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Walking, sacroiliac joint dysfunction and hip pain

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Walking incorrectly may "unlock" the SI joint, leading to SI-joint related low-back pain as well as wear and tear in the acetabulum.

I was going to write about something else this week, but I've been noticing something in my practice, and I figured I'd better write about it before it slips my mind.

I should also apologize to all my wonderful SI joint teachers who took the time to really coach me with respect to SI joint dysfunction, (Diane Lee and Linda Joy Lee, Marcy Dayan, Paul Chek, Shayne McDermott, David Ewert, Mark Finch, Tom Myers, and most recently, Richard DonTigny), because it is very probable that you actually did teach me this, and I forgot and have now simply relearned it for myself.

For those of you that are not in the medical, physiotherapy or exercise field and have no idea what and where the sacroiliac joint is, it is the joint between the sacrum (the triangular bone at the bottom of our spines that the tailbone is a part of) and the pelvis. People that have SI joint pain frequently point to the "pelvic bump" area in the very low back where the dimples are as the achy spot, and that pain is often one-sided.

For non-medical/exercise people, skip to the next paragraph where I'll explain this more simply, but for those in the field, what I've noticed is that most people that get SI joint pain seem to walk using their hip flexors as the prime movers. While walking quickly, the pelvis is frequently in anterior tilt and/or there is a distinct forward lean of the trunk, and very often the person with the dysfunction is "pulling" their legs forward rather than "pushing" them. In my practice at least, using the hip flexors to walk seems to be a far more obvious pattern in SIJ dysfunction than a Trendelenburg sign , although the patterns do frequently go together. I realize that someone in anterior tilt also tends to have poor local stabilizer and poor glute function, but I have found that even when someone has generally improved their pelvic position and been trained to connect to those muscles in other functional patterns such as stand-to-sit-to-stand, unless their faulty motor-recruitment pattern in walking is also corrected, the SIJ pain does not go away due to the constant forces trying to unlock the joint. So I have put gait to the top of the priority list, and have been spending a lot of time recently teaching people how to walk - and it seems to be helping. Because I frequently see this same faulty walk pattern in those that have had or are about to have hip replacement surgery, I think it is possible that overuse of the hip flexors during gait may pull the femur slightly forward in the acetabulum, potentially creating a wear problem leading to the need for hip replacements. Therefore in my opinion, correcting this faulty gait as soon as it is recognized (possibly in late childhood or adolescence) may go a long way toward not only reducing future pain and suffering, but also reducing the need for hip replacement surgeries. If a study has not already been done on this, I think the idea has potential!

Probably the easiest way to explain how poor pelvic position affects gait is to actually try it and feel it in your body. So, stand up, and pretend that your pelvis is a bucket, and you are pouring water out the front. You should feel like you are sticking your butt out behind you, and you have a big arch in your low back. Now try walking while maintaining this pelvis position. Notice how you have no choice but to use the front of your hips to move your legs? Notice how effortfull this is? Not good. Hard on your SI joint, hip joints, low back, turns off your local stabilizers and your gluteus maximus, and way over uses the hipflexors and quads. If you have SI joint or hip pain or if this is how you tend to walk, it may be worth your while to try a different way.

First, stretch your hip flexors gently for a minute or two. Then, while hanging onto something, try standing as tall as possible on one leg on a small stable stool or a stair, tucking the tail under slightly (hold the bucket level so no water spills out) without squeezing the buttocks, so that the other leg can hang down completely suspended from the hip socket. You should be able to swing the leg like a pendulum with no muscles gripping the leg bone at all - it pretty much moves by itself with no muscle effort. That is how one's leg should feel in the swing phase while walking - loose, like it's hanging, and pretty much moving by itself. So, now get down from the step and try walking. The trick is to walk while standing as tall as possible - this will frequently be enough to bring your pelvis to a neutral position. If you can't get that "hanging" feeling at the hip joint while you walk, stretch your hip flexors again, stand taller, and tuck your tail under a bit more by using your lower abdominals to gently pull up the pubic bone. If you are walking correctly, you will not only feel like your legs are floating, but you will also feel that any work that is happening is coming from the back side of the body rather than the front side.

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Lee, Diane The Pelvic Girdle Churchill Livingston, 2004.

Lee, Diane and Lee, Linda Joy An Integrated Approach to the Assessment and Treatment of the Lumbopelvic-Hip Region DVD, 2004

Lee, Diane and Lee, Linda Joy Postpartum Health for Moms - An Educational Package for Restoring Form and Function after Pregnancy CD ROM 2006.

Lee, Diane Assessment Articular Function of the Sacroilac Joint VHS

Lee, Diane Exercises for the Unstable Pelvis VHS

Richardson, C, Hodges P, Hides J. Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain Churchill Livingston 2004.

DonTigny, Richard Pelvic Dynamics and the subluxation of the sacral axis at S3 The DonTigny Method.

Myers, Thomas Body Cubed, A Therapist's Anatomy Reader "Poise: Psoas-Piriformis Balance" Massage Magazine, March/April 1998.

Myers, Thomas Body Cubed, A Therapist's Anatomy Reader "Fans of the Hip Joint" Massage Magazine, Jan/Feb 1998.

Myers, Thomas Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists Churchill Livingston, 2001

Chek, Paul CHEK Level 1 Advanced Back Training Chek Institute.

Johnson, Jim The Multifidus Back Pain Solution: Simple Exercises That Target the Muscles That Count New Harbinger Publications Inc. Oakland CA, 2002.

Lee, Diane Understanding your back pain - an excellent article explaining the concept of tensegrity and its importance in stabilizing the pelvis and spine.

DeRosa, C. Functional Anatomy of the Lumbar Spine and Sacroiliac Joint 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Gracovetsky, S. Analysis and Interpretation of Gait in relation to lumbo pelvic function 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Dananberg H. Gait style and its relevance in the management of chronic lower back pain 4th Interdisciplinary World Congress on Low Back & Pelvic Pain, Montreal, 2001.

Online at www.kalindra.com A fantastic website devoted to sacroiliac dysfunction.

Copyright 2007 Vreni Gurd


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Comments (138)

#1: SIJD
Submitted by exSIJDpatient (not verified) on Fri, 08/17/2007 - 4:45am.

SIJ dysfunction is very common disorder. SIJ pain is just one symptom of many it can cause. Some say it is mostly women's disorder. They are right, but many men have it too. About 80% of people have it causing them many different Muscular Skeletal Disorders.

Most common SIJD case is upslip: Other ilium has moved out of it's natural range and got stuck because of a trauma, fall, slip, or other accident. usually it is also rotated forward (anteriorly). When stuck it has no schock elimination and all those forces from down to up go to spine and causes countinuous stress there: wear and tear of spine and discs.

When pelvis is not functioning symmetrically it stresses the spine. There you get scoliosis, extended lordosis, wear and tear in discs and vertebra. Also altered pelvic ring posture causes piriformis tightening, back muscles tightening, bad body posture, neck problems, shoulder problems,.. And to legs not only hip problems but also knee, ankle, achilles and many others too because it changes the way you walk.

But because the pain usually comes after yers of walking with SIJD that is difficult to diagnose. The trauma that caused it is so far in history. And it is not only a disorder for adults but also for children too. To children it causes ie. idiopathic scoliosis. See those pictures they use describing scoliosis: 9 out of 10 have pelvic bones malaligned. They say scoliosis causes that. But if your pelvis is not levelled the spine can not be straight. Can it? It was corrected from me at the age 35 and I had had mild scoliosis, short left leg and unleveled pelvis for all my life. Not any more!

And when they diagnose that rotation scoliosis, it means your other ilium is more forward than other (uplip and rotated). It causes that twisting force to lumbar spine. And up in shoulder level you willingly fight against it trying to compensate that twist...

And when you have both SIJS upsipped you will get very exteded lordosis and you walk like Donald Duck ...

This was a short message about SIJD

Submitted by Vreni Gurd on Tue, 08/21/2007 - 5:46pm.

Hi there,

Glad to know you got over your SIJ problems.

I agree that when there is a malalignment at the SIJ, whether one-sided or bilaterally, problems may occur either up the chain into the lower and upper back, ribs, shoulder or neck, or down into the hips, knees, ankles or feet. I also agree that many scoliosis problems are more likely to be based in a malaligned pelvis causing muscle imbalances in the hip muscles rather than an actual leg-length discrepancy and I think scoliosis almost always comes from below (although it is possible that the neck, particularly the upper two vertebrae, may be driving the pelvic malalignment, which is in turn causing the scoliosis.)

No matter what the SIJ malalignment, whether an upslip, rotation, outflare, inflare - whatever, the first step is to correct the alignment. I find Richard DonTigney's program works quite well for that (I have a link to it in the post above). Then the second step is to stabilize the joint with transversus, pelvic floor and multifidus work as well as to correct any muscle imbalances through appropriate stretching, and the 3rd step is to look at all movement patterns and ensure that the motor recruitment is good, so that the SIJ is not being pulled out of alignment by poor motor recruitment habits.

Thanks for your comment, and giving more info on the topic!

 

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Vikram (not verified) on Sun, 09/30/2007 - 1:06am.

Hello Vreni,

I agree with your comment about Scolios starting from below.

I have had lower back pain for since age 19 or so. I am now 36 and it is much better.

I used to be a competitive runner (400 and 800 metres) and have had several lower back and knee related problems (ilio tibial tendon syndrome, lateral lordosis, SI joint dysfunction, poor pelvic movement, prolopsed / herniated discs - L4 and L5) . I also did used to cycle bent over, racer style and had a trauma three years earlier direct on my tailbone when someone kicked my feet out from under me from behind. In my opinion, though,  the immediate cause of the pain was the daily running training with poor coaching.

Of course, of the injuries, only the last (L4, L5 discs) could be verified for myself through imaging technologies, the rest also depended greatly on doctors' opinions through the the SI joint problem responded to manipulation) . The lower back pain was much more on the right side with very slight numbness behind the thigh on occassion.

I was told to give up running - while I was willing to drop compeitive track, totally giving it up was something I was not prepared to do.

With lots of reading and talking to open-minded doctors and physios, the following things helped me:

1) Greatly increasing lower abdominal strenght (i.e. being able to keep both legs raised and horizontal for almost a minute while hanging).

2) Increasing gluteal (?) strength and flexion by doing deep squats with light weight.

3) Cutting down on stretches that could encourage hypeflexion in the back of the legs and hip.

The three above did reduce pain during exertion and movement while running but didn't reduce postural or immobile pain e.g. while standing or sitting (assuming your feet can rest firmly on the floor).

2) The 2nd problem was taken care of by shoe inserts.  This was based on a few assumptions:  a) the assumption that an incorrect foundation or alignment in an load bearing column will cause misaslignements further up. Think of a column of bricks. If one brick is displace forward, then the next one above  to be displacedbackward to keep balance, and the next one furher above has to be displace forward again and so on. b) Physics law of action and reaction.  If weight pressing down on the SI joint exists only when there is a supporting force pressing up through the feet and legs. If that chain incorrectly transmits the force of impact on foot strike the effect could be felt anywher above including the SI joints. My own estimate, based on back of the envelope calculations is that when running full speed (say 100 m in 13 seconds) on a hard surface your feet can strike down with rebound force of 15 or more time your body weight.

Anyways, going forward with the above assumptions, I thought that there may be something wrong with my foot. It is then that I remembered that in early childhood around age three years I was diagnosed with flat feet and had to wear orthopaedic boots for two or three years.

Armed with this information, I purchased orthopaedic insoles with a posted heel and arch support. The heel is thicker on the inside i.e. the raised arch support continues to taper gradually towards the heel.

That days was my first entire pain-free day in years. I had in fact spent all day on my feet visting museums and in the evening went for a short run too. That was also pain free even though it was on a tarred road surface, not a soft surface.

In short, you did mention that there are some patients of yours who don't get cured of SI joint dysfunction. I would suggest that the problem could be due to over-pronation or flat feet causing anterior tilt of the shin bone along with some lateral rotation of starting from the ankle joint in turn causing an inward lateral rotation of the femur in turn causing an anterior tilt of the pelvis causing SI discomfort. If one foot is flatter or more pronated than the other, it will cause apparent leg-length discrepancy, lateral pelvic tilt and corresponding focus of back pain on one side.

Here's the link to an article which talks similary (para 8)http://www.chirosmart.net/rst/sone.txt  . These is the shoe insert I purchased, a Podiatrist at Eneslow was able to disgnose in half an hour what back and spine experts had missed for years. L420 insole (see http://www.eneslow.com/html/launch.cfm?siteid=4&itemcategory=111&priorId=27) and L620 insole (http://www.eneslow.com/html/launch.cfm?StartRow=9&itemcategory=111&priorId=27&siteid=4) . This is not a commercial plug, if you like you can redirect to any link pointing to similar shoe inserts, it's just that I know that the ones advertised here work.

Regards,

Vikram

 

Submitted by Vreni Gurd on Tue, 10/09/2007 - 8:52pm.

Hi Vikram,

I completely agree with you that SIJ dysfunction can come from the feet, and it often does. If the feet are flat, that will usually cause an internal rotation of the femur, medial instability at the knee, weak gluteus medius muscles at the hip, and frequently an anteriorly rotated pelvis, which would lead to the SI joint unlocking. This can be particularly problematic as you point out, if one foot is flatter than the other, which would create a torsion in the pelvis.

The trick in all this is figuring out what is driving what. Is it the feet? Is it the upper two cervical vertebrae? Is it a breathing problem which throws the head forward causing problems lower in the back? Is it standing on one leg more frequently than the other? Is it working as a cashier where you are rotating in one direction all day long causing a muscle imbalance in the pelvis and trunk? Was there some acute trauma to the joint? Is a poor diet causing a leaky gut problem, which would then through the neural reflexes turn off the neural control to the deep local stabilizer muscles that control the motion at the SI joint? An SIJ problem can be caused by any of the above, and probably a myriad of other reasons.

Only once the cause of the problem is dealt with will the orthopedic pain issue be resolved for good. Yes, we can align the pelvis and spine through chiropractic, muscle energy techniques, massage or what-have-you, and we can teach people how to stabilize their pelvis using the correct muscles, but these may only be stop-gap measures until the ultimate driver of the problem is found and corrected. That is why I think it is extremely important to look at body in a very holistic way. If someone shows up with a painful SI joint, usually the issue will not be resolved by looking only at the SI joint. The SI joint is the victim, and the challenge is finding the cause. Frequently the cause is far away from the SI joint itself, as you so clearly pointed out in your comment.

I'm glad the orthotics worked so well for you. You may also find it helpful to work on strengthening the arches of your feet. If your feet are extremely flat, you may never be able to get to the point of being able to run without them, but perhaps you will be able to tolerate walking if you happen to forget to put them in your shoes ... And you may also find it helpful to check with a knowledgeable physiotherapist to make sure you are using your transversus, multifidus and pelvic floor correctly, as these muscles dissipate forces away from the SI joint, which would be extremely important when you run. Just an idea.

Thanks for your helpful comment!

 

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by gdean67 on Fri, 12/14/2007 - 6:29pm.

Dr. Andrew Levy of Center for advanced medicine, New Jersey

 I just wanted everyone to know- stay away from this guy. After having my PCL replaced from Dr. Edward Decter (another Dr. to stay away from) Dr Levy was fast to shoot down Dr. Decter, as he said I never needed the PCL operation in the first place- and why he calls him “Quick Eddie” Dr. Levy said the cartilage in my knee was dead and needed to be replaced- and performed the operation.   

After the operation, my knee was actually worse then before the operation, Dr Levy told me a screw came lose and he needed to take it out. When I told him I was in between jobs and my insurance wouldn’t start for another month, he said that he would do the surgery for free- as long as I help him get the full amount from my insurance, for the first operation. I told him that I would see what I could do-and I appreciated him doing this operation for free. 

After removing the screw which he said he would FREE, my knee was still killing me and I was barely able to walk- but figured I would give it some time. I kept my promise and contacted my insurance company. I was told- what they pay the Dr. has nothing to do with me and I shouldn’t call again. After 3 months- my knee still killing me and having trouble walking, I was shocked when I received a bill from Dr. Levy for the amount of $16, 376.00. The bill was for removing the screw, plus the difference my insurance didn’t pay him for the first operation. I tried calling him for 1 month, to try and find out why I received a bill for something he said he was doing for free- He never took my call. 

After receiving a letter from his attorney a few months later- I started speaking to attorney’s to see what I could do. They all said the same thing- you signed a waiver from the first operation and you have no proof that says he was doing it for free.  I had the pleasure of finding out yesterday, that Dr. Levy’s attorney put a Levy on my on my bank account, which withdrew EVERY penny I had. My mortgage payment and many other checks I wrote bounced- leaving me scrambling to find out how I am going to pay all these bills- since my once a month commission check is now gone, along with my entire savings. 

Dr. Levy is a POS that did nothing for my knee and has now turned my life upside down- just in time for the holidays. Happy Holidays Dr. Levy!!  Stay away from him- he is a liar the worst Dr. in the tri-state area!!    

Please pass this letter to anyone who is thinking of getting orthopedic surgery- so they don’t find themselves speaking to Dr. Levy

Submitted by post traumatic stress disorder (not verified) on Fri, 12/28/2007 - 11:10am.

You can also have problems if you drive with your wallet in the back pocket of your pants.

Submitted by Vreni Gurd on Mon, 12/31/2007 - 6:55pm.

Yes, if the joint is unstable, and depending where the wallet is pushing on the pelvis, I can see that it may push the ilium forward unlocking the joint. Also, with a wallet there, one would be sitting in a torqued position in the seat which in itself may cause problems. Thanks for bringing this up!

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Anonymous (not verified) on Wed, 02/13/2008 - 7:16am.

Hi, What might you recommend when custom orhtotics, physical therapy and core exercises fail to restore si joint function??? I have run the gamut of physicans and traditional medicine and still can't get much better. Here is a brief synopsis and history: I am 37 years old. I had my second c-section 16 mons. ago and just weaned my son. It has been 10 months since I learned I had SI problems after starting a walking, jogging, and gradual running program after the ok from my obstetrician. I started running more and then one day I could barely walk. My back, hip, and knee was also hurting. I did have some hip pain during the pregnancy and saw a chiropractor. From what I understand, the hormones during pregnancy, postpartum and during breastfeeding contribute to relaxed ligaments. My physical therapist told me she personally believes postpartum ends a year after stopping breastfeeding. She feels only then will my SI ligaments fully return to normal. She said she can't do any more for me since I can at least return to some exercises and do daily chores even though I still have pain. She said everyone has some pain and inferred that at my age pain is expected?? I feel that my chiropractor contributed to the problem after reading some of Mr. Dontigny's info. : a forceful adjustment called "million dollar roll" I believe. I have been told I have idiopathic scoliosis and that by one sports med doctor said I needed a heel lift. The chiro. told me I didn't need a heel lift. The podiatrist said I needed custom orthotics because I had the beginnings of bunions and bunionettes. I wear them, but am not convinced they are helping as far as SI function is concerned. I have been told I have IT band syndrome as well. I have had an mri on my knee an emg on my leg. I have had one round of prolotherpy performed by a physiatrist so far and will be returning for another soon. I feel that is probably my last hope??? I can't even do the eliptical machine or walk without pain. The pain is usually in my butt. Sometimes it becomes so bad I have to take pain medication and lay down. A few days ago my hip was hurting so badly I was limping for a few hours. I have begun doing the DvD " Better Abs, Buns, Back by Chek to strengthen my core. I believe it will improve my posture as well. I am aware of Mr. Dontigny's self corrections and I have self taught them. At times they do help. I have read all of his info. on Kalindra's SI resources. I have a Serola belt but when I have tried to wear it, I walk strangely and it rubs my upper IT band and makes it more inflamed so I have not worn it. Any info. is greatly appreciated. I hope this all makes sense. I have tried to be brief yet detailed. Thank you for your time!! Sincerely, Dee

Submitted by Vreni Gurd on Thu, 02/14/2008 - 11:53am.

Hi Dee,

It's great to see how proactive you have been in trying to help yourself recover - that bodes well! The only way to tell for sure if you have a leg-length discrepancy is through an X-ray, but most of the time there is an appearance of a leg length discrepancy, but it is actually caused by a subluxation in the SI joint and muscle imbalances in the hip. Developing SIJ problems after pregnancy is VERY common, and especially after a C-section, as the stabilizer layer (transversus abdominis) of your abdominal wall has been cut. Even though the muscle has been sewn back together again, function is often disrupted, and you need to relearn how to use that muscle to stabilize your pelvis. So, my bet is your problem is more related to the front part of your stabilization circle than the back. You did not have SI joint problems before having children?

I completely disagree with your physio that pain has to be something we accept as we age. And you are only 37! I would continue to work with the Dontigny corrections, as the first step to recovery is to get that SI joint aligned properly. The next step is to find your transversus abdominis, and get good at using it. You may need to find a physiotherapist that is familiar with how to cue TA, and better yet, find one that uses a real time ultrasound to help you through biofeedback. (That is probably a very tall order!)

Try lying on the floor on your back, and gently try and take the tissue just above your pubis, and SLOWLY draw it in, as if you want to wrap that tissue around the back of the pubic bone. You should feel a muscle contract in the centre, just above your pubic bone. Another cue that may work, is to try and draw the two pelvic bones (ASISs) towards each other. You should feel a deep tensioning across your lower abdomen. Pulling up your pelvic floor by lightly squeezing your anus, stopping urination, or gently pulling up your vagina should create a transversus contraction as well.

You can try this while standing. Let your gut hang out completely, and then try and draw in the part well below the navel. If when you draw your belly in it is happening at the navel or above, you know you are doing it wrong. And don't be surprised if you manage to do it once or twice and then can't anymore - your nervous system will tire very quickly. Just take a break and then go back at it a bit later. Better to practice for a minute once an hour than to try for an hour a day all at once.

Once you can find the muscle, try and hold a light contraction and breathe. Work on extending your hold times. Incorporate holding into standing, walking, sitting, lifting etc. And keep doing the Dontigny exercises at least in the morning and at night if not more frequently.

Prolo can be very helpful if the ligaments are loose, and yes pregnancy loosens them, but they will tighten up again. It is impossible to know, not seeing you personally, but my suspicion is that the ligaments in the back are not the source of your problem, but rather your stretched out abdomen from the pregnancy, and the problem caused by cutting the transversus. I worry that if you get too much prolo now, when your ligaments do tighten, they will be too tight, which may create a different kind of problem. You may want to discuss this with your prolotherapist.

As for a SI belt, I like this one, because with the velcro strap, you can add the compression where you need it. I think you may need it at the front. This article may help you understand your back pain from a different perspective.

You may find it helpful to stretch your IT band and TFL (personal trainer), and toe spreaders may help you avoid bunions. You should have complete control over all your toes, and an ability to spread them and make your feet wide. Toe spreaders can help you find your toes again, if that is an issue.

Good luck in your journey!

 

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Anonymous (not verified) on Fri, 02/15/2008 - 8:19am.

Dear Vreni,

Thank you so much for your feedback and help!! I appreciate your time very much! 

I do not recall having any SI problems prior to my 2nd child and c-section.  The only problem I have had prior is the IT band diagnosis and overall alot of flexibility. 

I will talk to my physiatrist about becoming too tight from the prolo.  He had told me my left side SI is tight and becomes "stuck" and my right is loose.  My p.t. said the front of my pelvis is slightly forward and down on the right side, my back (si) dimple is slightly deeper than the right.

What you say makes sense to me.  That may be why I also get some pubic pains at times also.  I will start working on the TA as well as continue Dontigny's exercises/corrections.

I am very far from B.C.  I just located a CHEK Level II and Holistic/Nutrition Lifestyle personal trainer in my area, Ohio, U.S.A.  I will contact her.  I hope she is as knowledgable in these areas as you are.

Thanks again so much! You have given me hope and encouragement!

Sincerely,

 

Dee

 

Submitted by Vreni Gurd on Fri, 02/15/2008 - 3:17pm.

Hi Dee,

Do remember that my comments are only based on what you told me and no assessment, but at least it gives you a place to look!

If it is the R side of your pelvis that is forward and down, that is the side to concentrate the Dontigny exercises on. Once the pelvic bones seem even, do the other side, and keep switching back and forth until they no longer shift, but stay even.

Glad you found a CHEK Practitioner /Holistic Lifestyle Consultant to work with! She'll assess you and move you in the right direction ...

All my best!

 

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by is si bad? (not verified) on Mon, 04/07/2008 - 11:02pm.

Hi Vreni

I have been in physical therapy for 8 months now - mostly treating my si joint. We have tried othothics, gait modification, hip flexor, quad and hamstring stretches. We have worked the multifidus, and TA, and PF. I am still hypermoble. An adjustment lasts for 1 week at the most. I have been given self correction exercises but can only get the joint to go back into position about 10% of the time. I have tried a SI joint belt but it caused my back to hurt more so I quit using it. My PT has moved my limitations down over that last 8 months to the point that I am only suppose to lift 10lbs max from waist high. I have done the exercises religiously just as the PT assigned them. I have increased my calcium magnesium, and vitiamin C to help promote ligament healing. My PT is at a loss for what to try next. . When I have asked the PT why it is taking so long I am told that my age is a factor - I am only 45. Prior to this injury I was always active doing hiking, biking, skateboarding, cross country skiing, kayaking, road and mountain biking. I really want to be active again and hate the limitations that I now have. I hate to see my muscles atrophy from lack of use. Do you have any other things that I could try. I am very discouraged.

Any advice that you can give would be greatly appreciated.

 

John

Submitted by Vreni Gurd on Tue, 04/08/2008 - 10:53am.

Hi John,

It sure sounds like you are doing all the right things. Are you doing bridging exercises to strengthen your glute max? How about glute medius exercises, sidelying? These muscles are both very involved in not only moving you but in stabilizing the hip and SI area (especially glute medius, which lifts the opposite side of your pelvis up so you can swing your leg through in gait). Lats too, connect to the fascia that comes across the lower back. I imagine your physio has these covered ...

Another consideration may be the position of your top vertebrae. Sounds whacky I know, but often so goes the atlas, so goes the sacrum. Perhaps your physio can feel the transverse processes of the atlas and see if they feel even side to side, or if the bone feels rotated or translated. You may need to see a nucca chiropractor to get that bone gently nudged into place.

If your ligaments have loosened to the point that the muscles are not able to take up the slack, then you may need prolotherapy. A doctor injects a sugar solution (I think) into the ligaments, which tightens them up. Usually you need to go for a few treatments, and I don't think the treatments are much fun, but they can really make a difference to your stability in the long run. I've had a few clients that have found that's the only thing that worked.

I can imagine you must be very frustrated, if you are accustomed to an active lifestyle ... Good luck!

 

Vreni Gurd

Health and Vitality Coach
BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Danny (not verified) on Wed, 06/11/2008 - 8:53pm.

Hi,  I'm a 23 year old male and have been dealing with back pain and hip pain for almost two years and have seen chiropractor and pt's, with little results. I have  been told  I have a torqued pelvis, my right hip feels like it sticks out to the right and my right leg always feels longer than my left. I have recently pinpointed that the muscles on my right side pull my joints and my pelvis out of alignment. I feel the worst pain when I get up from using the toilet. My right it band and tfl feel like they tighten up while I'm sitting down on the toilet and I have tried all positions to try to get myself comfortable but the pain is still there. I use a lift on my left side but my body still feels out of balance. I've been adjusted many times and found  little to no relief. I feel like my entire pelvis is shifting to the right side of my body and I cannot run or walk without pain or uncomfortableness on my right leg and hip and when I stand for a long time it hurts to the point where I need to sit down. I've just started a new job in the DC area and all I could think about is the pain. I've tried to stretch out my IT and my TFl but it keeps tightening up.Does anyone know any good IT/tfl stretches or exercises to fix the pelvis,or even any specialists in the area, I'm running out of ideas and forgot how it feels to walk normal without pain. Please, any ideas would be appreciated. Thanks....

Danny

Submitted by Vreni Gurd on Wed, 06/11/2008 - 11:01pm.

Hi Danny,

It sounds like you may have a muscle imbalance in your hips, which results in one hip appearing higher than the other, or one leg appearing longer than the other. I would suggest looking at the Dontigny exercises (click the Dontigny link in my post), and see if the bracing exercises help you to level your pelvis. Leveling your pelvis is the first step. Can your chiropractor or massage therapist manage help you with that?

Next you need to learn how to stabilize the pelvis, and low back, so perhaps a physical therapist can help you find and connect to your transversus abdominis, pelvic floor and multifidus muscles, as well as your strengthen your right gluteus medius and TFL (I suspect the R side would be weaker than the L).

At the same time as you are working on your pelvis stabilizers, you can work on stretchng the tight muscles. I suspect that it is your left TFL and IT Band that is tight and needs to be stretched, and not the right one, whereas your right inner thigh may be tighter than the left, and your right side muscles (QL, obliques) that run between your pelvis and your ribs are probably tighter than the left.

Once you can connect to your stabilizer muscles well, you need to integrate those muscles into movement. You need to learn how to stand on the right leg without the hip collapsing out to the side. Then you need to learn how to bend that knee and stay strong through the right hip. A good physical therapist can be very helpful with this. Or look for a Chek Practitioner www.chekinstitute.com near you to look at your posture and design an appropriate exercise program that will balance your muscle system out for you.

Please understand that I have not examined you, and what I am suggesting is only based on your description, so I can't be certain that what I am suggesting is accurate. But it may provide a starting point. I do think you can get better, especially if you find the right help.

Good luck - you are too young to be in so much pain ...

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Danny (not verified) on Wed, 06/18/2008 - 8:51am.

Thanks...there is a chekinstitute in my area... I'm going to give them a call today and ask if they have any experience dealing with my condition. It is actually my right IT band and TFl that are constantly tight. How can I level my pelvis? I 've recently been doing some of dontigny's exercises and pelvic tilts as well, what technique would I need to ask a chiropractor to perform on me in order to straighten my pelvis?I've spent hundreds on chiropractors who used That "million dollar roll" on me and it felt ok as soon as they did it but I was back in pain that same day. I forgot how it feels like to walk normal without pain on my right hip.Also my right hip makes this pop sound when I lean over and keep my legs straight, it is congruent with my right hip feeling like it sticks out. Also, would  an osteopath be able to help? again thank you very much for your help.

Submitted by Vreni Gurd on Wed, 06/18/2008 - 9:07am.

Hi Danny,

Yes, your right TFL, IT band may feel tight, but I expect it is actually closer to taut - something like when the elastic is completely stretched out. You can't stretch it further, but it feels really tight.

The roll will help it feel better, but unless you can staiblize your own pelvis using your own muscles, the relief won't stay. You need someone to teach you how to connect to your stabilizers. A Chek Practitioner would be a good idea.

An osteopath may also help, but I don't know how much exercise they do.

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by ejego on Wed, 06/18/2008 - 9:49pm.

Thanks so much for your article! I have had hip pain in my right hip for about 2 years + after an instructor over stretched ,my right hip flexor. I felt like it was streched too far, but didn;t think much of it until I started training for a half marathon, and then I experienced pain in my pubic symphysis and it was horrible. That has subsided, but the pain in my right SI joint/ low back has been getting worse over the past 3 weeks or so. I have been doing exercises given to me by the Athletic trainers at my university, but they have not seemed to help. I do walk like Donald duck and I have been working on strengthening my lower abs, but it doesn't feel as though it is working. If you have any input on exercises or stretches, that would be great! Also, it feels as though I have a lump above my right hip tha I assume in inflammation- it isn't locates over the SI joint, but in the muscle in around the lumbordorsal area. Also, my SI joint on the right pops a lot- and I would like that to stop! Any input would be great as I do not have access to a PT. Thanks- Emily

Submitted by Vreni Gurd on Wed, 06/18/2008 - 10:57pm.

Hi Emily,

Please understand that I am pretty much guessing, based on what you said here. I think you need deep stabilizer work too - did you read the description of some of the transversus exercises above (comment 9)?

Probably your sacral R multifidus is not doing its job, and so the lumbar erectors may be in spasm, creating the feeling of a lump or swelling in the lumbodorsal area. (I'm not too sure about this, but it may be something to explore). And you may also need R inner hipflexor motor control/muscle endurance work, as those fibers attach both to the vertebrae and the lumbar disks. Try lying on your back with your knees bent, and imagine you are sucking the leg bone into the socket, buttocks and sit bones wide. This will engage the iliacus and psoas, which may be helpful to you.

The other thing you can try is to lie on your stomach, and place your fingers in the soft tissue between the pelvic "bumps" in the back (PSISs), and imagine you are trying to squeeze those pelvic bumps together without gripping your butt. You should feel a muscle (multifidus) swell under your fingers, without the big lumbar erector firing up. My guess is that one of the sides of multifidus may not be functioning as well as the other. You need to get good at an even, low, gentle contraction, that you can hold for at least 3 minutes without it fading out. Once you can engage multifidus and psoas gently, and integrate these holding exercises into your movements, I am hopeful that the popping may stop.

A gentle pelvic floor contraction should stabilize the pubis. If you put your hand on your perineum, as you do a pelvic floor contraction you should feel your perineum lift up and away from your hand. If it pushes into your hand and you can't figure out how to pull it up, you may need to seek more specialized help from a pelvic floor specialist.

Good luck - hopefully your athletic trainer can help you with at least some of these ideas ...

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by link building services (not verified) on Wed, 07/02/2008 - 4:44pm.

Once you can connect to your stabilizer muscles well, you need to integrate those muscles into movement.

Submitted by Vreni Gurd on Wed, 07/02/2008 - 8:37pm.

I can't believe I left that out. Not much good only doing this stuff lying on the floor!

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by whistler accommodations (not verified) on Wed, 07/09/2008 - 12:04am.

Walking is not just a simple recreation anymore, we need to pay attention to how we walk.

Submitted by Sloan DeFilippo (not verified) on Wed, 07/30/2008 - 7:58am.

Hi, Ms Vreni Gurd.

I am so happy to have found this site. I began having groin pain in 2005 and it got so bad that I went to the orthopedic who found that I had a labral tear in the left hip. After having the operation(arthroscopic repair) and during physical theraphy, I began developing pain in the other hip(right). I had some more test done to make sure I did not have another tear. Finally I found out that I had a herniated L5/S1 and bulges and annular tear in the L5/L4. I then had epidoral shot, Facets inject/prolotheraphy and had no relief. I then went for theraphy on the back and all the exercises seemed to make it worse. Bridges, side lying abductions and such. I then and am presently doing decompression. I am realizing after reading your post that a lot of my issues are coming from my SI joint. I am also getting myofascia theraphy which truly helps. The therapist finds that my Si joint is always stuck on the right side. I have been paying attention to my gait patterns for about over a year and have had minimal changes in pain.

Yesterday was the first time I engaged in muscle work in the gym in two months. I did light leg extension(five pounds) light hamstring curl(5 pounds and light horizontal leg press making sure that my knees does not pass my hips on the return. But yesterday I had a lot of soreness deep inside the inner groin and stomach extending into my inner thighs to my knee. It has causes difficulty in walking. It feels better today. I also believe that my Si joint issues increased after doing a yoga class. I feel I over stretched. The therapist also noticed that my hip rotators are super tight and I have began to stretch them more.

Can you please help me on starting a home program to help and heal from this issue? I am a personal trainer and feel as if I have no knowledge when it comes to this issue. Also during all my physical therapies not one pt looked or addressed my Si joint issues. It has alway been my hips and lower back. I am only 42 and has have this issue since the age of 38. I also have two children and with my last child did experience some knee pain. I also picked up running right after pregnancy and feel that might have added to my issues. I also have a hard time doing abdominal work, although the hanging leg lifts seem to not bother me too much. Swimming has also been a problem and that is why I looked into decompression.

This is such a confusing injury and the fact that I have so many issues leave me at loss on what to do first. Please help me. Thanks so much Ms Sloan

 

Submitted by Vreni Gurd on Wed, 07/30/2008 - 1:53pm.

Hi Ms. Sloan,

Wow, sounds like you are going through a very rough time. First thing I would do is see if you can find an Integrative Neurosomatic Therapist (a type of massage therapist trained by Paul St. John) to assess you for a leg-length discrepency and/or a small hemi-pelvis (one side of your pelvis being smaller than the other). If you have either of these conditions, you may need a lift in your shoe, or a lift under one butt cheek when seated in order to keep your pelvis and therefore your SI joints and spinal column level. That alone can go a long way to reducing pain syndromes, and preventing SIJ and disk herniations. Far more people than we realize are suffering because of leg length inequalities or a smaller hemipelvis.

The other thing I would do is look for a physical therapist / CHEK Practitioner that can help you connect to your transversus abdominis, pelvic floor and multifidus muscles, to ensure you are using the correct muscles to stabilize your pelvis and spine. Often after child birth, the transversus and pelvic floor has been completely stretched out, and the pelvic floor may have been torn or cut, so half the body's stabilization system is gone. Reconnecting to these muscles is key to getting out of pain, as doing glute work, sit ups etc. works muscles that are meant to move you rather than stabilize you. That can create spasm and pain if the underlying stabilizer muscles are not working adequately. Only once the stabilization system is functioning well can one exercise the moving muscles without problems. One easy trick you can try, is to stand and sit as tall and wide as you can at all times. That will go a long way to decompressing you. We are meant to stand in tension, not compression, so fight gravity all the way! Often that will get your stabilizer muscles to work, too.

Where do you live? If you are in the Vancouver BC area, I'd be happy to help you.

Good luck!

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by shotbod on Thu, 08/07/2008 - 10:03am.

Thanks so much for your quick and helpful response. Alas I live in United States, Florida ,otherwise I would be right at your clinic. Is there a link for me to find a chek practitioner? I found something but I am not sure. When you said sit tall and wide, did you mean sit with my legs open? Also, I forgot to mention that my surgery for the hip labral tear was the beginning of my right side issues. The position I was put in was on my back, the operated hip/leg was pulled a few millimeters and the other leg/ hip was put into a very wide abduction position. After surgery I also have been dealing with a chronic hamstring problem. I woke up to a huge lump on my hamstring connection where it inserts into the inner back knee. It would cause so much pain when touching it and would spazz for three days after making it so difficult to sleep or concentrate on what I was doing. With physical theraphy it finally calmed down a little. The last orthopedic doctor told me that it was not a cyst since it did not show up on an mri. He said it was a chronic muscle bunching of my hamstring. He also said that I had a weak medial quad muscle and to strenghten them. He said that my hamstring issues will subside if I do. I agree when I stretch it which I do several times a day it helps but it is right back to the same the next day. I roll on a roller a lot also. Before they found the herniation I was diagnosed with a hip strain and periformis syndrome. I am still dealing with all of that. Swimming and biking are out of the question. The left knee(operated side) burns like crazy after and my groin would get really tight. Bending to tie my shoelace I would get a pulling feeling in my groin.I have had a lot of mixed advice for my leg length and my arches. My left arch have collapse but with advice from a great website "The Fitness Fixer" has helped me to correct my gait and to concentrate on using the right muscle to stabilize the arches.The last foot scan I had told me that my left arch(the problem arch) was fine but my right was collapse. It seems that everyone I see has a different opinion. The last chiropractor I was seeing for three months, three times a week seemed to be confused because each time I went in the leg length discrepancy would change from one leg to the other. The most relief I have received so far is from my myofascia relief therapist. All my issues seem to be coming from the glutes,groin and outside hip area radiating to my knees. I am especially sore there after my decompression theraphy. I have three more to go and feel deep down that maybe all my issues are not from my herniation. Thanks again for your advice . Cordially Mrs Sloan D

#26: Tampa?
Submitted by Vreni Gurd on Thu, 08/07/2008 - 9:46pm.

Hi Mrs. Sloan D,

Are you in/around Tampa? I would suggest you book an appointment (or a few) with the St. John-Clark Pain Treatment Centre in Clearwater. They would probably do wonders for you. Paul St. John is very well known in the massage world, and Randall Clark and Tracy Allan Jones are fabulous therapists as well. 727-347-4325. Or if you are not in Tampa, call the number and they will give you the name of the Integrated Neurosomatic Therapist nearest to you. You can hopefully find a CHEK Practitioner here.

I did not mean to sit with your legs spread wide, but rather to relax the butt muscles so your sit bones can spread. You may find it helpful to actually use your hands to manually spread your sit bones when you sit. This will give you a wide, stable base of support while seated. Your thigh muscles and hip flexors should be (soft and gushy) while you sit, so if they are not, you can work on relaxing them.

Good luck on your journey, and don't give up! I would bet your pain can be much reduced.

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by cee-bee (not verified) on Fri, 08/22/2008 - 9:23am.

I suffered for years and years with chronic pelvic pain that seemed to be orginating from my right ovary and uterus. This pain almost wrecked my marriage, as you can imagine. I finally found an OB/GYN who believed it was a muscle problem and sent me to a physical therapist. She discovered that the ligaments on the right side of my sacroiliac joint were very loose and my hip rotater muscles (esp obtrurator internus) on my right side were inflammed. She suspected this was from on old injury. The only one I can remember occured when I was about 9 or 10. I'm now 47.  Mt PT worked on me off and on for a year and the muscles did respond. However, because the ligaments remain loose, the muscles repeatedly get inflammed. Now my insurance no longer covers treatment. I have a sacroiliac belt to help hold the joint in place, which is only somewhat effective. What else can I do? Will a chiropractor help? Massage therapist? I'm in a rural area with few resources.  Thanks, Charlotte

Submitted by Anonymous (not verified) on Fri, 08/22/2008 - 12:05pm.

i doubt anybody will be able to help me, but just incase...four and a half years ago i had surgery for a pilonidal cyst. the cyst was not painful at all as it had opened and drained on its own.  last year, the cyst became infected again, but did not open and drain on its own and was excruciatingly painful. i could not walk, sit, or stand without wanting to cry.  i got it drained (after a horrible 2.5 hr drive to my doctor) and felt incredible relief. he suggested surgery to decrease chances of another infection but said it wasn't absolutely necessary. b/c i couldn't take that much time off from my summer internship i decided to delay it until winter break. witner break came around and since i was experience zero pain or problems from the area i decided to forego the surgery. now, THIS summer, the pain came back. at first it was very subtle but eventually i realized it would not go away on its own and i had to go to a doctor. i thought for certain it was related to the pilonidal cyst b/c the pain was in exactly the same area, and similar pain but not nearly as intense. well, the doctor looked at it and said the area looked fine and he didn't think a surgery was necessary. he gave me an Rx for antibiotics b/c i was going abroad and i expressed concern that it would get worse and i wouldn't have a doctor to go to, but he told me to take them only if it looked bad and the pain got way worse. well, that didn't happen while i was abroad fortunately, but the pain did pop up every once and awhile and though it was mild it was pretty annoying. so anyway, a few days ago, it started getting sooo annoying b/c it started interrupting my sleep. no matter what position i'm in i feel mild pain in my lower back. i also feel it when i sit (the worst probably) or even stand. the only time i DON'T feel is if i stand on my right leg. otherwise if i'm on both legs i feel a pain go down my left leg. it has gotten so ridiculously annoying and the past few nights i've had to take tylenol pm. yesterday i went back to the doctor and he said the pilonidal cyst is NOT infected. he also poked around that area and it didn't hurt with him putting pressure there.  (last year when the cyst was infected it was VERY tender to the touch.) so..i am so confused. it seems like my pain is not related to the pilonidal cyst but then what??? the pain is minor (relative to the pain of an infected pilonidal cyst which i would not wish on my worst enemy) but it is NOT pleasant.  i wonder if it could be sacroiliac joint dysfunction? and if maybe my pilonidal cyst or surgery caused it? i have no idea..i just want answers b/c i don't know how much longer i can live with this discomfort.

Submitted by Anonymous (not verified) on Fri, 08/22/2008 - 12:15pm.

Hello,

I am a 23 y/o female and I have been diagnosed with SI dysfunction(3 years ago). I was in boot camp when a female fell from a 5ft platform and I caught her wrong and we both landed wrong in a rocky terrain. I did not seek treatment right away and when I did I had 3 pelvic stress fractures and one in each foot. I did not get treatment until 6 months after my diagnosis and continued to train(bad idea). I have went to Physical therapy 2 separate times for a period of 12 weeks and both methods that they used did not help only aggravate my SI joint. The chiropractor was the best source for me but only lasts for a little over a week. Any time I lift something to heavy or step wrong I get a flare up and I cannot do anything. Being in the military you have to be physical. I am to the point that a brisk walk almost has me in tears. I don't like taking meds and I had a shot and it only made it worse. I have done acupuncture and myofascial release. I am in a environment now and I don't have access to a chiropractor. I need some advice??

Submitted by Max (not verified) on Thu, 08/28/2008 - 2:52am.

Your site is great and I really appreciate it! I have always enjoyed reading your site.

#31: Regards
Submitted by jef on Sun, 08/31/2008 - 12:32pm.

Hello. Nice day. I have reading your site. It's realy necessary and useful.  Regards.

Jefry Morgan

Cars and insurance writer

http://trialroad.com

Submitted by Vreni Gurd on Sun, 08/31/2008 - 12:49pm.

Hi Charlotte,

If the ligaments are loose, prolotherapy may help.  You would need to find a physician that does that kind of treatment - basically injecting sugar water into the ligaments to tighten them up.  Usually a few treatments are needed, and the they certainly are not fun.  But it can help a lot.  Try googling prolotherapy and your home town or nearest city and see what comes up.

Otherwise, getting very good at connecting to your transversus abdominus, multifidus and pelvic floor may help take the strain out of the other muscles, and wearing the SIJ belt.

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

#33: Cyst?
Submitted by Vreni Gurd on Sun, 08/31/2008 - 1:06pm.

To be honest, I'm not too sure what to suggest.  The fact that you can get yourself out of pain by standing on one leg makes me think that the problem is mechanical rather than from the cyst.  So it could be SI joint, or possibly an issue with your lumbar vertebrae, or possibly the organ fascia is "glued" to the muscles, and pulls when you are in particular positions.  I would suggest you see a physical therapist or orthopeadic physician have see what they think as a start, and then possibly see a visceral massage therapist to make sure the colon is not stuck in any way.

 

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Vreni Gurd on Sun, 08/31/2008 - 1:16pm.

Hi Military gal,

I feel for you - SIJ pain can be horrible.  I suggest stabilization work would help a lot.  I think you need to connect to transversus abdominus, pelvic floor and multifidus.  Read comment 9, and comment 19 above and try and do the exercise suggestions.  If you have access to a physical therapist that can help you learn how to do these exercises correctly, that would help a lot!  

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

#35: Muscles
Submitted by seo services (not verified) on Wed, 09/03/2008 - 2:00am.

you need to concentrate on your health specially on your muscles.

Submitted by Credit (not verified) on Thu, 09/04/2008 - 3:41am.

Your site has very much liked me. I really appreciate it!

Submitted by Health Guru (not verified) on Fri, 10/24/2008 - 1:03pm.

Great post Vreni. I've been dealing with some serious nerve pain cause by a herniated disk - while getting treated for it, I learned my si joint was completely locked up and a few other things that I was doing in my day to day life that were fueling the condition. A few things that helped me were walking backwards for a few minutes everyday (sounds weird, but it helps) and moving my feat into a 45 degree outwards angle when standing still and walking - this was the big one for me - I guess I had been walking incorrectly for years? who knew! I give most of the credit for my healing to a massage therapist who uses special techniques to unlock the joint - this helped the disk move back into place and the pain was relieved (still not 100%)

Your advice here is really good, hope others get some relief from your suggestions.

Cheers

Submitted by Vreni Gurd on Fri, 10/24/2008 - 8:15pm.

Hi Health Guru,

I bet walking backwards helps - what a brilliant idea!!  I think I'll start using that with people.  Glad to know that you found someone to help you, and give you the tools to help yourself.

Richard Dontigny (see the link above), believes that disk issues originate from SI joint dysfunction, as this would torsion and tilt the sacrum which would then lead to the vertebrae being tilted, aggravating the disks.  This does make sense, although I don't think all disk issues originate as SI joint problems.

So Dontigny's system is all about putting the SIJ in the correct position.  I use his techniques every day.  I think he published first in about 1963! And I bet these are the techniques your massage therapist is using ...

Glad you liked the post!  :)

 

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by matt (not verified) on Sat, 11/01/2008 - 6:52pm.

Hello,  I'm 28 and have been dealing with sacoiliac problems for at least 10 years.  I was pretty physically active in shape. I spent 6 years in the Marine Corps.  Typically i could visit a chiropractor and have it adjusted and be fine in about a week or two. This episode i have now has been going on for 3 months. The right side is locked up and painful to even put weight on my right leg.  I'm suppose to start physical therepy next week. I'm just hoping there is something i can do to prevent this from happening again....

thanks

matt

Submitted by Irvin (not verified) on Sat, 11/01/2008 - 9:53pm.

Hi Vreni, i've been reading the posts and it has provided me with alot of info.  I am 27 yrs old, male and race triathlons.  About 1 year ago I began experiencing left side glute pain, it gradually spread to the hip joint, QL, TFL, glute med.  My left side lower back muscles are also overdeveloped compared to the right side.  Excercise (run, swim, bike) aggrevates it and sitting for long periods or standing still it is irritated mainly left QL area (very deep) and stretching the hip joint feels like it is "tearing" and has some sharp pains.  Recently, my mid back and shoulder blades are feeling very tight too.  I have been doing some of the stretches and corrections found at DonTigny, but even some of those stretches cause a deep hip pain.  I just had an MRI done and waiting for results.  Left thigh front and side are also numb, a very superficial numbness but it's always there like meralgia paresthetica.  Please help!!!

Submitted by irvin (not verified) on Sat, 11/01/2008 - 9:56pm.

Hi Vreni, i've been reading the posts and it has provided me with alot
of info.  I am 27 yrs old, male and race triathlons.  About 1 year ago
I began experiencing left side glute pain, it gradually spread to the
hip joint, QL, TFL, glute med.  My left side lower back muscles are
also overdeveloped compared to the right side.  Excercise (run, swim,
bike) aggrevates it and sitting for long periods or standing still it
is irritated mainly left QL area (very deep) and stretching the hip
joint feels like it is "tearing" and has some sharp pains.  Recently,
my mid back and shoulder blades are feeling very tight too.  I have
been doing some of the stretches and corrections found at DonTigny, but
even some of those stretches cause a deep hip pain.  I just had an MRI
done and waiting for results.  Left thigh front and side are also numb,
a very superficial numbness but it's always there like meralgia
paresthetica.  Please help!!!

Submitted by Vreni Gurd on Sat, 11/01/2008 - 11:06pm.

Hi Matt and Irvin,

I gotta say I feel a bit helpless, and am not sure how I can really be of much help without actually seeing you personally.  Without actually being able to examine you and see what position the bones of your pelvis are in, whether or not you have a leg-length discrepancy, how well you are activating your stabilizer muscles etc., I don't know what new I can suggest that has not already been mentioned above.  

I think the key is finding someone that can assess where you are at now, and can then  work with you to formulate a recovery plan.  There is no doubt that there is a lot you can do to help yourself, once you have a working diagnosis. Is one ilium more flexed than the other, and if so, which one is more flexed?  Do you have an inflare / outflare going on, and if so, which way?  Do you have an anatomical leg-length discrepancy?  Is the problem simply instability of the SIJ? 

I would suggest you call 1-866-597-3772, and ask if there is an Integrated Neurosomatic Therapist near you, and then go see them. Or discuss the issue thoroughly with a chiro to get an idea what he/she thinks is going on, and what exercises he/she thinks may be helpful and which you should avoid.  A KMI Practitioner is another excellent alternative, or a Rolfer, or any other structural integrator may be helpful.  CHEK Practitioners can help you with the stability side.  So can a good physical therapist. There are lots of good people out there - it is a matter of finding them.

If you are in the Vancouver BC area, feel free to contact me.  I'm really sorry that I can't be of more help.  I hope you can understand that generalities are not good enough, and everyone needs their own personalized plan.

I really hope you find someone good to help you...

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Sony Portable Playstation PSP (not verified) on Sun, 11/02/2008 - 7:12am.

Your site has very much liked me. I really appreciate it!

Submitted by Irvin (not verified) on Mon, 11/03/2008 - 11:16pm.

Hi, I am actually in Victoria BC!!  I am very interested in seeing you and believe you may be able to provide me with some good insight and direst me in the right direction.  How ma I contact you and where is the clinic you work at located?  thanks!!!

Submitted by Irvin (not verified) on Mon, 11/03/2008 - 11:18pm.

Hi, I am actually in Victoria BC!!  I am very interested in seeing you and believe you may be able to provide me with some good insight and direst me in the right direction.  How ma I contact you and where is the clinic you work at located?  thanks!!!

Submitted by Irvin (not verified) on Mon, 11/03/2008 - 11:19pm.

Hi, I am actually in Victoria BC!!  I am very interested in seeing you and believe you may be able to provide me with some good insight and direst me in the right direction.  How ma I contact you and where is the clinic you work at located?  thanks!!!

Submitted by Medium Length Hairstyles (not verified) on Mon, 11/24/2008 - 4:02am.

Your site is great and I really appreciate it! I have always enjoyed reading your site.

Submitted by Eva (not verified) on Fri, 11/28/2008 - 9:03am.

Hi Vreni,

I am so impressed!  You are really so full of knowledge and have given so much help!  

I'm hoping maybe you have some advice for me as well.  I am a 35 y.o. yoga teacher and I began having sciatic pain about 9 months ago.  I thought at first it was from tight external rotators (piriformis etc.) so I tried to stretch them more and be patient.  The pain lasted, so I had an MRI.  The report said my L5/S1 was herniated.  

What  I noticed most during this time was that when I lay on the floor, brought my knees up to my chest and rocked from right to left, I could feel the left side si joint press against the floor.  When I rocked to the right (the problematic side), my si joint felt like it was caved in, almost like nothing was there.

I went to a physical therapist who gave me exercises to balance my pelvis - lying on my side and squeezing a pillow, pushing my right leg back and my left leg forward.  This seemed to work at making my pelvis look even, but was also the beginning of incredible hip pain.  Its the worst after sitting.  When I stand, it takes about 5 seconds and then I get this wave of pain from deep in my hip joint that makes me feel like I'm about to pass out.  It lasts about 10 seconds and then I can breathe again.   It hurts a little now while walking, but not so bad.  mostly its transitions like from standing to lying down.  

I've been to a good chiro, and he thinks I may have facet joint syndrome since I continue to have pain even after the adjustments.  He also popped my right si joint back in place but it doesn't seem to want to stay.   I finally tried the cortisone injections (that hurt incredibly to get!!). That was just a few days ago, so I am not sure yet if they will help.

The sciatic pain I first felt started after doing (I think) too many and too
intensive backbending postures in yoga.  Do you think bending back and
flexing my spine could have caused my si joint to go out of wack?   

I feel like I understand a lot of the mechanics, but am unable to heal myself - so frustrating!!  Any input would be so appreciated.

Eva

Submitted by Vreni Gurd on Sun, 11/30/2008 - 12:03am.

Hi Eva,

The reason I ask the question is that I had SI joint pain for a number of years, without any fall or car accident or anything to set it off.  The stabilization exercises that I speak of above took away my pain, but I never understood why I developed the pain in the first place.  This July I learnt that I have a 15mm leg length discrepancy.  Therefore my pelvis was always tilted in standing, creating a torsion within the pelvis between the sacrum and the illiums, irritating my SI joint.  This can also create disk problems and facet joint irritation, as the tilt is usually corrected somewhere in the spine.

So, you may want to investigate that possibility.  I find that most health professionals think that leg length discrepancies are very rare, whereas the appearance of a leg length discrepancy is common.  I beg to differ.   According to the research of Knudson, up to 60 percent of us have an anatomical leg length discrepancy, and I suspect that this is frequently the undiagnosed cause of many painful syndromes from knees, to hips, to back, to neck, to headaches.  A simple shoe lift can go a long way to remedying the problem.

Forward bending postures may aggravate disks, and back bending postures may aggravate the facet joints.  Based on your description, your sacrum is torsioned within your iliums, (I think your right ilium is inflared, left outflared - but you would need to be assessed for this) which would clearly impact the position of the acetabulum of your hip joints too.

Perhaps seek out the help of an Integrated Neurosomatic Therapist to assess you for leg length discrepancies, assess your pelvis, atlas ( top vertebrae) and cranium,  and come up with a treatment plan for you.  Staying connected to your bundhas, particularly mula bundha would clearly help as well.

Hope this helps a bit!

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

#50: pain!
Submitted by Eva (not verified) on Sun, 11/30/2008 - 3:11pm.

Thanks so much for getting back to me!

There was no trauma right before the pain started.  Maybe a month before, I did "throw my back out" after doing a few intense yoga classes w/ lots of upward facing dog, and then using the abductor machine at the gym (would that make sense as a cause?).  That was scary, but it went away after a few days.  I stopped all backbending for a while, and then when I started again the sciatica came. 

The chiropractor I've been seeing said my atlas/axis was way off, and that he could palpate something that he shouldn't have been able to (scary again!) but he adjusted it so hopefully that will help

I will definitely investigate the leg length idea.  Do you know of anyone good New York City or Brooklyn?

One more question ~ I started doing the exercises from the pdf by DonTingy.  The one where you squeeze the knee in and push against the hands seems really good, but I'm still really hurting.  Is there a basic time frame for these exercises to notice improvement by?

In the meanwhile, bandhas engaged!

thanks again,

Eva

Submitted by jim (not verified) on Tue, 12/02/2008 - 4:28pm.

everytime I go out and do a fair amount of walking, my lower back, hip, leg,knee, all on the left side , give me incredible pain. I can hardly stand for any length of time. I usually struggle to get into my car to sit. the pain subsides somewhat.Doesn't happen all the time , but when it does , the pain is excruiating.I have been to an orthopedist before this all happened. {I had 2 epidurals about a year ago} one on both side of my back. The right   is fine, but the left is causing me the problem. at the time, he told me I had 3 herniated discs. Could this be what is causing my problem?I take percocet for the pain.  

Submitted by Vreni Gurd on Tue, 12/02/2008 - 4:41pm.

Try Dominique Hall - I'm pretty sure she is in NY.  Email me privately and I'll get you her contact info.

 Make sure you are not over-using your hipflexors while doing the Dontigny exercises - that may help a bit.  

Good luck!

 

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Vreni Gurd on Tue, 12/02/2008 - 4:53pm.

Hi Jim,

Hard to say for sure, since your symptoms don't all seem to fit the classic disk herniation symptoms, so there may be something else going on as well.  Usually disks hurt more with sitting than with standing.  The pain down your leg can definitely be coming from the disks, so perhaps there is something going on with your standing posture that is aggravating them.  Are you sidebending right when you stand or walk? 

It is possible that your disks are contributing to your pain, but it is possible that something else is going on too - facet joint problem? Stenosis?  Spondi? 

Does lying on your stomach and coming up on your elbows, just relaxing your back and butt help or make it worse?   It sounds to me like you need someone to examine you thoroughly, also look at your posture and functional movement patterns, give
you a working diagnosis, and some ideas on what you can do to resolve
the problem.

 

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Angela (not verified) on Wed, 12/17/2008 - 10:48am.

Hi Vreni,

My 14 year old son is a soccer player and has been plagued by debilitating pain in his lower back for months.  After several visits to pediatric ortho with no luck, we were sent to physical therapy, where they determined that he had SIJ dysfunction.  He stopped soccer altogether, went to PT and got better (this was over a 3-4 month period).  As soon as he went back to soccer, the pain came back.  He is in extreme pain on a regular basis...cannot get out of bed, bend down to pick things up, trouble transitioning from sitting to standing...something a 14 year old shouldn't have to deal with.  I have always noticed that he has poor posture, leaning forward when he walks, shoulders slumped, hips appearing to be tilted anterior.  Your article about walking incorrectly affecting SIJ dysfunction seems to hit home, and I am anxious to try your recommendations about walking from above.  We live in San Diego, is there a center that specializes in SIJ dysfunction that we can take him to?  He was not as enthusiastic about his exercises and therapy before, however, now that he is on the high school soccer team (but cannot play due to the pain) is very eager to do whatever it takes to get better.  Any other advice, literature to read, etc. would be greatly appreciated.

 

Thanks so much!!

~Angela

Submitted by Angela (not verified) on Wed, 12/17/2008 - 11:13am.

Hi again,

 

After reading a few more posts, I realized that I might need to give you a few more details.  My son was found to have a very slight leg length discrepancy, which was corrected by an adjustment...lying on his back, bending both legs and pulling on one while pushing on the other.  This seemed to put him in alignment, but just walking around for a minute put him right back out of alignment.  He also had a significant weakness in his glute muscles on one side.  All of the pain is on the left side.

He was given glute strengthening exercises by one PT for the weak side, but to be honest, he never really did them with much consistency.  He also was given a belt to wear, which he said helped a bit in the beginning, but then later said it was making him hurt more.  The other PT was focusing more on core strengthening.  Also, he has the tightest hamstrings I have ever seen, particularly for an athlete.  I am not completely familiar with all of the other exercises he was given, as I was trusting him to do them...plus he went to pt 2  x's per week, so he was doing them there.   He did do his stretches, since he liked doing those.  I now realize that I am going to have to be a bit more involved and know exactly what his exercises are, which muscles they are working, and oversee his exercises to ensure that he is doing them.  Sorry for the long post.  Hopefully the extra details will help.

 

~Angela

Submitted by Vreni Gurd on Wed, 12/17/2008 - 1:23pm.

Hi Angela,

Being in San Diego you can get great help from the Chek Institute in Vista.  I would suggest you contact them and see what they can do for you.  www.chekinstitute.com.   I can't write more now, as I am heading out of town but they can definitely figure out what is going on, and help him recover.  They have a lot of experience dealing with athletes too.  Good luck to him.  You are right.  14 is too young to have so much pain!

 

Vreni Gurd

 

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by online games (not verified) on Fri, 12/19/2008 - 10:45pm.

hi

exSIJDpatient

I agree with you.

Good job.

Submitted by Anonymous (not verified) on Tue, 12/23/2008 - 2:42pm.

HELP, HELP, HELP!!!

I have always had a sway in my back and big booty.  I had my second child and couldnt walk for last trimester and realized (after my own research) that I had stressed my SI joint.  Once the baby was born I had no pain...back to normal.  Then I waited too long to buy new shoes and what I call my "reoccuring heel spur" came back.  I got the new shoes and it has been a year and I am still in pain.  However, I have done more research and learned that the heel pain is not a heel spur at all.  Over the summer, I was working on losing the excess baby weight and worked out like crazy and even started jogging and playing tennis...havent done that in years.  I realized I have reinjured my SIJ and developed hip pain and the heel pain is really in the back of the heel and just burns.  Bottom line is I am not done losing the weight and I have taken different breaks for weeks at a time  from exercise (due to illness of myself or children) and get great relief from this but I must do cardio or I will not lose this weight.  I have received great relief from mat Pilates but it doesnt stick.  I alternate days now and my cardio days are followed by lots of hip pain after sitting for longer times and heel burning after sitting but can even feel the heel pain with legs propped up on sofa.  I feel a dull pain sometimes in my left side of lower back and the right side never bothers me. 

One last thing, I know that the huge amount of excess skin I have hanging in front after losing 175 lbs is not helping my posture and SIJ but I need some help to maintain relief so I can exercise, just to even stay healthy...forget weightloss at this point.  I miss working out w/o having pain afterward.  I do feel the heel burn during the workout. 

Please help, I do not know what else to do.  However, am looking to get panniculectomy to take the stress off lower back.  I tend to have weak ankles too. 

Mama in pain. 

Submitted by Cheryl Ann (not verified) on Tue, 12/30/2008 - 1:12pm.

I have had this problem with SI pain since the birth of my son 18 years ago.

I have gone to many orth docs (about 15 years ago) and none could diagnose my problem.  About 3 years ago, I started going to a chiroprator.  He was to only person who helped me and made me feel like I was not a hypochondriac.  His help is only temporary though.  When I leave his office I feel good, but once I do anything (lift a gallon of liquid, etc) my SI pops and starts acting up again. 

I cannot exercise since it is too painful (even sleeping is interupted by pain and I need to constantly change position).  This has caused me to gain a significant amount of weight over the last 18 years (about 60 pounds).  this weight gain causes the original problem to worsen.  I feel like I am in a downward spiral. 

Now my left hip socket has starting burning as well as the muscle spasm that is constantly over my SI joint.  My right leg is shorter than my left now (because the pelvis is pulling it up).  I have tried to lose wt. with diet (but metabolism is slow) and wt. loss for me is nearly imposible without exercise.  I cannot sleep on my back without a pillow under my legs.  Cannot sleep on stomach more than 10 minutes before SI starts burning.  I cannot sleep on left hip for more that 10 minutes before the hip socket starts burning.  Outer side of my thigh down to knee feels bruised most of time. 

Although the chiropractor, massage and hot tub are the only things that help me, I cannot afford to continue with these treatments.  Is there any advise that you can give me to work on my problem?  If I can find an MD or DO my insurance will pay for it.  They will not pay for chiropractic, massage or much of the PT. 

Any advise would be appreciated.  Medical docs just say "loose wt. and take Ibuprofen". 

                    Thanking you in advance,

                                                      Cheryl

Submitted by Vreni Gurd on Tue, 12/30/2008 - 4:52pm.

  I'm guessing that your leg and heel pain may be due to nerve pain coming from your back, or possibly from a tight or taut piriformis muscle in your butt.  I don't know if this is what is going on, but you may want to explore the question with your doctor.  Your description of pain with sitting and with your legs up, and also your description of "burning" make me think that.  It is possible that a subluxed SI joint will create a disk problem in your low back, which may be causing your leg symptoms.

It makes sense that Pilates helps you feel better, as you are activating your stabilizer muscles when you do Pilates.  Try and activate those same muscles as you go through your life, to keep you pain-free between sessions.  Hold in your pelvic floor as if stopping the flow of urine, or gently squeeze your anus as if preventing the passing of gas.    Try holding in the tissue just above your pubis.  These are the muscles that are designed to stabilize your SI joint.  I'm thinking that it would help if you had your exercise program checked by a physiotherapist, because clearly something in your workout is creating your heel pain.  Your physiotherapist can also check to be sure you are using your stabilizer muscles properly.

If you have a big arch in your back, the hipflexor stretch that I describe in my post above is really important for you, and may help a lot over time.   I would also do the Dontigny exercises, found at the Dontigny link above.

If you still have more weight to lose, I would suggest eliminating flour products, especially wheat, and also all sugary foods.  This will help you drop the weight, so you won't have to rely on doing intense cardio sessions which are clearly irritating your tissues.  Your meals should include above-ground veggies and either a flesh like fish, poultry or meat, or possibly eggs/cheese etc.  Don't worry about eating low fat, as fat does not make you fat - sugar and flour do.  Some butter on your veggies will help you absorb the nutrition from the veggies.   If you also stay away from vegetable oils, this is a very anti-inflammatory diet, which may also make a big difference to your pain levels.

I hope that helps a bit - as you can imagine it is very hard for me to do much, as I can't know what is really going on without actually seeing you.  If you are in the Vancouver area, please feel free to contact me and I would be happy to help you personally.

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Vreni Gurd on Tue, 12/30/2008 - 5:45pm.

Glad to know that chiropractic and massage help - this tells you the problem is probably mechanical.   My guess is they line you up which makes you feel better, but then you are unable to maintain the position due to poor stabilizer function, so the SIJ "pops out" as you say, when you lift something. 

Have you tried looking for a good physical therapist who can teach you how to connect to your stabilizers, so that after your chiro appointments can last a bit longer?   Try practising holding your pelvic floor, drawing in the tissue above your pubis, and trying to squeeze the "pelvic bumps" in the back together without squeezing your butt cheeks.  This should activate pelvic floor, transversus abdominis and multifudus, your important pelvic and spine stabilizers.  Usually after having kids the pelvic floor and transversus abdominis are very stretched out, and don't work as well. I wrote a lot about how to connect to these muscles in one of my comments above, if you want more details.

You may find an osteopath that can help you and be covered.  I'm thinking the reason doctors can't find your problem is they tend not to be trained in how to tell if your stabilizer muscles are working, so if that is the problem, they won't find it.  That is within the scope of practise of a good physical therapist.    I think it is too bad that coverage for PTs is poor, as if you can't stabilize your pelvis and trunk against the weight of your limbs as you move, you will be sore.  That is not something that can be fixed with a pill.  It is learning how to live in your body differently, movement retraining, with the help of a chiro and massage therapy to line your body up.  Only once you know how to stabilize your own body will you be able to handle a full exercise program without pain.

I personally think it is worth the money to pay for someone good.   Usually someone good figures out what is going on in less treatments, which costs you less, and secondly, you get better.   Unfortunately, when it comes to chronic muscle aches and pains,  the professionals that help the most are not covered by insurance.  So, the choice is to pay, or to be in pain.  Kind of sad, eh? (yeah, I'm Canadian ...)

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by DK NJ (not verified) on Thu, 01/08/2009 - 7:43pm.

Hi Vreni-I am very impressed by your knowledge, and hope you can lend me some advice.  To give you a little history, I am 34 years old and have a reconstructed hip from a jet skiing accident 16 years ago.  I am now pregnant with my second child, and experiencing terrible problems with my leg and/or hip.  I don't know if it's related to my previous hip injury, the pregnancy, or the fact that maybe I was running too much on an incline.  Additionally, I think I lost the arch in my feet and have been wearing outdated orthotics while running.  I am walking with a cane at this point b/c I am limping so badly, it's causing even more pain and I feel very unstable. I am also experiencing cramping up the side of my lower leg.  I went to the orthopedic, but he can't do very much testing due to the fact that I am pregnant.  I also went for an EMG to eliminate nerve problems.  That was negative, I am fine with respect to my nerves in my leg (she couldn't test my back b/c of the pregnancy).  I am also starting to see a physical therapist.  I just went for my initial assessment this past Monday, and interestingly enough he mentioned my SI joint.  We are going to start therapy tomorrow.  So I decided to do a search on SI joint damage, which led me to your site.  I would appreciate any advice you can offer.   I am a very active person, and would like to get back into my exercise regimen to maintain my weight during this pregnancy, and make me feel better overall.  Thanks in advance!

Submitted by Vreni Gurd on Thu, 01/08/2009 - 10:40pm.

Hi DK NJ,

Your physio will probably be able to help you - SI joint problems are not usually due to tissue "damage", but rather to it being in slightly the wrong position, which stretches certain ligaments and muscles and slackens others causing irritation.  

When the innominate (one side of the pelvis) is not quite in the correct position, it will effect the hip joint as well, as the hip attaches to the pelvis.  

It is possible your physiotherapist will be able to help you get the SI joint back into the right place, but it may be hard to keep it in place during your pregnancy because the front of your stabilizer system is being stretched (transversus).  You can work on connecting to your pelvic floor (stopping the flow of urine, or gently squeezing the anus) in order to try and keep the joints stable.

SI joint issues can create nerve problems ...  Not sure what else I can tell you - all I can say is best of luck!  :)  Glad you have found a physio that can help you.  

 

Vreni Gurd

 

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Invisalign (not verified) on Mon, 02/02/2009 - 2:04am.

I'm overweight! I am 4'11 (basically 5ft) and i weigh close to 195lbs.
i was on certian medications throughout the years - that i recently stopped taking- which caused me to gain A LOT of weight. Since i stopped taking the meds, i've lost 20lbs. I'm stuck now.

I think the main problem is that I do not get enough exercies. I work at a childcare center, so im constantly moving/running with the kids ... and i park on the 7th floor of the parking garage at school JUST so that i can walk up the stairs when i go back to my car.

I need more exercies, but its hard to find time. I want to start walking. I do not want to do weights quite yet because I do have A LOT of muscle. I'd like to loose some fat before doing anything else.
I have 3 siblings that are basically my life, my responsibility. If i do go walking, they have to come...So we wouldnt be going all that fast. (It will probably be the kids who decide how fast)

Submitted by Anonymous (not verified) on Fri, 02/13/2009 - 1:38pm.

Please help me if you can.    I've found this site of yours to be helpful

and informational.  I'm a very active 46 year old  figure

competitor and in April 2007 I had a dramatic change in condition.

I was diagnosed with spondylolithesis L-5/S-1 and bulging disc.  Since that

date my gate has changed and I have been dealing with "tight" hip flexors and mild

numbness in my right leg, usually below the knee.   Sometimes I feel as if my left

lower leg is feeling the slight numbness too.   I can not sit for too long before my

lower back and lower legs are "annoyed".  The day that my overall physical

condition changed I was doing chest/ legs/ and abs.   Sit ups and lunges.  Also,

I was doing lunges on an  incline treadmill.  So far I've seen three chiros, three

PT's, one neurologist,  and an orthopedic surgeon.  I live in Kentucky and

resources are limited as far as expertise for athletes go.

My present PT is using muscle energy to correct SI joint disfunction.  I believe

she told me that I have an outflare and an anterior torsion.    I've been following

many stretches for my lower body such as hip flexors, quads, lower back,

piriformis,  IT band, psoas, hamstrings and inner thighs.   Although I have been

faithfully stretching and she has been aligning my SI Joint, I still can't seem to

get out of the vicious cycle of tightness and somewhat numbness.  Even after

stretching it comes back especially after cardio.   Later in the day, I seem to pay

for my physical activity.  Also I've been working specifically on lower abs, hams,

glutes and rear delts in order to try to improve my muscle balance.    It would

seem  that after working diligently for five weeks I would be well on my way to

recovery.   Any input of your would be appreciated.

Submitted by CMFJ (not verified) on Thu, 02/19/2009 - 12:05am.

I'm trying to figure out what my problem is and I found your site.  I'm and active  58 year old female, 5'4". 130lbs.  I've been having foot problems for a number of years-bunions and pronation of both feet.  I used orthonics but probably need to have them redone.  What I did do is change all my shoes which helped with the feet.  Now, for the last 6 months, the front of my upper thighs and my lower back hurt especially when I am up on my feet for long periods of time.   I feel like my upper body is collapsing.  It's hard to sit and get comfortable...not really pain.  When sitting I definitely notice my lower back bothering me.  In fact for the last year, I have been using a lumbar pillow when I drive.   If I could pinpoint the start (remember, I'm 58 and my memory sucks) when I began going back to the gym regularly, I do 10 minutes on the bike, eliptical machine (I do this backwards) and treadmill. Then I complete the circuit.  I can't help but wonder if I may have SI Joint problems and that it might have been caused by this exercise routine.  I am not in pain while working out.  As I begin the diagnosis process (I've already had blood tests for arthritis and had a hip X-ray-all negative) I'm wondering if my problem may be caused by my feet throwing my body out of alignment thereby affecting my legs.  I'm not sure if I should see a podiatrist first or move forward with my primary doctor? Any thoughts as I begin this process?  

Submitted by CMFJ on Thu, 02/19/2009 - 12:24am.

While researching my problem, I ran across your site.  I am an active, 58 year old female, 5'4", 130 lbs.  I have had foot problems for years and was diagnosed with pronation of both feet. I use orthonics (probably need to have new ones as these are very old). I changed all my shoes and my feet have been better. Now, the front of both upper thighs and my lower back hurt.  My back has been bothering me to the point that I use a lumbar pillow when I drive; I can't get comfortable when sitting; and I feel like my upper body is collapsing.  I have been exercising regularly for the last 3 years.  In the last 6 months, I changed my routine: I do 10 minutes each on the bike, eliptical machine (I do this backwards) and the treadmill. Then I complete the circuit.  I am not in pain when I exercise.  I just can't be up on my legs for long periods of time before my upper thighs and back begin hurting.  I have seen my primary doctor and have had blood tests for arthritis and a hip x-ray-all negative.  I'm wondering if I might have SI joint inflammation or if my problems could be caused by my foot problems causing my body to get out of alignment.  I'd appreciate your input regarding the best direction to take as I begin the diagnostic process. Thanks.

Submitted by Vreni Gurd on Thu, 02/19/2009 - 9:31pm.

Obviously I am completely guessing here, but are you standing more on your toes than your heels?  Do you wear high heels a lot??  Is your orthotic the full length of your shoe, or does it lift your heel?  Is your pelvis tipped forward like you are pouring water out the front?

If the above is true, you may find it helpful to stretch your quadriceps, hip flexors, and low back on a regular basis, and practise standing as tall as you can, with your bodyweight going through your leg bones and out your heels.  You should not feel like you are contracting your muscles while you stand.  Shift your pelvis forward or back until you can relax your leg muscles, and practise standing that way.

Just an idea - I can't know without seeing you, what is going on.  I hope you understand.  I'd suggest you see a good physical therapist to help figure out what is going on, and guide you in what to do to reduce your pain.  Good luck.

 

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Vreni Gurd on Sat, 02/21/2009 - 11:47am.

Hi there,

Dealing with both a spondy and a disk bulge complicates things, because a spondy is made worse with spine extension and a disk is made worse with spine flexion (usually).  The result is you need to maintain neutral spine in your exercise routine so as not to aggravate one or the other.

I would focus on motor control of the transversus abdominus, pelvic floor and multifidus, all vital muscles that stabilize the lumbar spine and pelvis.  Almost always after an injury these muscles shut off, and need to be "re-activated" and hold times built up.  When they are not working, the outer muscles take over, over-compressing joints, and causing the feeling of tightness.  

Getting the stabilizer muscles to work is more a "mental" exercise than a physical exercise, as you need to figure out how to re-establish the brain-muscle connection - it is not really about strengthening.  You can easily do this in neutral spine - I would ask your physio for help with this, once she/he has aligned your pelvis.  My guess is that if your pelvis keeps torsioning the same way, one side of multifidus, and possibly one side of transversus may not be working as well as the other, allowing the pelvis to "go out" again.  Hopefully your physical therapist can determine for you which sides need work, and help you find the connections again.

Good luck,

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by SamsungLN52A650 (not verified) on Tue, 03/10/2009 - 5:33pm.

Nice post Vreni. There is a good set of information that could help a lot of epople in understanding the right problem and  a cure for the same. Thanks for sharing.

I've been dealing with some serious nerve while getting treated for it, I learned my
si joint was completely locked up and a there were few other things that i was doing aggravated the situation but now slowly bse of some exercises and some posture correction I am leading my way back to normal.

Submitted by security training (not verified) on Mon, 03/23/2009 - 5:52pm.

As a medical student, it is very cool to knw more about SI joint, Thxs for your post, Not only from the post, but also from the comments also we can get more info, that is great :)

Submitted by Anonymous (not verified) on Fri, 04/03/2009 - 6:44am.

I had a major car accident as a passenger 5 yrs ago @ 23yrs. Multiple injuries.

spleen/diapraghm/lung/5 frac ribs/3frac pelvis, 1 straight through my sacrum/knee/head/wrist/elbow

After asking many doctors why i can not walk properly to be looked at blankly.

Never retrained how to walk at any time .

Have now an answer that the SIJ the ligament was serverly damaged, It no longer works at all after the accident. And im the worst they have seen, which has made me feel special ; ) It was lucky that my GP (whom i have changed 3 times) ref me to a specialist who is involved in research. Alot of doctors, physio's are unaware of this and do not approach it at all. Even after a pelvis has been crushed.

I always have tried to walk properly, I am yet to take a proper step. Trying to see through my other pelvis fractures (the pain and ltd mobility) It took time to realise to even me that there was something else wrong and not being able to walk should not be happening.

But last year while standing (which i hate) my right lwr back just sort of gave way, i could not put all this weight i have been needing to put on it anymore.. Tears weld in my eyes my future saw a wheelchair and no more life. I didnt think my back pain could get worse.

During this past year i then developed sharp neve pain on my right spine (this happened jan 09) just above the natural curve of the back.

This pushed me to get this final opinion. I could not rely on my right side at all at the beginning of this year.. just basic things that have not been basic for me anyway are now intolerable.

 

Being diagnosed now and given my options well option about 6wks ago, the last few weeks are even harder my right hip is now unreliable and i have alot of the sypmtoms i thought where nerve damage happening to my right thigh/ hip and knee.

Its now nearlly totally dibilatating.

Kids say i walk like a grandma.

The walking with the buttock out as you mentioned at the begginning is a movement i have tried to avoid for yrs and one my body had kept doing. With both hips now painful and unable to rotate properly plus the lwerr back cracking and moving so grossly it has been a position that is happening continuesly now.

Also my left foot always would turn out i did some stretches releasing the glute i do daily now to straighten my foot.. But now i realise it happens for a reason balance now my right foots all over the place with my jolting right hip. And the left to help with whats happening to the right is returning to that habit. It always felt a little fake trying to make it face forward to make it look normal.

My pelvis is twisted and so is my abdo, with spiny movement/bend which gets worse the harder my body tries to work. Sometimes i think im shrinking then i realise im twisted...

 

Its a terrible thing, i feel now only empitness in this (SIJ) spot with leg movement and pressure. Now that i am resting controlling the other tissue injuries/ligament/muscle.

With rest alot of the pain decreases. But as soon as there is more activity the ripping in that spot begins. Simple as just sitting. Or standing, moves that are like slipping over and touch. and of course walking. With constant instability everythings hard.

Bending rips it the most, and is one that i have not been able to stop from happening To bend I extend the damaged leg to the side of my straight then bend the other knee putting all my weight through the right side then lift myself up using the right leg.. Now this is much harder and causing aching and great pain the the right hip..

thanks for listening...

Also get alot of swelling in legs/ lwr back/ pins&needles/sharp nerve pain mostly around the hips and buttocks and lwr back not always sciatica/feet just about everywhere.. upr body straining and limping adds to my arms swinging and trying to stabalize me, involving my neck and torso too.

 

Submitted by Anonymous (not verified) on Fri, 04/03/2009 - 7:03am.

Heel pain can happen after prolonged bed rest. Due to the lack of circulation.

Once it happens it hard to stop it from happening unless you only rest for 6-8 hrs in bed. Because it keeps coming back easily. It is a circulation issue.

Stockings that you get to lessen the risk of thrombosis is what they give you in hospital this helps circulation. Dont leave them on all of the time though.

My heels are hurting me alot lately.

You can also fold a towel in half and roll it up place your legs on to stop your heels from touching the bed. You may need to also put one under your knees (or a pillow) because having your knees hanging puts alot of stress on them. You'll know when you try to bend them (knees) that you cant.. then u need a pillow.

And stretches in bed, rotating your ankles around, squeezing your butt checks, bending & strightening your legs.

Its annoying and painful and suks that it happens. Sometimes gets so bad cant even put my heels on the bed so i hang them off the side.. Even hurts now when standing.

Your prob could be different but heres some info anyway ;)

Submitted by raisengirl4 on Sun, 05/31/2009 - 8:22pm.

...the chicken or the egg?

Hello! I was involved in a car accident this past March.  I had to slam on my brakes to avoid a truck that came into my lane. I still had my foot on the brake when my van was rear ended. I had no idea a car was anywhere behind me, so needless to say, I was not prepared to be hit. As a matter of fact, I was turned to the right asking my passenger "What is that noise" when I got hit (the noise was the car skidding behind me). The driver told me she was going 40 mph; she told the officer she was going 30mph. There was minimal damage to my van. I think that was due to the fact that my tow-hitch punched a hole in the front of her car. Anyhow...

So, I spent the rest of the day mostly okay; very shaken and a little sore, though. The next day, I went to the ER. The muscles from my mid-back up into the areas between my shoulders and neck (on both sides) were very sore and very tight. The pain extended up into the back of my neck on the right side. After x-rays, I was told I had "straightening of the cervical spine" and "cervical sprain".  I was prescribed pain meds and muscle relaxers and sent home.  The meds did very little for the pain. I detest muscle relaxers b/c they just make me feel horrible.

The next day, I woke with a headache like I had never had before. Light, noise and movement made it worse. It seemed to be worse behind (in?) my right eye.  The pain literally made me so sick I was, continually, trying to throw up (not a pretty thought, I know). Back at the ER, they talked me into letting them give me a shot for pain. That made me more sick. The only plus was that I was finally able to talk sensibly and I could stand to open my eyes more. I still had the "all over aching and pain. It was very difficult to turn my head. After a C T scan w/out contrast of my head and neck, I was told that I have a bulging disc at C4 C5 ( I know that is not uncommon for most people). I was still in so much pain that I, luckily, found a bathroom to get sick in again, before I left the hospital. I was prescribed different pain meds and sent home; they did not help either.

As the next couple weeks passed, the "all-over ache and pain" diminished and was replaced by new issues. My right shoulder, around my shoulder blade and up into the back of the right side of my neck were constantly hurting. The increase in pain seemed to lead to the bad headaches (which I was having atleast twice a week). I also noticed sensations reaching down the upper part of my right arm. And, the fingers on my right hand would get tingly. I actually found myself dropping things on occasion. Pacing myself seemed to be all I could do. During the next week or so, I noticed that my right foot would become tingly. It was more noticable when I was driving (which was still difficult due to the fact that it was still hard to turn my head). I, then, began to experience sensations, and occasional quick pains in my right buttock , that extended down through the back of the thigh. At this point, I was unable to sit, stand or move for more than an hour without extreme discomfort. I began to learn the signs of the "no turning back point" when it would become extreme pain. Laying down was my only relief (sometimes that didn't stop it).

By now you may realize that I am without health insurance. But, I was in the process of gathering paperwork for a free medical program. I was trying to hold out on returning to the ER. But, one night, in mid-April, I had sharp twinges of pain in the mid-back on my spine and sharp shooting pains in my thunb, index and middle finger of my right hand. It scared me...so, I went back to the ER the next morning. I was diagnosed with cervical radiculopathy(sp?) and sciatica. The doctor kept stressing that I needed to get an MRI. I was also told that I had scoliosis (but they didn't offer more details on that and I didn't think to ask).

I was prescribed a six day run of steroids. By the end of those six days, there was a bit of an improvement. The free program did not work out at all. So, my lawyer gave me referral number where I chose a PCP. The Friday before I saw him, I took my nine year old to a b-day party. She talked me into dancing the Cha-Cha slide with her( I knew better than to do the hops). Obviously, there was no headbanging or breakdancing or anything of that nature.    :-)

That night, and for the next four nights, I did not sleep. The scaitic symptoms were horrible. It seemed to radiate through my whole body. I tossed and turned. I wanted to take my leg off. And, starting that same night, I had extreme night sweats. Even during the day, my leg seemed to have a mind of its own. And I felt very heavy and very weak. Now, I try to keep in mind that "even if a doctor has no bedside manners, it doesn't mean he is a bad doctor". But, sad to say, I was not one bit impressed. I know I shouldn't expect him to cry with me, but when I expressed the fact that I didn't know why I was sweating profusely...he responded with "I don't know either" and that was that for that subject. After that visit, I wondered if I might have some sort of infection. So, I took three days worth of leftover antibiotics I had at home and I drank lots of water. The sweating passed after about another week. The doctor stated that, for the sake of keeping it all low cost, I did not need to see a specialist or any more imaging of any type. I was very skeptical when he referred me to the P.T. center. But, fortunatly, the people there have been great. They treat me like a person.

I started with TENS therapy, massage and excercises. These visits began the first week of May and I can say that I have only had one debilitating headache since. I began by being treated for soft tissue injury. Aside from the sciatica, which gave me various good and bad days, the majority of my pain was at the top of my shoulder blade and to the inside of it. It would extend into the back of the right side of my neck. At some point, I developed a huge area of sensitivity on my spine at the spot right below the "lump" at the base of my neck. Wind, my hair, the shower and my shirts constantly irritate that spot. And, it can become painful when I am active for any amount of time. During the massages, I discovered area of pain I never knew I had around my shoulder blade.

Although the sciatic symptoms were always lurking, the pain in my shoulder and neck seemed to be easing. Then after about two weeks of therapy it came back full force. And, I developed a pain in my lower back aroung the same time. It was anything from an ache to painfull twinges that were gone as soon as they started. It ran from my spine and out towards the right. After about another week I could feel slight aches and pains on the opposite sides that seemed to mimic both my shoulder and lower back. I swear I even felt the same sciatic symptoms on the left side on occasion. But, it was all so slight it's hard to say. And, I have had the happy introduction to the middle toes on my right foot going numb if I sit on any hard surface. The only relief I feel is when I walk. My gait has changed, though.  Even laying down doesn't really help.

The P.T. finally told me that my right hip is tilting forward and that my right leg is a bit longer. They readjust my hip every visit and, now, she jokes with me...saying that all it takes is for me to breathe one time and my hip goes back out. She also said that is what is causing the sciatica.  They never have offered to say what is exactly wrong with my shoulder and the spot at the base of my neck, except to say that muscle tightness is impinging the nerves there.

I was fortunate enough to see a different P.T. last week. She took the time to explain that it was the S I joint that was the problem. And, she showed how the sciatic nerve runs through it. I did not think to ask if any of that could affect my shoulder.

So, I guess my actual questions are:

*Could the "fender-bender" have caused the problem with the S I joint ( I think so, as I have never had a problem with my hip or with scatica...even when I was pregnant)?

*Could my hip be causing the pain in my shoulder and the base of my neck?

*And, do S I joint issues cause scoliosis or is it the other way around?

If you took the time to read my novel here, thank you and have a good night!!!

Submitted by Vreni Gurd on Mon, 06/01/2009 - 6:54pm.

Hi Raisingirl,

Absolutely the fender bender can cause the problem with your SIJ.  The whiplash that affects your neck and cranium will affect the low back and SIJ via the Lovett Reactor relationship between the temporal bones in your cranium and the iliums in your pelvis, as well as the occiput of your cranium and the sacrum.  Furthermore it is quite likely the top vertebrae (atlas), as well as other vertebrae in your neck may have gone out of position.  That top vertebrae encircles the brain stem, which if encroached upon can create problems all through the body.

If your SIJ is not in a good position, that will impact the position of the hip joint, which will cause a reaction up the chain in the shoulders and neck.  So it goes both ways.

SIJ malposition can definitely create a scoliosis due to muscle imbalance around the hip which tilts the sacrum, forcing the spine to correct for the tilt higher up the chain.

I suggest you seek out an INT Practitioner (a form of massage therapy).  You need to get your neck and cranium treated as well as your hips and pelvis to sort everything out.  Call 1-866-597-3772 to find an Integrated Neurosomatic Therapist near you.

 Good luck - you can get better - have faith, and keep seeking out the treatment you need.

 

 

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by Caroline Hough (not verified) on Fri, 06/05/2009 - 2:26am.

Hello Vreni

I found your site by accident and am really very happy and grateful that I did so. I have suffered with lower back pain on & off for the last 15 years ( I am 57 now) and have tried various treatments. I am normally a very active person, walk distances every day out of necessity and find this very debilitating. Physio does help at times, but over the last year my bouts have been more severe and I have developed wear & tear in my right hip to the extent that the only treatment is a hip replacement which I feel is my last resort. On Monday this week I started doing leg swings, concentrating on my walking and not spilling any water and also doing the hip flex exercise. Wednesday night I was lying in bed on my back with a cushion under my neck and unconsiously turned my right leg to the outside and on doing this there was a really very loud crack as in when you twist your ankle, but it was not my ankle or knee, and have to say I didn't feel anything inside my hip , leg or pelvis, but something must have been out of joint and gone back in as I felt different immediately. Its absolutely incredible to see the difference in me within such a short time. I am already walking better (though feel awkward and stiff) and can get in and out of bed with ease. and have control back of my right leg, can also lift it etc. I would like to mention that over the years I have always said that the top of my leg feels as if its out of joint, but they've said its not and the consultant that I saw a few months ago that recommended a hip replacement also said that nothing was out of joint.I am now worried that whatever it is will pop out of joint again. What can I do to prevent this? There has been cracking coming from my uper leg today, but can only hear it not feel it to be able to pinpoint where its coming from?

Regards

Caroline Hough (UK)

Submitted by David (not verified) on Sun, 06/07/2009 - 1:06pm.

I have been experiencing back pain since 22 years of age. I was never a flexible kind of guy and I torn my ACL in college playing intramural soccer. I waited 2 months to get a surgery and in the mean time I kept shitting my body weight on left side (where I have my good knee). Even after the surgery I kept unconsciously shifting more weight on my left side due to my right knee never been as strong as my left knee after I have torn it. My therapist warned me to put equal amount of weight on both sides, but somehow I ignored the idea mainly unconsciously. I began to have stiffness in my hips when I was delivering pizza, especially when I would get out of the car. One day I went jogging after work. My hips began to hurt on one side. It hurt so bad that I had to stop running and walk back to my car. I walked like a duck for the rest of the time and began to experience back pains. It hurts my thoracic spine when I cough. I feel like my right groin area is extremely tight compared to my left groin area. I cannot run anymore as pain in my sacroiliac joints does not allow me. My chiropractor said that my left leg was .5 milliliters shorter, but than my right leg was shorter. My chiropractor told me that my lower back twists to one side which causes leg discrepancies. My pain shits from one side of the buttocks to another from time to time, but it is more prevalent on my right side. I can lift one leg easily while my other leg takes great effort to lift and it usually shakes when I lift it. It seems like my lower back twists to one side and on X-rays it seems like one side of the hip is higher than the other. When I sleep on my side I have to change sides continuously as prolong position on one side will start to hurt my back. Any suggestions? I tried chiropractors, PT, inversion table, and YOGA which makes me feel slightly better, but the pain always resumes and comes back.  Orthopedics tells me that they don’t really see any serious problems with my back, but I am in terrible pain frequently. Ibuprofen helps me a lot with pain especially when I am sleeping.  I cannot play any sports anymore.  Any suggestions?

Submitted by Vreni Gurd on Mon, 06/08/2009 - 5:52am.

Hi David,

 

I would suggest you contact Neurosomatic Educators in Clearwater Florida 727-597-3772 to find out who the closest Integrated Neurosomatic Therapist is near you, and then go see that person.  You need a complete postural assessment so that the therapist can determine which muscles are too tight and need to be released through soft tissue work.  Once your structure is straighter, most likely your pain will be reduced.  If your leg length discrepency is anatomical (a bone actually being shorter than the other) rather than functional (muscle imbalance in the hips or your top vertebrae being out of alignment), using a sole lift or shoe insert will help level your structure.  The amount of the lift needs to be determined.  Based on your description, I expect you have a functional leg length discrepency, however.

You can also read some of the earlier comments on the first page about how to connect to your local stabilizers.  This can also be very useful.

 Good luck ...

 

Vreni Gurd

 Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by John Cumming (not verified) on Tue, 07/14/2009 - 11:03am.

Your post is very interesting. I have hip pain/lower back pain as well. It started randomly one day when i went for a 5 mile road run, just at the end of the run i started gettingalot of pain in my hip.. i kept running and it got worse till i got home. I was in severe pain the next day and have been noticing the pain ever since (1 year ago) I went to a sugeon got MRI,nothing was found, he sent me to a physio and he got me to do exercises he fixed my posture but nothing changed in my hip pain. The only thing that helped it was when i was away on an army camp for two weeks and i was always on my feet, running and tabbing for two weeks. The first 2/3 days when i ran,i felt pain .. but after that it was fine. I did a 72 km tab with 40kg on my back and my hip was fine! i came back two weeks ago and got back to sitting and normal days and now my hip pain is back and is increasingly worse when i drive or sit. I have selectiomn for an army course in september so need to get it fixed. 

I also had orthotics when i was younger for fallen arches and stopped wearing them because i felt fine and was a lazy kid! i also used to do alot of situps- 100 a day but busted my tailbone so now my skin chaifs when i do sit ups so stopped. Now i realise i need to strengthen my stomach again and get to the orthotic guy.

Hope to god it works, thanks for this post!!

john

Submitted by JOHNRC on Tue, 07/14/2009 - 11:13am.

Your post is very interesting. I have hip pain/lower back pain as
well. It started randomly one day when i went for a 5 mile road run,
just at the end of the run i started gettingalot of pain in my hip.. i
kept running and it got worse till i got home. I was in severe pain the
next day and have been noticing the pain ever since (1 year ago) I went
to a sugeon got MRI,nothing was found, he sent me to a physio and he
got me to do exercises he fixed my posture but nothing changed in my
hip pain. The only thing that helped it was when i was away on an army
camp for two weeks and i was always on my feet, running and tabbing for
two weeks. The first 2/3 days when i ran,i felt pain .. but after that
it was fine. I did a 72 km tab with 40kg on my back and my hip was
fine! i came back two weeks ago and got back to sitting and normal days
and now my hip pain is back and is increasingly worse when i drive or
sit. I have selectiomn for an army course in september so need to get
it fixed. 

I also had orthotics when i was younger for fallen
arches and stopped wearing them because i felt fine and was a lazy kid!
i also used to do alot of situps- 100 a day but busted my tailbone so
now my skin chaifs when i do sit ups so stopped. Now i realise i need
to strengthen my stomach again and get to the orthotic guy.

Hope to god it works, thanks for this post!!

john

Submitted by Natalie (not verified) on Sun, 08/09/2009 - 5:21pm.

If you are still experiencing pain, I highly recommend Pilates (I recommend it to everyone actually!). It is best to go to a studio that provides small classes and Reformers (a pilates machine) with a knowledgeable instructor. I have SI Joint dysfunction and found pilates through my physical therapist several years ago. I am now an instructor. After learning the causes and treatments for SI, I am convinced that pilates provides strength necessary to relieve pain. It is the only thing that has worked for me. Good luck!!!

Submitted by Lisalis on Sun, 10/11/2009 - 1:11pm.

Hi,

 I have some questions. I am a fitness instructor and was very active until 8 months ago. I have scoliosis a 23 degree curve not bad. Its an S curve so my right hip hikes up. Probably my right leg is longer. I've been wearing a 3/8 inch lift in my left shoe for the last 4 years and it really helped because I used to have pain on my right side. 8 months ago teaching pulled something out in my lower left side had Several MRI's extremely small herniation in L-4 or L-5. The doctor said its nothing well my whole left side is of my it band is so tight and sore it rubs right over the trochantor and my piriformis on the left is killing me I went for PT no help at all. I have been seeing a chiropractor for the past 5 years who is usually great he does a lot of techniques Kineseology and muscle testing. He said something is going on. I went to a podiatrist and got new orthotics because I thought maybe that's the problem. It's still killing me. Is there someone in Long Island or Queens NY that you could recommend? I also had 2 epidurals no help and 2 rounds of trigger point injections that aggravates it. I am frustrated because this is interfering with my job. I'm a 42 year old female in good health except this problem. My zip code is 11793. If I have to I'll travel to the NYC.  What do you think?

Lisa

Submitted by devaneym on Wed, 10/28/2009 - 6:58am.

I am experiencing si joint ache on the L side and i have been unable to resolve it despite the treatment of numerous health care professionals. I am  a 57 year old male and I ran competitively for a number of years. Because of this injury i limit myself to mostly interval work on the exercise bike and 1-2 treadmill running sessions of 15-30 minutes per week if conditions permit. I was fitted with custom orthotics but they didn't make any difference. I do core work such as side planks and handstands as well as pushups and some hip stretching daily. Despite the lack of success i try to maintain a positive outlook in that this can be resolved if I can only find the correct treatment which begins with a correct evaluation. I would appreciate any help or guidance in this area. I work in lower Manhattan and perhaps there are qualified health care practitioners in this area.

Submitted by sloan (not verified) on Sun, 12/06/2009 - 11:01am.

Hi Verni.

I found your blog about a year or so ago and posted with my problems. Since then I have had a large improvement to my left hip. But alas not my right. Since then I have been seeing a myofascia release therapist who truly has helped the healing on the left operated hip. My right side is not responding. To date I have been doing pilates, walking, swimming, bike riding when pain allows. 

My symptoms now are  constant quad and psoas pain. My rightgroin where my leg meets my pubis is constantly in a tight spasm. It feels as if the ligaments or tendons have adhere to the bone. My periformis and glutes are constantly tight and pulls my hip out to the side. Because of that it throws off my gait. My knee pops all the time and my hamstring makes a popping sound when I bend over. I sleep with a pillow between my legs and upon waking I do pelvis tilts and some light stretching before getting out of bed. The weird thing I have also noticed is that after walking for cardio and doing some floor works like pilates movements, I feel so much looser for a day after but if I do not walk I am back to square one again. I forgot to mention in my last post to you about an incident that occured after my right hip began hurting. I went to see a chiropractor who decided to alighn my cocyxx bone. Right after he did it my symptoms magnified. Before I was only having issues with my lower back and problems with turning my knee in. But after the problems that developed was tingling down the legs and periformis tightness. AndI ran out of insurance so henever really fixed my cocyxx bone. My myofascia release therapist was able to fix it after just three visits and it has stayed. i AM TRULY AT LOSS WITH WHAT TO DO NEXT. I noticed in one of your response to a post that you mention that the colon can get stuck to a muscle. Can that happen with the bladder as well. I did have issues with that after my hip labral tear. I was unable to go to the bathroom and had to run to the emergency room that night of my operation. It took three tries to get the catheter in me and am wondering if maybe they nixed it? I had cat scans done that showed nothing. I am about to go to have my  polops  removed. Although that did not show up in the cat scan or mris. Can that be a link to my pain as well? Although to be honest with you I don't think so. Can I have periformis dysfunction from polyps or stuck organs? Please help to sort this out with me? I have tried it all. Stretching, gait correction, core strengthening. I even workout with my myofascia release therapy and he has admitted to be baffled. This is now been going on since my hip operation in Jan of 2005. We are entering 2010 and still no relief or reason for my continued pain. 

Submitted by sloan (not verified) on Sun, 12/06/2009 - 11:03am.

Hi Verni.

I found your blog about a year or so ago and posted with my problems. Since then I have had a large improvement to my left hip. But alas not my right. Since then I have been seeing a myofascia release therapist who truly has helped the healing on the left operated hip. My right side is not responding. To date I have been doing pilates, walking, swimming, bike riding when pain allows. 

My symptoms now are  constant quad and psoas pain. My rightgroin where my leg meets my pubis is constantly in a tight spasm. It feels as if the ligaments or tendons have adhere to the bone. My periformis and glutes are constantly tight and pulls my hip out to the side. Because of that it throws off my gait. My knee pops all the time and my hamstring makes a popping sound when I bend over. I sleep with a pillow between my legs and upon waking I do pelvis tilts and some light stretching before getting out of bed. The weird thing I have also noticed is that after walking for cardio and doing some floor works like pilates movements, I feel so much looser for a day after but if I do not walk I am back to square one again. I forgot to mention in my last post to you about an incident that occured after my right hip began hurting. I went to see a chiropractor who decided to alighn my cocyxx bone. Right after he did it my symptoms magnified. Before I was only having issues with my lower back and problems with turning my knee in. But after the problems that developed was tingling down the legs and periformis tightness. AndI ran out of insurance so henever really fixed my cocyxx bone. My myofascia release therapist was able to fix it after just three visits and it has stayed. i AM TRULY AT LOSS WITH WHAT TO DO NEXT. I noticed in one of your response to a post that you mention that the colon can get stuck to a muscle. Can that happen with the bladder as well. I did have issues with that after my hip labral tear. I was unable to go to the bathroom and had to run to the emergency room that night of my operation. It took three tries to get the catheter in me and am wondering if maybe they nixed it? I had cat scans done that showed nothing. I am about to go to have my  polops  removed. Although that did not show up in the cat scan or mris. Can that be a link to my pain as well? Although to be honest with you I don't think so. Can I have periformis dysfunction from polyps or stuck organs? Please help to sort this out with me? I have tried it all. Stretching, gait correction, core strengthening. I even workout with my myofascia release therapy and he has admitted to be baffled. This is now been going on since my hip operation in Jan of 2005. We are entering 2010 and still no relief or reason for my continued pain. 

Submitted by Vreni Gurd on Sun, 12/06/2009 - 12:10pm.

Hi Ms Sloan,

Good to hear from you again.

Sounds like you have made some progress, although I guess it isn't feeling like much.  Bottom line is the root cause of your problem has not yet been successfully determined I figure, although it sounds like your myofascial person is a gem.

You may decide it is worth your time and money to book an appointment with the St. John Clark Pain Clinic in Clearwater, and go for a few days.  Get an appointment with Paul or Randy.  The first thing they will do is check to see if you have a leg-length discrepancy or a smaller pelvis on one side, and refer you for an X-ray to confirm and verify the amount of the discrepancy.  If this is the source of your problem, no amount of massage or exercise will work.  You will need to put a sole lift in your shoe  or you will need to sit on a "butt pad" on one side whenever you sit.

Paul or Randy are excellent at figuring out root causes, so if it is not a leg length problem they may be able to determine what the problem is.  Perhaps it is organs like the bladder.  Perhaps it is something going on in your neck or cranium, which have a very important relationship with your pelvis.  So, is the cranium and neck driving the pelvis and hip problem?  Perhaps.  Yes, moving the coccyx into the correct position can help a lot, and moving it out of position can make things hurt a lot. I figure you would need a minimum of 2 appointments, possibly more, but it would be money well spent. Phone in advance to book your appointments and make a trip of it around when you can get in.   Bring along  the 2 pairs of shoes you wear most of the time in case you need to get them fixed while you are there.  The fellow they refer to there is so inexpensive I'm thinking of mailing my shoes to him to get them done - probably cheaper than what I can get here at home even with shipping.  (Yes, I have a very significant leg length discrepancy.  No one has ever noticed that my shoes have been altered.)

Anyway, that is what I would suggest.  Keep working on your stabilization exercises, and try to avoid butt-gripping, which would squish that SI joint, cause trigger points in piriformis and/or the other external hip rotators which may refer into the groin.  I have a feeling that is only a band-aid solution, but it may tide you over until the root cause is found. 

 Good luck, and thanks for contacting me again.

 

Vreni Gurd

Certified Integrated Somatic Therapist

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by kensz (not verified) on Tue, 02/02/2010 - 2:54pm.

I just found this site. It's great! Here's my issue:

I first had hip pain in my left inner hip at 24 years old (thank you Marine Corps...). "Clicking" and inflammation, with pain down to the knee. Lower back weakness. This had ben going on for FOURTEEN years! I couldn't even lift my leg to get in car to drive without intense pain as I lifted the left leg. I was/am very active (run/bball). The pain would be less in the morning and grow throughout the day.

Ortho doctor had me get those painful injections into my bursa (X ray guided). PT had me doing stretches/techniques that provided relief, especially when she'd "pull" my hip out of socket (hip impingement)? She had me put an insert in my left shoe- no result for pain.

Holistic chiroprator has helped somewhat. He showed me the left side of my hip was higher than my right side and resets me once every two weeks. He then had me put  the insert in my right shoe.....

 NO MORE left side pain! Now I have the exact same high level of pain in my right leg!!!!  Again, my left leg feels great. The first time in 14 years! But now my right hip is killing me... 

I have taken the insert out and am still having that pain in my right leg. I play bball four times a week and feel great while I'm playing. But afterward hurt ALOT.

I believe this is a gait problem that I'm having. What doctor should I see? Should I get special inserts? Who can tell me what I'm doing wrong?

Thanks! 

Submitted by Craig cartwright (not verified) on Sun, 03/14/2010 - 4:59pm.

Hi,

I had terrible SIJ pain sometime ago, but no-one could diagnosis it! PT was hopeless, as was chiropractor and an osteopath.

It was so bad I couldn't lift my legs up when lying down, I was terribly crooked, and I couldn't cough or sneeze without great pain The worst thing was a horrible "sick" feeling from my lower back and hips.

I went to see another osteo, he took one look at me and said, "your hips are out."

He massaged me, made some gentle adjustments, but most of all he had me lie on my back, checked to see which leg was shorter, then had me bend my knee almost to my chest then lie my leg, still bent, to one side.

He then gently snapped my leg out straight, maintaining the tension, and did this a few times until my leg was the same length.

He then did the same with the other leg, however he snapped it back from the knee-touching-the-chest position.

I felt ever so much better, however it took a few weeks to come COMPLETELY right, as he said it would. He described it as a sprain, and would heal like one, and should be treated carefully.

Since that time if I get lower back pain I know its SIJ problems, and will often get a workmate or friend to adjust my peg for me. Often this makes the problem go away IMMEDIATELY, unless I've actually injured myself, then it takes a week or two.

THis treatment has changed my life, so I hope it helps somebody else!!

Submitted by Charz (not verified) on Wed, 04/21/2010 - 12:04pm.

Hi,
I have read much of these posts, and feel for the first time I am NOT ALONE! Whew! I'm 48 yr old female, diet and weight are good, trying to self diagnose and remedy myself--which is not good!!! What I can't seem to figure out is what kind of doctor to see for TREATMENT?! ....Ortho, Chrio, Podiatrist?? Not one doctor has said it's my SI joint... Orothopedic says it's not my hip, chiro sees leg discrepancy, and podiatrist wants to put arch supports in my size 5 tiny feet, which are too high for my foot/arch, causing even more pain! I have leg discrepancy, arches falling inward, ...to worsen things, my gait is off, and I'm developing corns on the left (longer) side. I just need one physician to help me "heal". I live in south-central NJ (Princeton area)---anyone have a suggestion on who I could go to for all of the above?
thank you for reading and very
Much appreciated!!

Submitted by Vreni Gurd on Wed, 04/21/2010 - 8:07pm.

Hi Charz,

No, you are certainly not alone!    In my experience, what works best is a combo of chiropractic, massage therapy and corrective exercise.  That said, you need to find out the amount of your leg length discrepancy and get sole lifts put on the bottom of your shoe.  Once your pelvis is level you have a chance to heal.  Did your chiro tell you what your difference in leg length is?  To a certain extent it is possible to strengthen your arches by doing an exercise like picking up marbles with your feet and putting them into a jar.

Call the St. John Clark Pain Clinic 727 347-4325 in Clearwater Florida and find an Integrated Neurosomatic Therapist near you and see that person for a full assessment.   The INT can release the tight muscles.  A CHEK Practitioner www.chekinstitute.com can help you with the gait and exercise end of things.

I don't know of physicians that do this kind of work - possibly an osteopath??   Good luck on your journey.  I hope that helps.

 

Vreni Gurd

Health and Vitality Coach

Corrective Exercise Specialist

BPHE, CHEK 3, HLC 2
www.wellnesstips.ca

Submitted by cheap ghd (not verified) on Tue, 05/04/2010 - 11:54pm.

Since that time if I get lower back pain I know its SIJ problems, and will often get a workmate or friend to adjust my peg for me. Often this makes the problem go away IMMEDIATELY, unless I've actually injured myself, then it takes a week or two.

Submitted by harmny1117 (not verified) on Tue, 05/18/2010 - 2:06pm.

Did the prolo shots help? I am also in pain - 2 years now - and heading to New York City for 1st round of prolo

Submitted by Chris67bug (not verified) on Fri, 06/25/2010 - 2:24pm.

I've been suffering from pain in the SI joint area for the past 2-3 years. I first became aware of it whilst I sat at my desk in work and it has steadily got worse to the point where sitting is very uncomfortable. The pain is not acute, more 'nagging' but constant and worse when I sit.

I had an MRI done which showed a degenerated disc at L4/L5 and a 'little low signal change in the iliac sude if each SI joint superiorly representing sclerosis'.

Basically I'm wondering if the sclerosis is what is causing the nagging pain. My back is also stiff on bending forwards, however I have no leg pain and no restriction of leg movement at all. It is only the pain

Any help is most appreciated

chris

Submitted by Vreni Gurd on Wed, 06/30/2010 - 1:11pm.

Hi Chris,

Hard to know if the cause of your back pain is due to the disk degeneration or whether the disk is degenerating due to an SI joint problem, a leg-length issue or something else going on down the chain.  The pain and stiffness you describe is consistent with a degenerating disk.

You may find that avoiding sitting is helpful, and trying to avoid doing anything that rounds your back may keep your pain at bay.  I find putting some strong tape on either side of the spine from the ribs to the pelvis can be useful as a biofeedback system to let you know when you are starting to round your back.

See a good physio so you get a proper diagnosis and for some targeted stabilization exercises based on your issue .  My guess - and it is only a guess!  is that possibly lying on your stomach may relax your back.  IF so you can do this a few times a day.  Do the things that make your back feel better, and avoid the things that make your back feel worse.

Hope that helps.

 

Vreni Gurd BPHE

 

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips.ca

Submitted by Anonymous (not verified) on Tue, 07/13/2010 - 1:36pm.

Hi Vreni,

Please can you let me know what you think of this problem I have got.
In 2007 I rotated anteriorly and tilted on the left side with my pelvis, I also suffered with Lordosis of the Lumbar region. This they think was caused from going to a desk job from an active job. It took 3 months to 'cure', however my back/SIJ never really felt right and having read what you wrote initially about walking feeling similar to floating then I know I never did correct it, although only suffered pain when I had been driving or standing excessively.

Last August,2009, I broke my right Tib & Fib badly and was totally immobile for 6 months. Using mostly my left leg for support etc, now 11 months on I still do not have full strength in my right muscles and not able to live life normally (I am still off work). My problem is that since I have started to walk again I have suffered badly with my back and pelvis area. I did have a leg length discrpency of about 2 inches (?!?) but now it is down to half a centimeter. Apparently I had Trenlendenburg syndrome. Still, my right ankle does not have full 'curve' range when walking but physio say I do when sitting/laying down.

The issue is one doctor suspects my ankle is causing the knee joint out of line thus pushing my right SIJ out (I am now,again, anteriorly rotated but tilted on the right side this time)and another says its the SIJ being in the wrong place causing knee disfunction, thus ankle disfunction when trying to walk correctly.

I have lost a lot of muscle in my right leg and was even hypermobile when I had the external fixator removed from my Tibia. I am struggling to increase the muscle strength due to the question of what came first - the ankle or the SIJ, as one doctor says fix the SIJ and your ankle will be ok, the other says fix the ankle which will help the knee move freely and the SIJ.
What is your view on this?

Many thanks in advance,
A rather fed up,
Alison

ps: Your exercises listed in your blog above really help especially in regard to thinking of your pelvis as a bucket holding water. Thank you.

Submitted by Vreni Gurd on Tue, 07/13/2010 - 9:48pm.

Hi Alison,

I just don't know what to tell you.  I'd correct any anatomical leg length discrepancy with a sole lift and then see how you are after that, but without seeing you it would be imprudent for me to make any further suggestions.  I'm not trying to put you off, but I can't give you more info than has been already suggested in the comments above, except look for a good therapist to help you ...

 Best of luck to you.  I hope you recover fully.

 

Vreni Gurd BPHE

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips

Submitted by crisi (not verified) on Thu, 07/15/2010 - 8:14pm.

Hello, I read your response, and HAD to ask who treated you? I fell 7 years ago ( a little over). I am now 26 and this constant twisted, uneven feeling, and catching of my right leg drives me nutts! I even quit orchestra as I could not sit down for more than 5 minutes straight without getting up to pop my hips. I have been told by my PT i have an upslip and rotation of my right ilium ( the side I fell on). I wanted to ask you who and how they cured you?

thank you :)

Submitted by Vreni Gurd on Thu, 07/15/2010 - 9:15pm.

Hi Crisi,

A chiro should be able to realign your SIJ, and then you can work on stabilization exercises to keep it that way.

I teach my clients muscle energy techniques that they can use when they are feeling "out".  Click the Dontigny link in the post to learn some of those exercises.  Rotation of an ilium can usually be corrected with muscle energy techniques; upslips are harder but a manual therapist (chiro or physio) should be able to help you.

If the muscle energy techniques don't work, get a good massage to loosen the muscles holding the pelvis and then try again.

 

Good luck!

 

 

Vreni Gurd BPHE

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips.ca

Submitted by Vreni Gurd on Thu, 07/15/2010 - 9:16pm.

Hi Crisi,

A chiro should be able to realign your SIJ, and then you can work on stabilization exercises to keep it that way.

I teach my clients muscle energy techniques that they can use when they are feeling "out".  Click the Dontigny link in the post to learn some of those exercises.  Rotation of an ilium can usually be corrected with muscle energy techniques; upslips are harder but a manual therapist (chiro or physio) should be able to help you.

If the muscle energy techniques don't work, get a good massage to loosen the muscles holding the pelvis and then try again.

 

Good luck!

 

 

Vreni Gurd BPHE

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips.ca

Submitted by CJ (not verified) on Sun, 07/18/2010 - 1:42pm.

Hello, I'm so glad I found your site. I hope you can help me!

I'm 29 and feel helpless. For the past 3 almost 4 months now I have been experiencing terrible sharp and burning pains in my lower back, right buttock (that seems to travel right thru my abdomen, wraps around my right hip and into my groin, shoots down the inside and sometimes outside of my right thigh and into my kneecap. Recently, it's started to travel down my shin.

It started out with sanding some baseboard for about two hours and I started tightening up in my lower back, the next morning I couldn't move. A couple days later I was able to walk but, have terrible pain doing anything. The best position is laying down but, that's not even pain-free.

I've been to a chiropracter, massage therapist, family Dr., physical therapy, neurosurgeon, and am on my way Tuesday, to see a rehab Md. I've had an mri of my lower back, which showed nothing. I get my x-ray reading (lower back and right hip this time) Tuesday. No one has been able to help. I was on soma and percocet, which didn't help the pain go away, it only made me sleep and feel foggy. A week ago, the neurosurgeon put me on Mobic which, he said will take down inflammation. He said it takes a month to work, if that's what the problem is. But, it doesn't stop any of the pain. It's almost unbearable. Unfortunately, no one knows what is wrong yet. I was checked for leg length issues and was told they were too close to the same length to be the problem. I can't do anything without being miserable, what can I do? Please, please, please help if you can!

Submitted by Vreni Gurd on Sun, 07/18/2010 - 7:15pm.

Hi CJ,

 I hear your pain and frustration, but I honestly don't know what to tell you.  Your pain is probably nerve based judging by your symptoms.  It might be mechanical.  Can you find any position that does not hurt?  Perhaps lying on your belly?  If so, spend time in that position.   Anything that moves the pain out of your leg is helping.

I would keep trying different chiros, osteopaths, physical therapists etc. until you find one that helps you.  There isn't much I can do without examining you.   Where are you located?

 

Vreni Gurd BPHE

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips

Submitted by Randy in tampa (not verified) on Thu, 08/12/2010 - 4:29pm.

Hey guys, i just found this site today and want to say i think that all the feedback is great!! I have herniated disc's at L/4-L/5 and L/5-S/1 with spinal stenosis and flattening of my thecal sac. I also have a sensory issue with my bladder now because of this. Im 24 years old married with 2 toddlers and have been in severe pain scince my injury at work about 8 months ago (3 days after christmas of 2009) I did it at work, and was a delivery driver for Pepsi. Im obviously on workers comp and am seeing doctor and doctor and surgeon after surgeon, who want to do surgery and then dont want to. Its all a run around game. Anyway the main reason im here is because my physical therapist today told me about the serola belt. so i went to the website and it looks great...I was wondering if anyone here knows if that belt will help with my disc problems? thank you so much..if it helps the pain goes from my lower back, into my thighs, and sometimes into my calves.

Submitted by Abs King Pro Doubter (not verified) on Wed, 09/01/2010 - 8:53am.

Hi there,

I have built up a rather large spare tire over the years and lately it has started effecting my lower back.

I have seen the abs king pro being advertised on television and would like to know if it could help me lose a couple of pounds around my waist as to alleviate the excruciating pain.

Thanks,
Jeff

Submitted by help the teacher! (not verified) on Wed, 12/08/2010 - 12:34pm.

I have had mild-moderate pain in my right back/hip/butt/leg for 10 months now. I thought at first it was IT band syndrome, and nothing irregular showed up on my MRI. After seeing 2 different doctors, 1 chiropractor, and 2 different Physical Therapists, I am confident I have SI joint dysfunction. No doctor will confirm this, but the chiro. and both PT's find a right upslip and outflare and are able to manipulate it into place. Trouble is....I am unable to hold the adjustment.

In PT I am working hard on stabalizing my core and building inner thigh stregth and balance. Trouble is...I am now getting a NEW problem! I am getting PINS AND NEEDLES in my SHIN as well as pain in my groin (right side) that goes up into what I think is my hip flexer. The PT thinks my hip flexor is kicking in when I do my pelvic tilts and other exercises (not what we want to be using!!!) What advice do you have for me? Do you agree that that is causing the pins and needles? I can actually see a slight bulge of muscle, which I think is my hip flexor. When I tighten my "lower abs" it seems to tighten this muscle more on my right side and show a bulging line (it is a small bulge, but I see it). How can I activate these deep pelvic muscles without causing more pain? I want so badly to get better and will do anything to help this problem...

Also...I am only 27 and have never had children. I do not know what caused my dysfunction, but I DO HAVE an actual leg length discrepancy of a 1/2 inch confirmed by a scan-o-gram. I wear a heal lift in the short side (my painful side, the right side). At what point should I look into Prolotherapy? I have not had any injections of steroids or anything yet. I have been getting by with occasional pain killers, ice, and rest when neccesary. I used to be very active and want to recover completely, so I'm not sure if I'm doing the right thing by trying to fix myself through Physical Therapy of if I should be doing something more serious....I am a teacher and am on my feet ALL the time, and I just want to be pain free!

Any advice would be appreciated!,
Teacher in need of help

Submitted by Chiropractic (not verified) on Sun, 01/23/2011 - 11:56pm.

I would advise you to discontinue all your normal physical activities at least for the next two weeks.

Submitted by dumbbells (not verified) on Fri, 03/11/2011 - 5:30am.

But who will benefit from working with weights? Anyone who wants to improve their body shape, increase strength and fitness will benefit, so that covers about all those who intend to work.

Submitted by sia licence (not verified) on Sun, 06/12/2011 - 10:30pm.

I can not thank you enough for the blogposts on your site. I know you placed a lot of time and effort into all of them and truly hope you know how deeply I enjoy it. I hope I could do the same for someone else at some point.

Submitted by AJ the Muay Thai Gear Girl (not verified) on Fri, 06/24/2011 - 9:28am.

I recently took my first yoga class and was constantly corrected for the arch in my back. During that experience I began to realize my posture wasn't as good as I had thought. Keeping your shoulders back is one thing, but over arching the back is another. I had the misconception that this was the right thing to do. Thank You so much for this article. Your "water in the bucket" analogy clicks and I am able to easily correct my posture outside of Yoga class. I was headed for a painful future.

#109: Back Pain
Submitted by Mike Sutherland (not verified) on Fri, 07/15/2011 - 3:52pm.

I have been suffering from sciatica pain for years. The best thing I have found to help me with my pain is stretching. If I go more than day without stretching I really pay for it the next day.

Submitted by Zach (not verified) on Sun, 07/24/2011 - 12:43pm.

Hey Vreni,

I have had multiple sets of x-rays taken of my cervical spine and one chiropractor (pettibon, not specifically upper cervical) says that my main issue is the C2 vertebrae while the other (NUCCA practitioner) is treating the Atlas and when I ask him if C1 and C2 need to be treated separately to resolve my issues he is insisting that the Atlas adjustment will take care of the rest. I am due back for a follow-up appointment in a few days and want to be able to get as much out of the appointment as possible but most questions I ask are answered vaguely and almost always with (...."it'll get better, just give it time"). My main concern is that most NUCCA practitioners advocate treatment of the Atlas but some also mention that problems at C1 and/or C2 can be corrected using upper cervical methods which has me a bit perplexed. On one hand I am being told that the C2 vertebrae is what is wreaking havoc on my system (currently not seeing the chiro who saw the C2 as my main issue) while this other chiro (who I am currently seeing) is addressing the Atlas and failing to answer my question as to whether the C2 vertebrae is in alignment with the rest of the spine. To this point I am not noticing much relief in any of my symptoms (tight right traps, pain behind right shoulder blade, restricted rotation and flexion/extension in neck, some right lower back pain, right hip pain and some right ankle pain as well as lateral left knee pain) and my biggest worry is that the main problem (which could very well be C2 according to another chiro) is being overlooked because NUCCA doesn't directly deal with the C2 vertebrae.... or at least it seems some list the C2 adjustment as a possibility and others do not, only the atlas. I appreciate any and all advice you can provide on this matter.

- Zach

Submitted by Vreni Gurd on Sun, 07/24/2011 - 6:44pm.

Hi Zach,

No doubt the Atlas being in its proper position is critical for the health of the body, but C2 also encircles the brain stem and in my opinion also needs to be gently repositioned so that it is aligned properly.  A good chiro should be able to nudge it into place.  My feeling is you don't need a hammer to fine tune a Swiss watch, and often releasing the muscles that are pulling C2 out of place followed by a gentle mobilization may be all that is needed.  The treatment may need to be repeated several times however.  

Think of it like tuning a piano.  The first time, by the time the tuner has walked out the door, the piano is out of tune again.  The strings need to be "trained" to hold the new position.  So initially the tuner tunes the piano frequently, and over time the tunings are less frequent.

I really do wish NUCCAs would also address C2, but they never do.  Or at least I have not found one that does yet.  It would just speed up the process no end.  Maybe time to pay a visit to the original chiro that told you your C2 was out.  

You may also need neck stabilization exercises so you learn how to keep your vertebrae aligned.

Hope that helps,

Vreni Gurd BPHE

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips

Submitted by Auto repair Vancouver (not verified) on Mon, 08/08/2011 - 1:50pm.

In this blog its nice information is Walking incorrectly may "unlock" the SI joint, leading to SI-joint related low-back pain as well as wear and tear in the acetabulum.

Submitted by Geoff on Thu, 08/18/2011 - 11:49am.

Vreni,

I am a 40-year-old military officer, 5'7" - 140 lbs, suffering from foot, left knee, right shoulder, and back pain for 3+ years. (I am a fitness enthusiast & sports/nutrition nut.) It started as foot pain (diagnosed with peroneal tendinitis), but cortizone injections, soft casts, hard boots, injected steroid treatments, multiple meds, ultrasound, ice, diet changes, and six months of PT did nothing.

After two shoulder orthopedists (and one ineffective orthoscopic surgery), two podiatrists, three physical therapists, a physiologist, two different foot orthodic experts (3+ different pairs of orthodics), MRIs, x-rays, and two chiropractors, my current chiropractor says I have SI Joint disfunction (Category II). His treatment is 2+ weekly adjustments and walking - no other physical activity.

After 9 months of walking thousands of miles, and paying thousands of dollars (military insurance doesn't pay for chiropractic care), as well as not sitting, picking up my baby daughter, doing any household chores, going on car rides greater than 30 mins, carrying groceries, picking things up from the floor, etc., my "adjustments" don't hold more than 48 hours and the lower back pain persists regardless. The adjustments seemed, however, to eliminate the left knee pain and reduce the foot pain. However, I still couldn't go barefoot in the house for 30+ minutes without severe foot ache. After only two weeks on deployment, I'm back to where I started before the series of adjustments 9 months ago. When my left lower back hurts, my left knee hurts. When the pain shifts to my right lower back, the left knee & back pain disappears. Sitting hurts the most. Sometimes laying down hurts. Walking feels good. Running feels good too.

Four weeks ago I slowly started running again (for 5-15 mins a total of 8 times.) after 3+ years of inactivity. So I don't know if the relapse of knee pain and incease in foot pain is from running, not walking 2-4 miles/day, sitting too much, lack of chiro adjustments while deployed, etc. Regardless, the lower back pain has never improved (I don't remember having back pain before I saw the chiropractor.) A physical therapist told me two months ago I need to stretch and strengthen my core, and she doesn't think I'm out of "adjustment".

I don't even know who to trust about this anymore. I feel like I am too young to be in this much pain for this long. Do you have any advice on how to proceed? If so, I would be grateful. Thank you in advance.

Submitted by Vreni Gurd on Sun, 08/28/2011 - 12:16pm.

Hi Geoff,

I can feel your frustration, and don't blame you! 

My thought is that something is being missed.  Perhaps people have been focussing too much on where you hurt as opposed to looking at your structure as a whole and figuring out where the areas of tightness and weakness are?  Often the areas that hurt are the victims of other areas in the body that are not functioning optimally due to tightness or weakness, and if we keep examining the areas that hurt without examining the entire structure, we can be led astray. 

Some suggestions.  Can you kneel comfortably such that your knees are on the floor, and your butt is resting on your heels, toe pads tucked under and on the floor? 

Can you squat down all the way to the floor, feet flat, and feel comfortable sitting there for a while?

Can you lie on the floor keeping both shoulder-blades on the floor, and drop your knees off to one side, resting your legs comfortably on the floor in this twist position? Is your flexibility even to both sides?

Are your hamstrings even or is one tighter than the other?  How about your quads?  Balance from one side to the other is critical to keeping your structure pain free.

If not, continue working on these concepts gently until they are easy for you and the stretch feels even side to side.  Sometimes the issue is the lack of slack in the system so that bones are pulled out of alignment as soon as there is any one-sided pull.

The other vital part is stability.  Are you able to use the correct muscles that hold your bones in alignment?  If not, when you move your bones might be moving out of their ideal axis of rotation, creating a problem for you.  This is not about strength, but about motor control, and ensuring you are using the correct muscles for the job.  Pretty much everyone that I have seen that has pain, has a problem connecting to the correct muscles. 

I'd suggest a CHEK Practitioner, level 3 or higher to do a complete assessment on you and design a personalized exercise program for you.  www.chekinstitue.com

IF you do NOT have an anatomical leg length discrepency, the other suggestion I have is purchasing the Vibram 5 Finger shoes, and walking in them.  Do not run in them more than 5 minutes initially, if you want to use them for running.  You will use your feet and legs in a completely different manner, and initially this change if too abrubt will cause more problems.  But building up walking time gradually will probably help balance the muscles of the feet and legs.

Hope this helps,

Vreni Gurd BPHE

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips

Submitted by Dave a Walker on Mon, 08/29/2011 - 12:42am.

Is it possible that a misaligned SIJ can cause pronation?
I have narrow discs in L3 and L4 and always believed this was the cause of my lower back pain. I have walking races for a few years now, started from a hiking background to do a few off road races then started road races. I never enjoyed running because of the pounding. My wife is a runner and so i took up walking to keep her company. We can tarin together as she runs ahead then back to me etc. After a few races I got sore arches and changed shoes from New Balance to Asics Nimbus. Around this time also got my SIJ realligned by a Chiro I was fine in them for a year or so, I did a few marathons and Ultras, then this year i tried dome Skyspeeds, after 100ks the heel came off i went back to Asics and got a pair of Nimbus 12. I did Two oceans (56k) in them and felt fine. When is started Comrades(89k) , about 10ks into the race I got sore arches. this limited my stride and pace. I stll finished the race but never before did I have arch pain like that, i would have it for maybe a k then it would go away. I noticed that the left heel had collapsed in, I was pronating. It seems like after a number of ks or when tired or going fast that I pronate. I noticed previously that if my left foot slaps when i walk that it was the SIJ, and tahtwas why i went to the Chiro. I do not like Chiros so have not returned. I am now trying Stability shoes and feel the support in the heel area. but now I have started slapping again.
I noticed over the weekend that my left hip is slightly back so today i tried to consciously pull it forward while walking. It seemed better. Is there anything i can do to strengten the area to help this condition

Submitted by Geoff on Mon, 08/29/2011 - 7:21pm.

Vreni,
Thank you for your advice. I can do NONE of the stretches you mentioned. So, I will start there and look into the shoes. I greatly appreciate your assistance! Geoff

Submitted by C.Monet (not verified) on Thu, 09/01/2011 - 7:50pm.

I have a history of hip deformity in my family my mother and grandmother have both had 3 hip replacements each within their lifetime. This was very intense due to wires also being implanted in my mothers legs. I have also had issues knee surgeries due to the same issues as my mother and grandmother and also a deformed SI joint. At 21 I was aware of the condition and it has caused problems but only short term. I am now 41 the unlocking of the hips has become very painful this is not cracking but my hip simply gets stuck until there is a release of the crack or pop. I am unable to stand this has been going on for 3 days it feels like labor without a rest its constant deep and intense right on the left SI joint. I am now very concerned it will not let up at all now. What does this mean and how can it be corrected? I do want to mention that the way this condition is described on this site is exact so I am seeking help. Thank you to anyone for information.

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Submitted by Cherr (not verified) on Thu, 09/29/2011 - 4:16pm.

I have been having pain in my back from working out the wrong way. I love everything you talk about in here. I will pass it on.

Submitted by treatment for pink eye (not verified) on Sat, 10/01/2011 - 7:26pm.

I would advise you to discontinue all your normal physical activities at least for the next two weeks.

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Thanks you for your advice.

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Submitted by loestrin 24 coupons (not verified) on Thu, 10/20/2011 - 7:43pm.

Thanks you for your advice.

Submitted by Michelle reee (not verified) on Fri, 10/28/2011 - 5:37am.

I have suffered from SI joint dysfunction for many years and recently found a complete cure. Gluten Free diet has completly cured my dysfunction. If I accidently eat wheat, I feel it within 2 hours in my joints. Hope you all try this it has saved my life!!!!!!!!!!!!

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Submitted by Anonymous (not verified) on Fri, 11/11/2011 - 3:39pm.

My husband is a hard working on the move 55 year old man who has had a lifetime of lifting heavy things. He has never had back pain until 3 weeks ago. He was bending over the car installing a hose. A very simple job. His back began to hurt. 3 weeks later he can barely walk. We found some videos on youtube and followed the on line exams. He seemed to be positive for SI joint dysfunction. We initially thought it was his hip but everything points to the SI joint. He has had hip pain in the past, in the front of his body and on the side, both deep within.

The situation is that he had no symptoms leading up to this and he is all but incapacitated.
Where to start? I have him resting, taking anti inflammatories. I am going to look at his legs for length differences...maybe that is only done by doctor. Our son has a 1 inch leg difference and wears a special insert. Maybe he has an unappreciated difference if our son has this. We are going to do some IT and TFL band exercises.

We will go to the doctor but we thought we could do some common sense things first. I am a bit mortified.

So, if you were at the beginning, what would you do?

Submitted by Where to buy maqui berry (not verified) on Fri, 11/11/2011 - 4:22pm.

Hi there,

Thanks for sharing the information with us. Joint pain is too bad and I hope that everyone suffering from it to get recovered very soon. They say that prevention is better than cure so I think that we should take care when walking better than suffering from this bad condition.

Cheers,

Submitted by Anonymous (not verified) on Tue, 11/15/2011 - 12:01pm.

I tried the walking backwards thing you mentioned. Every single step I heard a popping sound that seemed to come from the left side of my butt. (Left side is the worst)
Is the popping an indication of anything significant?
I kept walking backwards and then walked forwards with feet 45 degrees out, and it felt good.

Sitting still is the WORST, so back to the donut pillow again until I see my pain mgmt doc the 29th of November. I am eating tiny meals and barley any carbs so I do not add weight to this problem.

I still think I need an updated MRI as I have not had one in 4-5 years. I have degenerative disc disease and had an L-4-5 disectomy in 1998.

Submitted by Vreni Gurd on Tue, 11/15/2011 - 7:50pm.

The key initially is getting a proper diagnosis, as treatments will vary slightly depending on what the problem is.  For example, for SI joint pain, the SI joint needs to be re-aligned, and then a stability program can be incorporated so the bones do not "go out" again.

If the problem is due to a disk problem - degenerative disk disease (which may happen as a result of an SI joint problem, the disk needs to be centralized, any vertebrae that are in poor alignment need to be re-aligned, and then a stability program can be incorporated.  Movements or positions that aggravate need to be avoided completely (sitting, bending over) and movements that make it feel better need to be encouraged. 

 A leg length discrepancy can cause chronic SI joint problems as well as
chronic disk problems, so a thorough assessment is critical.  Look for an excellent chiropractor or physical therapist that can assess and treat.  They are worth their weight in gold. 

Also, improving leg, foot and hip flexibility will allow for more slack in the system making it far more forgiving. One should be able to kneel on the floor, butt sitting on the heels,  toe pads turned under with no difficulty at all.  In my experience, most people with back pain cannot do this. 

Flexibility should be even between the two legs as well.  If one is tighter, once the range is used up, the tight muscles will pull the joints out of alignment. Doing all stretches with a neutral spine would be necessary, especially for a disk problem, so see an exercise professional who can teach you exactly what to do.

 Hope that helps!

 

Vreni Gurd BPHE

 

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips

Submitted by Edith (not verified) on Sun, 11/27/2011 - 3:25pm.

Hi,

You are right to assume that these people are doing something odd with picking up their feet....There exists 2 variations of this problem. One lot over use their psoas to pick up their feet and have deep curves and nasty disc problems from years of doing it that way.........the others stablilize themselves via the short hip stabilizers, decrease ROM and develop the SIJ issues.... NO AMOUNT OF CORE STRENGTHENING will solve their problems.

The problem starts in the feet......most have little idea about how to coordinate their foot and their knee....the knee doesn't flick forward from the foot which should be the driver of all walking.....there are some interesting muscles under the foot that get ignored by most and are critical to these problems.....

When a viable foot is created and used in conjunction with the knee the upper problems fade.....generally without any real attention to stretching, glute and core harassment.....orthodics in general only make foot problems worse......for nowhere else in the body do we believe that tethering, deactivating and containing actually makes muscles stronger.....

Edith

Submitted by log cabins (not verified) on Fri, 12/23/2011 - 8:34am.

Yeah thats great advice. Also I've noticed if i take supplements that are god for my joints and muscles that seems to really help a lot as well as taking omega 3s and so on and I think that Always stretching before and after exercise is key too!

Submitted by Anonymous (not verified) on Wed, 01/11/2012 - 9:50pm.

I have suffered for 9 years with SIJD, after years of strengthening, nothing helped, it was getting worse. I was recomended by my alt therapist to try a gluten free diet, My SI has not went out since the last time I had wheat. I didn't have a weekness or imbalance, as I was told for years. i was being poisoned by wheat. Please carefully watch your diet and see if you can help yourself. I wish someone could have told me this years ago. I would have tried anything to get better if only I have known. I am completly better now after being gluten free for 4 months. I have work to do to get back to 100% strength after years of disability, but I am well on my way, with little to no pain, if I stay away from gluten (wheat, barley, rye). Try it, it may help some of you guys also. Best wishes

Submitted by Vreni Gurd on Thu, 01/19/2012 - 11:18pm.

Hi there,

Yes, if one is sensitive to gluten (or something else), due to the viscerosomatic reflex, the stabilizers of the abdominal wall will be turned off, thereby leaving one vulnerable to SIJ problems, disk problems etc.

After being off the offending food, the gut has a chance to heal, and allowing the stabilizers to fire again.

So happy you are feeling better!  Cutting out gluten would probably help many! 

Vreni Gurd BPHE

Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips

Submitted by Sheryl Hutcherson (not verified) on Tue, 03/20/2012 - 2:45pm.

I found your article to be the most informative I have experienced regarding this weird pain I have been experiencing. I have been to my primary and also have an appointment with a hip surgeon (had a car accident years ago and have osteo arthritis in my hip). However I keep thinking it is that funny bump in my back which hurts more than the hip does. After trying these exercises and looking at the odd way I walk(with my head leaning forward and legs following) this all makes a lot of sense. I still can't figure out how a diet can affect this. I don't each much bread so that is a good thing. Thanks again appreciate the effort you have put forth to help us walking wounded!

Submitted by cindy connor (not verified) on Tue, 03/27/2012 - 6:08am.

I had SI joint problems ten years ago and developed something which I think may be related. So far physio has not solved the problem.
The range of motion in my left hip is severely diminished. When i lie on my back i can't lift my left leg or if I do manage to lift it an inch or two, I get feelings of sparks going down my shins. Pain in lower back in SI area. Thigh muscles tire extremely easily. I walk with a trelenburg gait on the left side most of the time and it is difficult to put weight on it. I have mild osteo in hips but have had that for a long time so dont think it is that
The reason i think this must be my SI joint is because of how suddenly it happened. I think something must be misplaced and stuck.

Submitted by Anonymous (not verified) on Tue, 05/01/2012 - 10:13am.

I appreciate this, but my thing is I've been through so many personal trainers, PT, chiros and I'm not finding someone this intelligent to help me get over this problem. I feel like I"m missing out on being able to run because I don't have access to someone that will really help me. How do I find a physio or something similar that is good? I live in Albuquerque NM, if someone could help me.

Submitted by Vreni Gurd on Tue, 05/01/2012 - 7:43pm.

 Hi there, 

I suggest you look for a  Chek Practitioner, Level 1 or higher.   https://www.chekconnect.com/Page/SearchForm

Best of luck to you.  Do keep searching.  You will find the help you need.

 

Vreni Gurd BPHE

 Health and Vitality Coach

Corrective Exercise Specialist

Certified Integrated Somatic Therapist (INT)

Metabolic Typing Advisor

www.wellnesstips

Submitted by nike free run men (not verified) on Thu, 05/03/2012 - 2:35am.

after being off the offending food, the gut has a chance to heal, and allowing the stabilizers to fire again.

So happy you are feeling better! Cutting out gluten would probably help many!

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#138: hip brace
Submitted by aaronT (not verified) on Thu, 06/27/2013 - 8:06am.

Vreni, I've been going through a lot of the posts and was surprised to find that very few people had mentioned using a hip brace of some kind or another. I have been using a sacroiliac joint belt for the last year and have been pretty satisfied with the reduction in hip pain. I think some of your readers might benefit from trying some type of hip brace. Hope this helps! --Aaron



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