sacroiliac joint dysfuction

so i have had low and mid back pain for some time now,that sometimes radiates into my hips and butt, no real health insurance just accident insurance so i hvn't been to a doc. From talking to people and my own research on the interweb, it sounds like i have some issues with my SI joint. I did a search i couldn't find a thing on SI joint dysfunction, yet everyone i talk to about it says its a very common thing and really isn't serrious. May not be too serrious or debillitating but the pain can be very annoying at times and i don't want to go through ski season like this. Any one else had issues with the SI joint, any suggestions, chiro, pt, ect...

Find a yoga class for old people not taught by an aerobics instructor. Go regularly and learn the poses that loosen up your hips, hams, quads and strengthen your core. I dealt with it w/o insurance for quite a while now that I have insurance a Chiro, massage therapist and yoga are part of the maintenance routine.

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Originally Posted by SuperChief

Find a yoga class for old people not taught by an aerobics instructor. Go regularly and learn the poses that loosen up your hips, hams, quads and strengthen your core. I dealt with it w/o insurance for quite a while now that I have insurance a Chiro, massage therapist and yoga are part of the maintenance routine.

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hmmm, thanks, i've been doing on and off anusara yoga for while now, seems to help somewhat, but not complete releif....yoga never really agrivates it, but it doesn't seem to be getting better, the yoga class is fairly tough, am i pushing it too hard and should find a easier yoga class, or should i stick with it as long as the pain doens't increase?

if your SI is misaligned a good PT or chiro should be able to re-adjust you. After your SI is adjusted and begins to stabilize you'll need to do some extensive core work to get things and keep thing strong.

1. I think your diagnosing yourself based upon talking to others and reading the Internet is similar to learning to ski by talking to others and reading the Internet.

2. I do have "SI dysfunction" or basically I injured some SI ligaments a few years ago. My P.T. saved my ass. It was brutally painful but some vitamin I (ibuprofen), manipulation, heat, ultrasound, cold and teaching me certain stretches to do routinely saved my atheletic life. The pain and spasm will crop again for me but I generaly can 'work it out'.

3. I have found that independent leg exercises exaccerbate my symptoms. So one-legged leg extensions and curls, one legged squats, lunges, single leg plyometric are on my avoid list for the most part. That sucks because they are great excercises but they usually lead me to seak out the nearest smack dealer.

Good luck.

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Originally Posted by Jim S

1. I think your diagnosing yourself based upon talking to others and reading the Internet is similar to learning to ski by talking to others and reading the Internet.

2. I do have "SI dysfunction" or basically I injured some SI ligaments a few years ago. My P.T. saved my ass. It was brutally painful but some vitamin I (ibuprofen), manipulation, heat, ultrasound, cold and teaching me certain stretches to do routinely saved my atheletic life. The pain and spasm will cro again for me but I generaly can 'work it out'.

3. I have found that independ leg exercises exaccerbate my symptoms. So one-legged leg extensions and curls, one legged squats, lunges, single leg plyometric are on my avoid list for the most part. That sucks because they are great excercises but they usually lead me to seak out the nearest smack dealer.
Good luck.

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yes i do see your point, but the person who i talked to was a pt and did some simple tests, and said it appeared to him at the time (at a party, yes we both had been drinking) a "stuck" or twisted SI joint, and the symptoms i read about on the net are pretty much exactly the symptoms i experience. i also find tight/sore hamstrings really make it hurt worse, never really thought about the independent leg exercises, i will definately consider it when at the gym. the one thing i find odd is that i can't really relate the pain to one specific injury, just started hurting one day last summer and never been the same since.
thanks

Ditto. My spasm occured gradually over a few days out of the blue to the point where I could barely move. It was unreal. I was very VERY scared that it was a huge disc.

I did have an MRI to r/o a disc. I didn't think I had one but just to check since...well....I read them all the time.

So contrary to what others are saying, my SI problems were never solved by any specific physical therapy. It really depends on if this is an acute injury that could just be realigned, or if it is a structural issue.

I've had sciatic pain my whole life, and it can be debilitating, and very frustrating and painful emotionally. Sometimes I have phases of a few months when it gets worse. It happens if I'm working out too much (and not stretching, muscle tightness), or not working out at all (imbalance of muscle strength among quads, hammies, ab and adductors).

Yoga saved me, and got me off of painkilllers years ago. After a lot of PT, acupuncture, yoga, massage etc, I've been told that either my legs are slightly different lengths or that my pelvis is slightly twisted. The hardest part for me was accepting that my body was not exactly symmetrical - no one's is. Once I learned to stop trying to make both sides behave exactly the same, and learned to accept that one side is going to be tighter, weaker, different feeling than the other side, then I could stretch and work out without over-doing one side which just exacerbates the problem.

Do some real Iyengar yoga, none of that fast-paced fitness kind of yoga. Learn the poses that stretch your piriformis - that will be key in keeping your SI joint loose and relieving the tension that builds up in your glutes. Treat both sides the same and let your body do what it wants. You can't really force it, but over a long period of time I think it's possible to structurally realign your body.

Every year I go into a ski season with the fear that the pain/discomfort will stop me from skiing, or make for a miserable season. So far it hasn't happened, and I go sometimes months without thinking once about my back. It won't stop you from skiing, and there is definitely relief in sight!

If you have any questions hit me up, been dealing with this for a long time :)

ortho-bionomy.org

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Originally Posted by splat

ortho-bionomy.org

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yeah looked into it, but the closest practitioner to me is in moab, and i am in slc

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Originally Posted by thebigeast

yes i do see your point, but the person who i talked to was a pt and did some simple tests, and said it appeared to him at the time (at a party, yes we both had been drinking) a "stuck" or twisted SI joint, and the symptoms i read about on the net are pretty much exactly the symptoms i experience. i also find tight/sore hamstrings really make it hurt worse, never really thought about the independent leg exercises, i will definately consider it when at the gym. the one thing i find odd is that i can't really relate the pain to one specific injury, just started hurting one day last summer and never been the same since.
thanks

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SI problems don't necessarily relate to injury.

Here is my advice: find a good chiro, this is their bread and butter. Don't just let them diagnose and adjust you, ask for exercises/rehab. If you don't like chiros, go find an osteopath.

Then it becomes a question of building up core strength. And no, this doesn't mean just doing crunches/sit ups/back extensions. It means doing things that work the little stabilizer muscles, fitball exercises and the like. Good coor rehab, some yoga focusing on opening up the hips, and chiro will do wonders.

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Originally Posted by Jim S

Ditto. My spasm occured gradually over a few days out of the blue to the point where I could barely move. It was unreal. I was very VERY scared that it was a huge disc.

I did have an MRI to r/o a disc. I didn't think I had one but just to check since...well....I read them all the time.

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Jim, if you ever get gobsmacked with that SI pain again, get a hold of me, so I can send you in to try orthobionomy. A man of the cloth such as you would make for a great testimonial about this bodywork I've been raving about.

I was diagnosed with SI joint dysfunction a few weeks ago. My doc sent me for an MRI, and then to a back specialist. I was given a pain killer injection in the left SI joint to make sure that that was the problem. They also gave me a steroid shot in the SI Joint. Has made a big difference in the pain and also has helped with the inflexibility I have been experiencing. But I am still having pain, but it isn't the chronic pain that basically was so debilitating. I couldn't run, bike, hike, drive or lift a bag of groceries. My MRI also showed some slight disk bulging in one disk. (Top disk in my tail bone, L-5 IIRC)

I'm going back to the doc for a follow up on Friday, so I'll ask about what I can do to help strengthen that area of my core. Would appreciate any feedback on what you guys do specifically in terms of core training/yoga to help stabilize your SI Joint. Do any of you deal with pain near your groin area too? I've got pain that sometimes shoots down the inner part of my left thigh right near the crotch area.

Thanks.

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Originally Posted by Danno

SI problems don't necessarily relate to injury.

Here is my advice: find a good chiro, this is their bread and butter. Don't just let them diagnose and adjust you, ask for exercises/rehab. If you don't like chiros, go find an osteopath.

Then it becomes a question of building up core strength. And no, this doesn't mean just doing crunches/sit ups/back extensions. It means doing things that work the little stabilizer muscles, fitball exercises and the like. Good coor rehab, some yoga focusing on opening up the hips, and chiro will do wonders.

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Words of wisdom. Especially finding a good chiro. If I had to pay $200 for every adjustment out of pocket, I'd still go to the same guy I see. Chiro to stop the pain, stretching/exercise to keep it away.

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Originally Posted by Danno

Good coor rehab, some yoga focusing on opening up the hips, and chiro will do wonders.

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Coors rehab and focusing on Yoga's hips opening.
Damn, that girl has one hell of a handle on therapy.

Danno - osteopathy fully embraces ortho-bionomy.

finally maned up and went to a cairo the other day....its a guy who specials in network cairopractic (ortho-bionimist suggested this type) and he gave me some interesting insight into whats going on with my condition..apparently its not just my si joint that is out of wack...my hips and lower back are all out of wack and uber tight, he says in 35 years of cairo h4e has never seen someone with as much tension in my back under the age of 40 (me 26), and as a result my left leg is 1.5 inches sorter than my right, its not in the bones but my hips are soo out tight that it makes me leg shorter and my left shoulder drop by about 1.5 inches.. went to see him once so far(tension in back already reduced greatly) and wants me in another 5-10 visits over the course of the next few months...really psyked to have some real insight as to what was causing my pain and glad to see its not disc related....

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Originally Posted by thebigeast

went to see him once so far(tension in back already reduced greatly) and wants me in another 5-10 visits over the course of the next few months...really psyked to have some real insight as to what was causing my pain and glad to see its not disc related....

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thats a good sign he is not a snake oil salesman, the chiro's you want to avoid will try to sign you up for a long term high $ plan with money up front ,take scans & x-rays they want to charge you for and claim they can cure diseases besides back alignment probs

I've had probs for almost 20 years after a minor getoff from a mtn bike .It didnt show on x-ray ,chiro's could move IT but never really fixed IT and at the worst IT could be debilitating for a few days .

In spite of being active with running ,all types of skiing,ww kayak ,mtn biking ,I had a weak core .I started with beginner yoga at the YMCA which I found pretty boring but that class was good to get down the proper form and eventualy went to Fusion classes which are pilates & yoga combined .

No reoccurances since doing a couple of years of regular fusion ,also the classes are 80% young women so the scenery is pretty good

for me the big exercise was/is warrior pose ,my bad side is my right side,if I do the warrior pose with my right leg BACK while I force my RIGHT Hip forward it helps a fair amount .I used to have to get out of my playboat on the river and do this one cuz jamming into a playboat was hard on the sciatic

Just a follow up on the SI Joint. I've been seeing a PT who is an Osteopath. I've had 4 sessions so far, and learning the exercises to strengthen my core and all the stabilizer muscles in the hips, lower back and glutes. My PT is amazed at how flexible I am. For a guy, she says, I'm more flexible than just about any woman she's ever seen. (This is something I've know my entire life.) The curse for me is that my muscles and especially my SI Joint, which is stiff, have a tough time dealing with my flexibility when I am active.

In any event, I still have a bit of pain now and again but hope that through working with a PT, that I'll be able to eliminate or greatly reduce the occurence of pain. But having had that SI Joint steroid shot did wonders for virtually eliminating a large amount of the pain I was feeling.

bumping this thread because i'm in a shit ton of pain do to sacroiliac joint dysfunction right now. tried to go skiing, bad idea, pain got worse, rested a few days, tried to go for a bike ride, felt fine on the bike but the next day the pain was trough the roof. I'm wearing a brace now and the pain is just driving me nuts. there is no position i can be in that doesn't hurt, besides laying in bed.
just wanted to rant and see if there is any more advice out there.

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Originally Posted by EVC_CO

bumping this thread because i'm in a shit ton of pain do to sacroiliac joint dysfunction right now. tried to go skiing, bad idea, pain got worse, rested a few days, tried to go for a bike ride, felt fine on the bike but the next day the pain was trough the roof. I'm wearing a brace now and the pain is just driving me nuts. there is no position i can be in that doesn't hurt, besides laying in bed.
just wanted to rant and see if there is any more advice out there.

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IME, it is a good idea to go see your doc. I wish I had followed that advice years ago when I injured my SI joint. I reaggravated mine over Thanksgiving. Of all things I bent over to pick up some wood, and it slipped out, and just hurt like hell. I haven't had a chance to start doing my core exercises for a week but plan on starting tonight along with some stretching exercises that my PT gave me to do. If I still have pain issues after a few weeks, I am going to wuss out and go see the same back specialist I went to the first time I injured my SI, and get a steroid shot to help with the healing.

I signed up for a shot, going to see if that helps, but still need to fix the root of the problem. one of my issues is that my hips are out of alignment and my left leg is longer than my right, trying to 'fix' this issue through 'sacrol corrections' in PT I think has contributed to this SI pain (I did not have the pain before doing PT for my L5/S1 microdiskectomy rehab).

posted in another GC thread that i'm looking for a good ortho in the south denver/littleton area that has experience with lower back pain primarily.

See my first post above. There are ortho-bionomists in Denver, I believe.
SI joints are something they fix spectacularly well.

Try Physiotherapy Associates in Greenwood Village (in Greenwood Athletic Club) -- I spent a good portion of several years dealing with the same thing .. .I also have a leg length issue, and too much flexibility in there. But I am really good now. I've had probably only three adjustments in the past 4 or 5 years.

I looked into them already, but my insurance (BCBS) doesnt cover them :(

They'll cover it if you get a doctor to prescribe it.
Or you could just drop $100 for a visit and be done with it.

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Originally Posted by splat

They'll cover it if you get a doctor to prescribe it.
Or you could just drop $100 for a visit and be done with it.

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would you see an 'associate member' or just a 'practitioner'?

the closest practitioner is an hour away.


Spook, sorry to hear about your issues, i've been in the chronic pain boat since about 05 but with some extended periods without pain. I haven't been to a chiropractor yet, only 2 orthopedic surgeons with Denver-vail orthopedics and my PT with Denver physical therapy.

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Originally Posted by splat

They'll cover it if you get a doctor to prescribe it.
Or you could just drop $100 for a visit and be done with it.

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The Blue Cross plan does not require a script/referal for PT. It comes down to whether they cover the treatment, or if the provider is a BC member.

oh, and EVC is a penny pincher (he calls it frugal :rolleyes:) and will pay out of pocket as last resort. :wink:

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Originally Posted by EVC_CO

would you see an 'associate member' or just a 'practitioner'?

the closest practitioner is an hour away.


Spook, sorry to hear about your issues, i've been in the chronic pain boat since about 05 but with some extended periods without pain. I haven't been to a chiropractor yet, only 2 orthopedic surgeons with Denver-vail orthopedics and my PT with Denver physical therapy.

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Go to a practitioner, see if you can find someone who is an instructor.
Call around and ask who is the best. Some people are better than others and really have 'the touch'.

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Originally Posted by thebigeast

so i have had low and mid back pain for some time now,that sometimes radiates into my hips and butt, no real health insurance just accident insurance so i hvn't been to a doc. From talking to people and my own research on the interweb, it sounds like i have some issues with my SI joint. I did a search i couldn't find a thing on SI joint dysfunction, yet everyone i talk to about it says its a very common thing and really isn't serrious. May not be too serrious or debillitating but the pain can be very annoying at times and i don't want to go through ski season like this. Any one else had issues with the SI joint, any suggestions, chiro, pt, ect...

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I have trouble with my SI joints. Actually screwed it up a few weeks ago and have been stalling on going to the chiro but have to call and see about tomorrow. Have had problems for years and dicked around with doctors and specialists who just wanted to Rx me pills and nothing did anything. Finally sacked up and went to a chiro and holy shit man, talk about flipping a switch. One pop and I was brand new. Once you get adjusted a few times you can usually just do it yourself lying in bed, stretching etc. Only when I do something to really screw it up does too much tension build up to self-alleviate it and I need to go back for another session.

Once you've got your pain under wraps, I'd start doing major core exercises. Abs, back, hip lexors, all that jazz. Me being lazy in the off season has probably lead to the resurgence of the pain, so I've got to get back on the horse for this season so to speak.

Best of luck, nobody ever wants to deal with back pain. Ugh, the worst.

I'm curious as to what type of leg strength training exercises everyone does, who has SI joint issues. I no longer do barbell squats, which is how I originally injured my SI. The PT facility I used to go to for rehab, had a few really cool machines for strength training of quads and glutes but I just don't have the kind of dough that I can shell out on a regular basis to go their exercise facility.

Some of the exercises my PT gave me was a bosu ball and one legged lunges, or lunges with the top of one foot resting on a bench. Also, wall Squats, and weighted lunges with dumbells. Other than that, I really don't do any other strength type exercises for the legs, so just looking for suggestions to vary the routine.

I also do bench step ups with kettle bells or dumbells. But those start out real slow and with no weights as I really need my core in shape or I can feel my SI during the early season.

with regard to SI joint shearing any strengthening should be done once your in a more normal alignment otherwise you are reinforcing the pattern and malalignment. assuming normal alignment is acheived, hip rotator strengthening, especially internal rotator and adductor groups which help to pull the two pelvic bones together, then abductor/trunk stability synergy work, then extensor/flexor balancing. as with anything, careful to notice how your pelvis and lumbar spine are also moving when you perform any of the motions, you can then choose to perform the motion with pelvic stabilty or with integration of the spine and pelvis, start lying on the floor to get acqainted with the influences, then move to standing, then move to more dynamic(bosu, bongo boards, skateboards, etc)

2 types of leg/pelvis mobility to consider:

1.the femur rolling under the pelvis (this will be lying down or sitting with feet free from the floor)
2. the pelvis rolling over the femur (think standing weight shift, standing rotation, single leg stand pelvic motion)

its always better to have someone assess you, a large number of symptomatic joints are related to the immobility of the opposite side, the more you strengthen a hypomobile joint the more your f'in yourself.

good luck

Turns out my pain is most likely coming from my L5-S1 Facet joints, I received a steroid injection to that joint yesterday and keeping my fingers crossed that the pain will decrease soon.

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Originally Posted by Toadman

I'm curious as to what type of leg strength training exercises everyone does, who has SI joint issues.

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for a stretch warrior pose with the leg of the offending hip out behind you ,drive the hip forward will help alot, my chiro will have me sit on the side of the bench with one ass cheep supported and drop the leg of the offending hip down ... same thing more or less as warrior pose motion

update: the injections were a success, the dysfunction was in fact L5-S1 facet joint and not SI. They are right next to each other so it's an easy misdiagnosis.

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Originally Posted by XXX-er

for a stretch warrior pose with the leg of the offending hip out behind you ,drive the hip forward will help alot, my chiro will have me sit on the side of the bench with one ass cheep supported and drop the leg of the offending hip down ... same thing more or less as warrior pose motion

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I actually had been given those techniques by my PT several years ago, but had forgotten about them until I did a bit of research on line. In fact, I dropped everything I was doing, and went and did exactly that, and the minor pain/discomfort went away completely. I now do that along with a few other stretches, that I had been neglecting, along with dusting off a resistance stretch band and really working those smaller core muscles. The one exercise that helps me the most is to just simply lie on my back and push against my knee as I try and drive it toward my head.

Isometric hip flexion (hand resisting knee towards head while lying on your back) is a good exercise to try to reset a posterior SI sublux. If you have an anterior sublux it won't do you much good.


Fighting gravity on a daily basis

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Originally Posted by Vinman

Isometric hip flexion (hand resisting knee towards head while lying on your back) is a good exercise to try to reset a posterior SI sublux. If you have an anterior sublux it won't do you much good.


Fighting gravity on a daily basis

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exactly. which is why what works for some may not work for others and potentially cause more joint stress. pardon the poor simile, your pelvis is like a dish towel you can twist in opposite directions, you need to know which way to spin the towel to untwist it. while it is certainly plausible to have a specific L5/S1 facet dysfunction, it is still worth while to make sure your alignment is returned to a more normal position, the positioning of the pelvic bones dictates the orientation of the sacrum, what sits on top of the sacrum? the injections alleviate the joint irritation but, if it ends up a temporary relief its worth getting looked at in addition to a second injection.

as an aside: predominately it will be the R pelvic bone that rotates, there are a few different theories as to why, it doesn't matter here, addressing the short/tight hip flexor muscle on this side by making them tighter can often be counterproductive ( oddly enough though, if you can shorten it for a duration it does help to reset and lower the muscle tone = pelvic re alignment)

there are so many contrary processes that can improve your alignment and muscle balance , if your not having success on your own it helps to have some guidance to sort out which ones may the best option for your situation

good luck

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Originally Posted by Jim S

3. I have found that independent leg exercises exaccerbate my symptoms. So one-legged leg extensions and curls, one legged squats, lunges, single leg plyometric are on my avoid list for the most part. That sucks because they are great excercises but they usually lead me to seak out the nearest smack dealer.

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Fuck. Had some back issues last week that I'm pretty sure are SI-related, and it happened doing single-leg squats. SLS and other one-legged moves are some of my favorite exercises. Though, reverse lunges seem to make it feel better. I'm generally anti-chiro, but if Vinman said go see one for this I think that might be the call.

Anyone have any long-term follow-up to share?

Wow, good timing on the thread bump. I was diagnosed by my PT with SI imbalance and have had chronic low level pain since the initial flare up last March. I finally found relief from serious, dedicated stretching of the entire hip girdle; quads, hammies, hip flexors, and glutes. But the icing on the cake was Pilates minimum twice a week (3 and 4X even better) and being very careful to avoid the activities which irritate it (duh!) like squats if not done properly. Not saying that's you Dantheman, but I was not keeping my pelvis neutral when squatting. Light weight, proper form, and reducing ROM helped as well.

Surprised I haven't seen Pilates mentioned here because it has been the best recovery and rehab I've ever experienced (serious core work) and classes have some great scenery. I think the best for my situation was the core work which helped stabilize my hip and helped the hip flexors work less. I've become a total Pilates advocate (thanks to my wife) who had a similar experience. She was so impressed that she completed the intensive teacher training and is a certified instructor and we bought a home reformer. After surfing all week mixed with Pilates and stretching have brought the most relief I've had all year just today. I was getting depressed and worried my ski season would be affected but am finally feeling hopeful.

I ski BC probably 90% of the time, started on non free pivot tele bindings BITD which i think contributed to my problems. Guiding for years with an expedition pack didn't help either, but switched to AT and not carrying a pack more than 30 pounds should help..