthopaedic appointment presently - my right knee is starting to go the same way. I use capsaicin cream and lidocaine patches when necessary and wear elasticated knee supports. I try not to take painkillers unless absolutely necessary. I walk my dog 50-60kms a week and keep moving my joints as much as possible. My local health board have a system - nhsanywhere - whereby I have had a couple of 12 week one to one sessions online with a rheumatology physiotherapist, she then recorded a set of exercises for me and posted them on youtube which I access.

distantshores

Nexus - I also have osteoarthritis in my right hip which has progressed over a period of years from moderate to significant. I did the exercises from this book religiously for quite a while a few years ago but did not self diagnose  sacral torsion and this has never been mentioned by any medical professional. The exercises did help to a degree but unfortunately wear and tear osteoarthritis is not curable as far as I know and I have tried all sorts of things to avoid surgery!

I was first diagnosed about 12/13 years ago and have been managing it ever since but it is getting to a point now where it is likely that I will have to have a replacement and I have been referred to the orthopaedic team for further investigation/hip op. Everyone is different and over the last 12 years I have managed to continue with my life which has included quite a lot of travelling around the world. I take supplements and do a lot of exercise which has probably helped but it is unpredictable and could deteriorate very suddenly so I want to be prepared as the waiting time is long for a hip op. Makes it difficult to plan anything and I am currently debating whether to book a trip across South India in a year's time.

At 51 you are about 20 years younger than me so I would definitely give the exercises in Susan's book a go but ask for an x ray so that OA can be confirmed either way. Good luck

Nexus7

https://community.versusarthritis.org/discussion/comment/714171#Comment_714171

Sorry to hear about your condition but it sounds like you are finding a way to manage things for now. Hope you can continue with that until an operation as needed...

Nexus7

https://community.versusarthritis.org/discussion/comment/714196#Comment_714196

Thanks @distantshores ! Wow, you really managed to hold out for quite a while after your diagnosis. Well done on managing to maintain a reasonably active lifestyle with this condition. I am hoping I can do the same or at least until I hit 60 ideally. My logic is that at that age it probably will be an operation I only require once on that hip and won't need another revision surgery later in life... Are there any particular supplements or exercises you would say have brought the biggest benefits in terms of relief from stiffness, pain, range of movement?

distantshores

Nexus - Not sure what has been most beneficial really. I have led (probably) a more active lifestyle than a lot of people without osteoarthritis as since diagnosis I have managed to do another (easy) walking trip in the Himalayas, go on a camping safari in Botswana, been to Australia and many other places so I think it is mostly a matter of luck. I am not in agony but I am aware that it could deteriorate suddenly so that is why I am now at least getting myself on the list for hip replacement. I saw my mother and my sister reach a point where they could hardly walk and do not want to get there myself. I

As far as supplements are concerned I take turmeric, flaxseed oil plus a calcium/D3/K2 supplement for osteoarthritis. I take paracetamol sometimes but not everyday.

For exercise at the moment I am doing a mixture of Tai Chi, Dancercise, Nordic walking and go to the gym although I am doing less Nordic walking and more gym as I don't like walking in the rain! The poles help. I also have trekking poles which I took with me when I went on holiday last year and that enabled me to walk a lot further than I would have been able to do without them. It is not possible to increase the range of movement (I have been told this by physiotherapists). It is important to keep up/build up muscle strength around the affected area and I have been given specific exercises by physio for that. I have also done the exercises with Leon which are available on this site. There are several others offering exercises sessions on the VA site.

I will see what they say at the orthopedic clinic in December. I am hoping to hold out for another year as I want to go to India for one last time this time next year (not the Himalayas!!). However, I don't want it to get to the point where it is too late to have the operation. I mostly travel on my own and this is making me a lot more nervous now as it would be very difficult if the hip gave out somewhere and I was on my own. I hope I will know when it is time not to go somewhere on my own although I would be going to India with someone else.

In general I would say that it is a combination of supplements, exercise, determination (or rather fear of surgery) and a lot of luck that has enabled me to keep going for so long. The medics don't go by what they see on the x-ray but on how it impacts your life and I have been told that they have seen people with a lot less damage than I have who are in agony and need a replacement asap. It is unpredictable and, in my case, it could stay within manageable levels for the rest of my life or not. Who knows?

Good luck with it all.

Nexus7

Thanks @distantshores !

I'm mighty impressed with your accomplishments since your diagnosis! I also love hiking and walking in the Himalayas would be high on my bucket list :-)

I believe I am on a similar trajectory to you with the same diagnosis (right hip OA) also trying to follow the same regimen of supplements, exercise and determination/fear.

Out of interest when you started with Susan's book did you notice that your right foot pointed 'outwards' or to the right and did it feel like you had/have a leg length discrepancy? My right foot definitely wants to point right and it does feel like my right leg is now longer than my left which I can only really explain by a sacral torsion...

distantshores

Hi @Nexus7 Just picked up this thread as I haven't logged in for a while. I don't think my right foot points to the right but one leg does feel longer than the other. I think the the right leg feels longer than the left so I suppose something is out of alignment (the pelvis)?

I am continuing with my supplements and exercises. I have just had a week in the Canary Islands and I took my walking poles with me. I find them very useful as they take the strain off the hips and I was able to walk quite a long distance along the beaches. I am seeing a private consultant next week so I have a list of questions to ask. I am hoping to avoid hip replacement until later on this year so I can make a trip to India in October. Not sure how I will manage getting on a train there but will see!.

Susan Westlake seems to have disappeared. She ran a forum linked to her book but when I last looked the forum seemed to be inactive. Will check it out again.

How are things progressing?

Nexus7

Hi @distantshores , just saw a notification you had sent a new message...

My right leg also feels 'longer' than my left and if I try and stand with both feet together pointed straight ahead that feels quite difficult/awkward with a few muscles around my right hip complaining about that position...

Since last we spoke (November 2023) I have taken the following actions:

1) Been to see a osteopathy practictioner (I had seen him write an online article about pelvic torsion so I was hoping he could help). Results are mixed and the methods he is using seem a little 'strange' compared to more traditional physiotherapy, etc... Jury is still out on this approach for me at this time...

2) On suggestion from the osteopathy I engaged in a full biomechanical assessment. I know I have developed certain muscle imbalances over the last few years as a result of or as a contributor to my condition and I wanted a more scientific approach/report on the actual variances between muscles - both left to right sides of the body and also muscles on opposing sides of a joint which is suggested should be kept at a certain strength 'ratio' (eg, hamstrings should be 60-70% strength of the quadriceps). The report is quite useful although I already had a strong suspicion about certain areas like very weak glutes and hamstrings on both sides but exaggerated on my symptomatic side.

3) Started on the Joint Pain Program being run by Nuffield Health in my local gym. This is a 12 week program designed to get people effected by joint pain on a path to reducing chronic pain and increasing muscle strength. The program is a little generic but I am using my report from step 2 above to help 'customise' my training program to focus on my specific areas of weakness/imbalance.

I haven't been able to track down Susan Westlake despite reaching out through a few channels. I have yet to completely immerse myself in the routine as described in her book so that is something I might also do in the coming months...