Sports Illustrated
SI Joint problems 3/23/2012 10:08AM Reply | Return to Index | Report Post
I raced on some lower back pain a couple weekends ago and I ended up limping away from the race. I saw a chiropractor the next day and he said the pain was coming from my SI joint. I thought it would go away with rest, stretching, icing, and strength work... but it's still lingering almost 2 weeks later. I have a late spring marathon and two other tune up races I am signed up for.

My questions are:


1) When you had SI joint problems, what finally made it go away?

2) How long should I expect to be out?

3) Should I just suck it up and spend the money to see a Chiro, ART, PT or can I realistically fix my problem with specific SI joint stretching / strength / core.

4) Any other words of wisdom from the LRC? I never get injured so this foreign territory for me.
nyloco
RE: SI Joint problems 3/23/2012 10:35AM - in reply to Sports Illustrated Reply | Return to Index | Report Post
Look no further. Mine flares up occasionally (first manifested itself after a twisting hard fall in a trail race), and I've found that the Self Correction exercises in here do the trick. Follow-up with the ones he recommends to stabilize and strengthen the area.

endyourbackpainnow.com/blog/wp-content/.../SIJ-Exercises.pdf
Robert Plantar Fascia
RE: SI Joint problems 3/23/2012 12:31PM - in reply to Sports Illustrated Reply | Return to Index | Report Post
I've been dealing with this lately too. Came off a long run and could barely walk the rest of that day. I pushed it, thought I had a sacral stress fracture (didn't), but took two weeks off. It went away, but came back as soon as I tried running again.

I had it checked out, and had a few things going wrong. One side of my pelvis wasn't moving in the full range of motion (it was "locked," as a chiro said) and wouldn't move forward like the other side; my stride was pretty uneven as a result. The hip flexor on that side was also significantly tighter; which came first, I'm not sure, but now I'm working to fix both.

You saw a chiro - did he/she do any work on you? I've been adjusted (specifically the SI joint has been released, but the other stuff is helpful too) a few times and it's worked really well so far (three weeks running without pain so far, haven't built my mileage above 50/week yet though). My walking is a lot more even, and I'm constantly stretching my piriformis and hip flexor. It wasn't an instant change (plus my walking stride is awkward as I re-learn to walk with equal-length legs), but it's an improvement and I imagine it will keep getting better.

In addition to this, I'd been to a PT and the glute on that side was barely firing. Again, not sure which led to which, but now I have to fix all the stuff going wrong.

I know chiros evoke some skepticism - some deserve it - but the guy I went to is very straightforward, was an athlete himself, and works with a lot of runners. So try that out if you haven't (it sounds like you've found one though). Try it in tandem with a PT if that doesn't seem to do the trick itself. Good luck.
Robert Plantar Fascia
RE: SI Joint problems 3/23/2012 12:33PM - in reply to Robert Plantar Fascia Reply | Return to Index | Report Post
Oops, and to answer your most pertinent question, core and self-guided stuff can help, but if you have an alignment problem (bad posture can be a cause - I developed all this crap after college when I started sitting at a desk for a higher % of the day) that won't necessarily help. See if it does - if not, chiro or PT might be the route.
Sports Illustrated
RE: SI Joint problems 3/23/2012 1:28PM - in reply to Robert Plantar Fascia Reply | Return to Index | Report Post
nyloco - thanks for the link. i've already started doing the correction followed by the exercises. unfortunately, it did not go away within a couple mins like it said happens to some people.

Robert Plantar Fascia - I saw a chiro the day after the race bc i was back home and pretty much got squeezed in bc he's a family friend. he did some work on me but not a lot. i since have not gone to any other doctor's bc i live in a relatively new area and don't know of a good one. and as mentioned, i thought the pain would go away with rest, stretching, etc. it's not.

it's funny you mention your awkward walk, bc my walk is off as well. virtually everyone is passing me when i walk down the street to the metro. it's getting better day by day, but im scared to run on it until i can no longer feel it with day to day activities.

it sounds like i need to see a chiro, pt to get realigned or it's never going away. sucks.
Sciatica Road
RE: SI Joint problems 3/23/2012 2:17PM - in reply to Sports Illustrated Reply | Return to Index | Report Post
Two-weeks and good-to-go, eh?

Consider carefully whether you want this to be a two-year injury. Howabout a 20-year injury? My point is, based on what you said, you are probably better off not looking at this as the typical 'little-nick-here', 'little-ding-there' injury.

If you are young and resilient, possibly you will be okay after you completely shut it down for...a month, giving your body time to heal, while breaking the brain-injury connection (if you can get occupied with something else).

I wish you the best.
Sports Illustrated
RE: SI Joint problems 3/23/2012 3:11PM - in reply to Sciatica Road Reply | Return to Index | Report Post
You may be right. I'm going at it carefully. I will not run until I no longer feel it in my day to day activities.

I hope i am not out 1 month, but time will tell.
Can you be more specific on breaking the brain-injury connection?
ORPhans are scary
RE: SI Joint problems 3/23/2012 3:19PM - in reply to Sports Illustrated Reply | Return to Index | Report Post
Hey Buddy-

I'm a 4th year med student and thought I'd just drop a cautionary note to you, but not to worry or anything. SI joint inflammation in young men such as yourself are not infrequently associated with an autoimmune disease process called "ankylosing spondylitis" usually hitting the lower spine and SI joints, before progressing elsewhere. given your risk factors I'd recommend at least crossing this off the list by going to an MD or DO and seeing what they think. Its treatable with prescription anti-inflammatories which will help a lot. Good luck.
Neliah2507
RE: SI Joint problems 3/23/2012 3:50PM - in reply to Sports Illustrated Reply | Return to Index | Report Post

Sports Illustrated wrote:
it's funny you mention your awkward walk, bc my walk is off as well. virtually everyone is passing me when i walk down the street to the metro. it's getting better day by day, but im scared to run on it until i can no longer feel it with day to day activities.


Hi Sports Illustrated --

Speaking from experience and also from working with different athletes and nonathletes with the same discomfort complaints and symptoms, it sounds to me like you have a malalignment stemming from the SI joint.

To describe it biomechanically, it sounds as if your hip bone (the combo of Ilium/Ischium/Pubis) has tilted and/or rotated out of alignment at the Sacrioiliac. It may or may not also be affecting your pubic symphysis (you don't have to have pain there but many times people will have intermittent groin pain).

I'm going to guess the SI joint pain comes and goes throughout the day? Is it typically worse at night when you are trying to lie in bed? The pain level is usually delayed according to activities. So while it might be tolerable if you go on a run Monday and get stiff and achey that night, the real pain might not hit you till the next afternoon when everything feels more rigid in that hip with less movement. Not that the SI-joint is as mobile as your hip joint (femur/acetabulum), but it DOES allow for a specific amount of movement.

Can you stand on a flat floor with no shoes in front of a full length mirror...try and palpate your ASIS on each hip. I recommend doing this without a shirt on and with your pants somewhat lowered so you can at least a good portion of your inguinal/groin area. Make sure that you have a natural lordosis but you aren't leaning towards one side. Just try to stand as natural as possible. Is one ASIS lower than the other? It doesn't need to be 5 inches off... even 1/4 or a 1/2 inch can make a world of difference in some people. I would be particularly curious if the ASIS on the bad hip was lower (the one with SI joint pain). Also, try to put your finger tips around the inside of your ilium by cupping them around the front of your hips. Does it feel like one hip might be rotated outwards (away from your belly button/midline) compared to the other side?

If you notice any of these differences I would definitely locate a good physical therapist who is knowledgeable with the pelvis AND spine. I don't think all chiros are bad but because you are an athlete and this problem was probably something that was an imbalance developing gradually without your knowledge, you are probably in need of specific stretching and strengthening. Even if a chiro "adjusts" you he's not going to give you the guidelines to change that imbalance so you'll be back in the door paying for another session. If you are interested I have some stretches and exercises you might be able to try... and also a myofascial stretching routine that someone can do for you on that may help loosen up the surrounding musculature in your hip and lower back to allow the SI-joint to mobilize better.
Mick Lovin
RE: SI Joint problems 3/23/2012 4:07PM - in reply to Sports Illustrated Reply | Return to Index | Report Post

Sports Illustrated wrote:

I raced on some lower back pain a couple weekends ago and I ended up limping away from the race. I saw a chiropractor the next day and he said the pain was coming from my SI joint. I thought it would go away with rest, stretching, icing, and strength work... but it's still lingering almost 2 weeks later. I have a late spring marathon and two other tune up races I am signed up for.

My questions are:


1) When you had SI joint problems, what finally made it go away?

2) How long should I expect to be out?

3) Should I just suck it up and spend the money to see a Chiro, ART, PT or can I realistically fix my problem with specific SI joint stretching / strength / core.

4) Any other words of wisdom from the LRC? I never get injured so this foreign territory for me.


_______________________________

1) I had the problem. It took months to go away. I saw chiro's and even a doctor who then referred me to a surgeon, who then suggested fusing it. I didn't, neither should anyone else. The SI is tricky and once it acts up, the possibility is always there. Times and treatment. Sorry, no magic pill.
2) Depends. Different for each case. Weeks, maybe months.
3) Yes. Stretching and treatment will help. But, again, it will take time.
4) I was almost injury free before mine as well. Usually it stems from something in the hip or hamstring pull.
Best advice: be patient and look at the long haul, or big picture. Not the next week. Good luck.
Sciatica Road
RE: SI Joint problems 3/23/2012 5:22PM - in reply to Sports Illustrated Reply | Return to Index | Report Post

Sports Illustrated wrote:
Can you be more specific on breaking the brain-injury connection?


That's a term I came up with, reinforced by a message board post by 'Gerry the Jogger' (aka Gerry Lindgren) on advice he gave here to someone with (IIRC) a lower-back injury. It was something subtle I read into his post, when he told her to avoid the pain.
Sports Illustrated
RE: SI Joint problems 3/24/2012 10:48AM - in reply to Mick Lovin Reply | Return to Index | Report Post
ORPhans are scary - thanks for the heads up. i think i can write this off tho as it's the first time im experiencing this pain and it got inflamed from racing hard. i'll be sure to mention it to the doc tho.

Neliah2507 - lord. LRC makes my injury sound like cancer. not that im not taking this seriously. to answer some of your questions:

- The pain is consistently there, tho more prominent at times than others.
- The only thing I really disagree with others about the SI joint is the lying in bed part. It's still the same pain, not any worse to better. Though some mornings it has been really inflamed and takes a while to warm up.
- I tried the mirror thing. it does seems a bit off (bad side seems lower), but i can't tell if im just imagining it either. i think i just need a professional opinion.

I have an apptmnt monday morning with a Chiro / ART. Hopefully they can tell me more. I'll also ask for a PT recommendation.

Thanks for all your help.

Mick Lovin - thanks for answering all my questions. i'm trying my best to be patient while all my friends are throwing down fast times and training hard. sucks.
oldmanstillrunning
RE: SI Joint problems 3/24/2012 12:09PM - in reply to Sports Illustrated Reply | Return to Index | Report Post
I had an S&I joint stress fracture a couple of years ago. It took 6 weeks of rest.
Sports Illustrated
RE: SI Joint problems 3/24/2012 12:52PM - in reply to oldmanstillrunning Reply | Return to Index | Report Post
Doc said a stress fracture is very unlikely because
1) I didn't do anything stupid like run an ultra.
2) I eat healthy and take vitamins.
3) No big jump in mileage. Consistent.

Probably will get an xray just to confirm though.
There now...
RE: SI Joint problems 3/24/2012 1:52PM - in reply to Sports Illustrated Reply | Return to Index | Report Post
I had an SI joint problem arise seemingly out of nowhere about 8 weeks ago. Looking back, I think years of tightness and core weakness paired with a recent pregnancy and quick mileage buildup post pregnancy are the culprits. In any case, pain was excruciating for a few weeks. I couldn't walk or sleep, let alone run. I immediately saw a chiropractor, and he did adjustments and we began physical therapy. About 4 weeks into the physical therapy, I felt better just moving around, but running was still not doable. About 10 days ago, I turned a corner with NO pain walking/moving/sleeping, and just a hint of tightness/pain running. Next step in physical therapy is core strengthening. (I have been cross-training heavily throughout.)

Anyway, I don't know whether the physical therapy, the adjustments, or the break from running are responsible for the improvement. It's working, so I'm happy. :)