Hey Supple Freaks,
Thanks as always for your amazing emails. You guys are the reason this thing goes on!
Today is an oversimplified take on pain in the SI region. Things to keep in mind when you are feeling the grief in this part of your low back:
1) changes in bladder or bowel function are serious= MD
2) saddle area numbness/tingling= MD
3) problems when you cough or sneeze= MD
4) unrelenting night time pain= MD
OK? Now grab that pain ball, a frozen steak to do some icing and see if you can’t solve that pain yourself.
People write books on SI dysfunction. It’s gnarly. This is less than the tip of the iceberg. But if you want to dig a hole, you have to start at the top (thanks AH).
Kstar
7 Responses to “Episode 118: SI Area Pain, The Basics”
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what can be done to protect the SI from injury during the deadlift?
the deadlift and squat both by their nature involve both sides of the hip equally, the deadlift I find to be a more stable lift and less likely for me to hurt myself than the squat.
That being said, if you are in a position where a) one hip is way tighter than the other, or b) you have crappy hip flexibility in general, you may be trying to bend over and pick up the weight and your hips do not want to go with your torsoe. which causes rounding of the back which is obvioiusly bad. Kelly talks about forward tightness but I feel it is the other side of the same coin, Tight up front(psoas + quads) is just as problematic as tight in the back( QL, piriformis, hamstrings, for example).
If you can visualize the effects of any of these muscles being tight and its effect on the body then you can begin to understand your own pain that you deal with… One thing to note. The injured side is tight and painful, and the stronger side is lose and hypermobile. Don't be fooled by thinking the side that is always popping is the side that needs the most attention.
Loosen up the tight side and eventually you will stop getting all the popping and movement on the stronger side. Over time if you neglect to do thisn the tight muscles will do their job of protecting the joint(pain all the while) while the hypermobile side trying to give slack for the tight side will eventually give out.
Finally remember that pain is a symptom, and it doesn't always show up. You may have a particular joint particularly noisy and exhibit no pain whatsoever, that doesn't mean you should ignore it. Since we are speaking about hips if one side is always popping and getting out of place while the other is symptom free. Than you need to focus on the symptom free hip, more than likely there will be differences in flexibility if you go looking for it. There is where you need to focus.
Remember the body will work to solve its own movement problems, but you may be completely oblivious that there is any compensatory work being done.
Anyway if the question hasn't been answered already from this post…, to protect the SI from injury, make certain that you have equal flexibility in and about your hips before you deadlift. Giving slack to the tight hip(s) will keep your sacrum from getting locked against the illiac and causing pain as your muscles cramp up trying to protect an already compromised joint.
Hey Kelly,
Thanks for posting this. I've had chronic SIJD for about a decade now.
You nailed my condition spot on, down to a T if you will. The stretch you showed is the only one I've ever seen that did not cause pain during a rehab period where only myofascial release & reverse hypers work to relieve pain/inflammation and increase mobility.
I'll be following this blog religiously as you seem to know more than 99% of the doctors out there on the topic, at least what the condition is, what it affects and possible treatments.
Thanks for the info!
eh what could pain while sneezing indicate? I get it sometimes after intense exercise
Seems like hollow rocking really helps with this too. I start by holding on bent knee with both hands, rock about 5 times, then switch to other leg, then go with both knees bent and finally with straight legs. The first couple times it feels like my low back doesn't want to bend at all, but by the time I am done it feels nice and lose. Any scientific basis for this?
great explanations.love all the anatomy & physiology