About a month ago while I was out on the run and felt a gradual tightening in my low back down through my right glute. Eventually I had to stop running and walk home. Fortunately I had a chiro appointment already scheduled for the next day and he diagnosed it has SI joint dysfunction. Since then I have made progress from being barely able to walk without a major limp to feeling mostly pretty good most of the time. Until I start running, that is. I laid off running entirely for over 3 weeks and have been doing rehab exercises religiously (glute bridges, squats, hip flexor stretches). This past week I ran on Tuesday (5 miles) and Thursday (7.5 miles). They were pretty uncomfortable but I could get through it. Now, this weekend I tried to run again on Saturday and Sunday and could not. I mean I suppose I could have slogged my way through it, but it would have been miserable. This is becoming epically frustrating and depressing.
Anyone have any tips for dealing with this? I know there isn’t likely a magic pill but I’d really appreciate it if someone has had some success with a particular approach.
Thank you
I’ve had my SI joint get out of place before. A PT is able to get it back into place. I’d try that instead of the chiro. It’s one of those things that, for me, rest didn’t fix - it needed to be manipulated back into place.
Search youtube for SI Joint Excercises, or SI Joint Self Correction, there’s some good stretches/exercises (most videos are going to tell you to do the same 3-4 things).
I am having some SI joint issues, and the Chiro every few weeks is still needed, but these prolong my pain free periods.
I went through SI joint pain a couple months ago and went through PT to get it in check. Essentially, you probably need to strengthen your core and 6-way hip strength while allowing the joint to heal. Most of what I did involved using PT bands for hip strengthening and then a ton of core work along with manual therapy (aka, elbows to my hip along with lower back massaging).
Do you sit a lot? I found that a standing desk has made a huge improvement for me along with some posture adjustments to engage my core more.
I’ve had my SI joint get out of place before. A PT is able to get it back into place. I’d try that instead of the chiro. It’s one of those things that, for me, rest didn’t fix - it needed to be manipulated back into place.
No no no! This does not happen. What likely happened to you is that you had SI joint pain which was alleviated with manual therapy. Analgesic effect. The SI joint is incredibly stable; it consist is several thick ligaments and even though it’s a plane joint, it does not allow much gliding since the joint surfaces are not flat, unlike for example the facet joints. It has incongruences which makes it even more stable. This is handy, because some movement will lead to ‘shock absorbtion’ during locomotion; walking and running. This reduces the load transferred up the spine. It does not, however, make the joint immune to developing painful responses to loading. That does not mean that the sacrum is out of place or anything, just like patellofemoral pain does not mean that your patella is out of place. It just means that you’ve got a painful SI joint, for now. It can resolve by getting manual therapy, from an analgesic effect.
The reason for me to bite back against this relatively harmless, as it seems, comment about your SI pain is not to discredit your experiance. It’s merely to discredit the notion that the SI joint can ‘go out’, creating a thinking that the spine and sacrum is an unstable structure which you cant challange. It’s not, and like all other connective tissue it relies on loading to be stronger. A thinking that it might ‘go out’ might lead to a set of guarded movement patterns and a thinking that the body in general and SIJ in perticular should not be trusted and challenged. It should and can! Rest (or rather, optimal loading!) is usually the answer for acute injury where real tissue damage is the problem, but when it comes to back (and SIJ) pain there is rarely a whole lot of actual tissue damage. Rest will only further decondition the tissues, lowering the pain threshold to load in these tissues. A caregiver should be able to help anyone suffering with these issues to find proper amount of loading (ranging from “rest” to “heavy deadlifts”) for the tissue to adapt, become stronger, and be able to tolerate more loading without signalling danger (nociception → pain).
I appreciate the clarification.
My advice as a coach to many female pro runners: please stop running immediately and get an MRI.
A few different injuries manifest similarly, with the primary concern being a sacral stress fracture. The onset of pain during a run is the classic presentation. Sacrum injuries happen to many elite female athletes (including Emma Coburn and Emily Infeld), and unless the chiro is experienced with elite athletes, there’s a chance they have never seen one before.
Does it hurt when you sit?
No matter what it is, I am so sorry you are dealing with it! Sending healing thoughts!
I appreciate everyone coming back on this. I’ve been really working on strengthening my glutes like a mad woman. And recently add in some specific core work. Although I will say that I have done planks every day for almost a year!
I do sit a lot and I think that’s what really pushed it over the edge. I have since bought a standing workstation and now I’m terrified to sit ever again.
I don’t know what my chiro’s experience with stress fractures is. I’m seeing him again on Thursday so will ask for sure.
I’m pretty down in the dumps about it. I am significantly better than when it first started, but when you can’t run it’s hard to keep that in perspective.
My experience has been different. My sacrum, and sometimes my innominate, gets rotated in ways that are dysfunctional and painful. Sometimes tissue work on muscles pulling bones out of place is sufficient. Sometimes it takes a strong manipulation of the bone structure to get everything back in place. The two professions that have satisfactorily treated me for this are PT with manual/functional background, and osteopath.
I had this issue, where basically my SI would not release. It caused lower back pain. I got adjusted by the Chiro week 1, deep/painful massage week 2…repeat 3 times and it cured me. If I don’t do the proper stretches to proactively prevent it, it comes back and I go back to the therapy.
Tri3 and Mike. I dont doubt your experiences or that your therapists could help your. I merely question your interpretation of your conditions. What you have felt at first was likely a dull ache, a feeling that something was off, wrong. A therapist has then examined you and told you what was wrong: your ilium/sacrum is positioned in some weird way, and that it needed to be nudged back. You were given manual therapy, and felt better afterwards. So far so good, until things like akbreezo describes start happening. She is now catastrophizing, which is bad for obvious reasons. She has also done a lot of core work to ‘stabilize’, and even though its good to work out (of course!) the notion that her SI-joint needed lots and lots of core work to not ‘pop out’ or anything can create movement patterns that are very stiff, guarded. Such movement is usually painful; try to clench your fist hard and move your wrist around.
So basically, if you spread the false notion that the SI joint is fragile, instable, etc you can create pain and disability, even in athletes. We need to trust our bodies, even in pain.
A good read:
https://barbellrehab.com/hips-out-of-place/
EDIT: I literally just found this gem through twitter. Also a great read.
http://www.pain-ed.com/wp-content/uploads/2013/08/SIJ-pelvis-In-Touch-Beales-OSullivan.pdf
You don’t know what I felt “at first” or at any time. I stand by my statements.
That’s right, I dont. I never meant to put words in your mouth. I just want people to know that the ilium and sacrum and their joining joint are very robust structures that do not go out of place (unless you are hit by a truck) and are not moved back into correct place by manual therapy. This doesnt mean that manual therapy wont have an analgesic effect. It just means that our bodies are very strong and some popping in the joints does not mean that we are changed. We are not jelly.
I am no expert, I was just posting what worked for me. I actually didn’t have pain at first, I felt like my running gait was off and the best way I can describe it was feeling like I was tracking sideways instead of along a line straight in front of me. This was followed by lower back/upper glute pain, and then what felt like hip flexor pain. The chiro told me that my SI joint wasn’t releasing…adjustments and massage (candidly I think it was more the massage and stretching) fixed it…that was over a year ago.
Support mortysct 100%. This SI joint is supported by some of the strongest ligaments in the body. And it actually moves a grand total of 10mm. Most perceived SI pain is masquerading as Lower back pain. Rule of therapy is to rule out the low back, rule out the hip and then rule in the SI joint only if at least 4 of 7 provocative tests are positive (laslett). What we feel is actually quite deceiving compared to what is actually occurring.