Sacroiliac joint dysfunction and rehabilitation, anyone?

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  • I'm gonna bump this as i've started to get discomfort that ranges from dull/warm ache to floating and strong pain in my right lower back. it makes me press my fist into my lower back muscle for relief, but i find it real hard to massage out myself.
    i looked into this and the census (via the interwebs) seems to be its my Sacroiliac joint.
    it started about a month or more ago, its particularly sore after walking (noticed when sitting or standing). while cycling its fine only the occasional twinge if i push hard.
    sitting at work is uncomfortable.
    i have ordered a Sacroiliac support belt to try and ease the aches. james and co, what are your recommendations? i wouldn't mind that yoga class. open to other suggestions and tips too.
    thanks,
    matt.

    Yoga's lovely, Matt, perhaps see you there sometime. This guy seems to be good, too--have you seen his thread yet?

    http://www.lfgss.com/thread29902.html

  • yea I get a similar sort of thing. a build-up of pressure around the tailbone area and just above it, and it feels like I need someone to stand on the area and lightly drop their weight on the joint to pop everything back into place shudder
    that sounds so wrong!! also my left hip makes an unholy cracking noise, usually followed by my right hip, which makes a slightly less earth-shatteringly loud sound, when I feel the pressure and raise my left leg away from the body, to the left, straight. If i lie down on a flat surface slowly, my spine usually cracks itself most of the way up too.

    I get it between my shoulder blades too, the only thing that helps is if somebody swiftly presses hard on the spot between the shoulder-blades, palms down putting their weight through their arms as much as possible, and then everything cracks and I feel amazing for a while until the pressure returns.

    hmmmm.
    is this bad?
    ive been to a chiro and and osteopath before. chiro said I have a back like a granny, osteo didn't find anything amiss.

  • cool. got some ibuprofen. got an appointment at the docs too. stretching knee to chin aggravates it :(

  • yea I get a similar sort of thing. a build-up of pressure around the tailbone area and just above it, and it feels like I need someone to stand on the area and lightly drop their weight on the joint to pop everything back into place shudder
    that sounds so wrong!! also my left hip makes an unholy cracking noise, usually followed by my right hip, which makes a slightly less earth-shatteringly loud sound, when I feel the pressure and raise my left leg away from the body, to the left, straight. If i lie down on a flat surface slowly, my spine usually cracks itself most of the way up too.

    I get it between my shoulder blades too, the only thing that helps is if somebody swiftly presses hard on the spot between the shoulder-blades, palms down putting their weight through their arms as much as possible, and then everything cracks and I feel amazing for a while until the pressure returns.

    hmmmm.
    is this bad?
    ive been to a chiro and and osteopath before. chiro said I have a back like a granny, osteo didn't find anything amiss.

    It does sound like developing more serious problems, sem--don't ignore it. At least do something like yoga. What I did when I was younger was that I was riding much too hard for my ability. With some proper training, I might have been able to, but the lasting result of not being able to is some problems in my right side--knee, hip, shoulder. What exactly did the chiropractor mean when s/he said 'back like a granny'?

  • What exactly did the chiropractor mean when s/he said 'back like a granny'?

    i think he was trying to be funny because my back was quite stiff and cracks a lot.

    i have started swimming, and might try the yoga, thanks. :)

  • Yoga's lovely, Matt, perhaps see you there sometime. This guy seems to be good, too--have you seen his thread yet?

    http://www.lfgss.com/thread29902.html

    Thanks Oliver,

    GrowUp - PM me for specifics

    Bluerip00
    (Physio to what seems like half of LFGSS!)

  • sacroiliac belt is offering a bit of relief. mostly when standing as, when seated, its not asserting as much pressure. hmmn.

  • If you really are suffering SA joint pain, there is a small chance it could be an early symptom of Ankylosing Spondylitis (an autoimmune condition affecting joints). You should go and see your GP since the best prognosis relies on early detection.

  • There are a lot of thoughts and opinions flying round here which could lead to unneccessary concerns. I'd recommend a thorough musculoskeletal assessment (from an allied health professional rather than your GP due to fewer time restraints) before taking / implementing any recommended interventions / medications.

  • I have been suffering very bad lower back pain since around Christmas time. I have always had a bit of a stiff back and over the years it used to flare up for weeks on end. However, this felt different as there was no letting up and it progressively got worse and worse, effecting not just my lower back but my neck, shoulders and into my knees. I have had to stop competitive cycling this year which I have found that very difficult and pretty depressing to be honest as I just cannot push a big gear like I used to and the pain afterwards is just too much

    Numerous visits to the Drs saw me getting fobbed off for Physio et etc. The Osteopath who I have been seeing for a very long time thought it may be a slipped L5-S1 disc, then another physio thought it was an SI joint dysfunction. So after loads of yoga and pilates and swimming, the pain was just not getting any better and some days it hurt just to walk. I was experiencing lots of the symptoms you describe Sem - loads of clicking and creaking as if I needed to be rearranged. Especially in my neck.

    So I went back to the Drs and demanded to be seen by a different Dr, perhaps someone who would be more sympathetic to my needs, after all I am never ill, so the least they can do now that there is something wrong with me, is to try and fix it!
    So I explained all my symptoms to her and she put me forwarded to have multiple blood tests and a spinal, sacrial and neck x-ray. She also wrote on the blood test referal - Possibly Ankylosing Spondylitis?

    Having not heard of this disease, I googled it and then obviously began shitting myself in case that's what I have - never mind that I was atypical to the usual patterns and age of onset, nor does it run in my family!

    Well, I finally had my appointment with the rhumatologist yesterday. Thankfully, all the blood tests came back negative for Ankylosing Spondylitis and the x-rays showed no signs of it. Needless to say, I was very relieved. However, the x-ray did reveal a badly degenerated L5-S1 disc, as my osteopath had guessed. She said this is probably to be expected in someone my age who has been cycling for about 20 years, as well as sitting on a PC all day and I have a terrible posture. It is also highly likely that the joint has become arthritic which is causing all the muscles and ligaments to spasm around it. This sets off a negative chain where all your muscles in the back become so tense and tight causing all this referred pain. I am under a lot of stress too at the moment. Just started a new job and my wife is expecting twins amongst other things :)

    So it seems like a combination of a degernated disc, artheritis, poor posture, too much cycling, too much computer work and stress have caused this unpleasant symptoms.
    The consultant suggested I have a series of deep tissue massages and acupuncture for a start and work on my core and posture etc ect, which I already knew about.
    So yesterday, I went for a deep tissue massage, cupping!!! and acupuncture and it has really esaed my neck off. At £50 a time, its a little pricey, but I feel that if I work hard on this I can overcome this injury and hopefully get back to racing again.

    I'm a little depressed that it' effected me so much, but relieved that we are finally getting to the bottom of what it is. I have an MRI scan booked in just to see if there is anything an x-ray may have missed but I am optimistic about the future :)

  • Hi Mike

    First off I'll say I'm not a medical expert and am just going to tell you my own experiences.

    A few years a ago I injured my lower back working as a care worker. I started seeing a chiropractor whenever my back would "lock up". Obviously it can get a little expensive, as your finding out. Plus a chiropractor only seemed to "unlock" my back as a short term solution. So I started looking on the internet for other solutions.

    First of all i found out about stretching excercises and strengthing my core which helped loads but my back still got tight at times and would still spasm and "lock up" if i did the wrong thing (such as lifting things that are two heavy or lying on the floor for too long).

    So I come to the point of my post, what i found when mooching on t'interweb was something called a "backknobber" forgive the innuendo like name (it's an American product so that might go someway to explaining it). What it is, is a large plastic S with ball like massage knobs on the end. You can get to any part of your back and kneck with it and give yourself a back massage and get at the tight knots/trigger points (do a bit of googling on trigger points and trigger point therapy/massage/ and mofascial realase/massage/therapy to find out exactly what i mean) to loosen up your back and kneck and hopefully help with the pain.

    Whilst its not as good as going to an expert masseur and getting a deep tissue massage or accupressure, the thing that i found is because i can use it EVERY day it stop the build up of knots and tight points whereas whith an expert you can only go when you can afford it so your back can be very tight by the time you get to see an expert. Also if your back is feeling particularly tight on a particular day you can get at the knots right away without having to book youself in to a massuer

    My "knobber" cost about £30 off fleabay and is one of the best £30 I've ever spent. I haven't been back to the chiropracter since April.

    Obviously everyones back and back problems are different, but it worked for me, it may work for you.

    Check out all the positive reviews on Amazon, after reading them i ordered one from fleabay straight away and haven't looked back

    Amazon.com: The Original Backnobber II by The Pressure Positive Company: Health & Personal Care

    Good luck

    Michael

    (I hope it's clear, but I'm not advocating using this tool INSTEAD of seeing experts but to be used alongside any accupressure, deep tissue massage etc your having)

  • mike, sorry to read about your troubles ...

    Back pain sucks. I have basically given up on getting rid of it and sort of accept it as a daily reality for me. My back pain comes in intervals and all the physiotherapists, chiropractors, osteopaths etc seem to have not helped much in the long term. Core strength somewhat did, as did light weight deadlifts, but every now and then I wake up and feel like 55 instead of 32.

  • Worth remembering that many back/musculoskeletal probs can be due to referred pain patterns.
    QL refers into SIJ,for instance.Medi profession tends to focus on treating the symptoms rather than the underlying causal factors.
    Fascial restrictions and TPs won't show up on an MRI scan.
    Unless they have undergone further specific CPD training,the stretches and exercises that most physios prescribe won't address the root cause.
    Ideally you need to have a kinetic chain/muscle recruitment pattern assessment,work station ergonomics correction,stress reduction prog,receive soft tissue therapy from a knowledgable therapist and undergo a corrective exercise programme...

  • Worth remembering that many back/musculoskeletal probs can be due to referred pain patterns.
    QL refers into SIJ,for instance.Medi profession tends to focus on treating the symptoms rather than the underlying causal factors.
    Fascial restrictions and TPs won't show up on an MRI scan.
    Unless they have undergone further specific CPD training,the stretches and exercises that most physios prescribe won't address the root cause.
    Ideally you need to have a kinetic chain/muscle recruitment pattern assessment,work station ergonomics correction,stress reduction prog,receive soft tissue therapy from a knowledgable therapist and undergo a corrective exercise programme...

    Am in full agreement with this (wish i could afford to get all this done) . One little bastard of a muscle that often gives me a tight back is the periformis (a hip rotator muscle) doing soft tissue work on this can be agony but the results are immediate relief

  • Soft Tissue work shouldn't be agony!
    Clients [and some therapists] with the No Pain No Gain mentality need re-educating as muscle guarding mechanisms [protective contractions] can kick in which is counter productive if you are trying to relax and release.

    As an example,indirect myofascial release can be super effective and requires the lightest sustained pressure.Less than 1 out of 10 on the pain scale.
    Direct Fascial work tends to be higher [I've been on the receiving end of 9 out of 10 treatments from a tutor...needless to say it was a counter productive session.
    Therapeutic work is generally in the 3-6 range.
    Trigger Point Therapy can be less comfortable though - circa 6-8.Although I tend to use sweeps in the 4-7 zone as this flushes blood into the sarcomere rather than doing a static ischemic compression on an already ischemic tender spot.Much more effective imo.
    Muscle Energy Techniques only involve a 20% muscle contraction so shouldn't register on the discomfort-ometer.But will relax soft tissue after the fact so as to make subsequent stretching more effective.

  • Muscle Energy Techniques [contract,relax,stretch] work well for Piriformis.
    And Active Isolated Stretching.

    No pain required.

  • You make some very interesting points Dude.

    Im not sure what you mean by this though

    QL refers into SIJ,for instance. Medi profession tends to focus on treating the symptoms rather than the underlying causal factors.
    Fascial restrictions and TPs won't show up on an MRI scan.

    What is QL, Fascial restrictions and TPs?

    And thanks for the recommendation MyQul, I shall look into buying one of those massagers

  • QL = Quadratus Lumborum = lower back muscle.Pain here is very common and used to be called Lumbago.Gardening type back pain = often QL,espesh after bouts digging.

    Problems in QL can refer pain elsewhere.Typically into the SacroIliac region.
    So if you have pain in the SI,rather than just focussing on that region,it would be prudent as a therapist to assess the QL.

    The Trigger Points in the QL,when assessed/palpated by the therapist might mimic the pain in the SIJ.

    Fascia is all pervasive.Think of it as the skin of your muscles and soft tissue structures.The heart is wrapped in fascia.
    It's everywhere and is interconnected.So fascial restrictions in one area can be felt elsewhere.
    Imagine wearing a tight fitting jumper and pulling it at the lower left front hem...you would most likely feel the tension on your right shoulder.
    So a shoulder problem might be caused by a restriction or imbalance elsewhere.
    It's not left field,just anatomy.
    I know of Doctors that know nothing of fascia! But they can give you a drug to mask the symptoms or refer you to a physio who will then give you stretches and exercises [that 90% of clients don't do for more than a day or two,if at all]
    If the prob is fascia or referred pain from another area you most likely won't get very far with this protocol.
    Importantly, fascia is known to have pain receptors.So when folk are suffering with a "muscle" problem,it could be and frequently is a fascial restriction.It can get dry,rucked up,stick to other structures,stop muscles gliding over each other etc.

    TPs = Trigger Points = taught bands of hypersensitive tissue.Aka Knots.Basically the the contractile elements of a muscle don't slide as they should.So they get locked,have poor blood supply,cause pain or refer pain elsewhere in known,predictable patterns.

    You now know more than most doctors,physios,chiropractors and massage therapists.

  • Very useful information. Especially like the jumper analogy as I said somehting very similar to my wife last night.

    It sometimes feels like my skeleton has grown but the muscles haven't and they are all being pulled really tightly accross it.

    How do I fix this then, aside from a stretching program that I am sticking to rigorously?

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Sacroiliac joint dysfunction and rehabilitation, anyone?

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