Lined up at our tent after a half marathon are about 10 women of all ages.
One complains of back pain that started at mile 4, another groin pain that is
aggravated after every race. Some report tight IT bands or aggravating
hip pain that kept coming up during training.
Would you assume these women all have different problems?
Not so.
Everyone of these women came to us with a SI (sacroiliac) joint problem.
The two sacroiliac joints connect the tail bone to the pelvic bone. It’s job
is to bear and transfer weight from the upper body to your lower body.
There is not a lot of movement in this joint, only a few millimeters, but it’s
critical to proper functioning of the spine and hips. It is located at the main
nerve center of the body causing low back or radiating leg pain.
The SI joint problem can result from too much movement (hypermobility)
or too little movement (hypomobility) resulting in misalignment.
Causes of SI joint dysfunction include:
- Trauma such as a fall or car accident causing misalignment
- Sports of overuse injury causing a ligament strain
- Leg length difference causing an imbalance between the joints
- Pregnancy resulting hypermobility from the hormone relaxin
At our running event, most of the women had hypermobility, some from
recent pregnancy. They complained of increased pain as they increased
running distance and when running up hill. They reported tightness in
their hamstrings, hip flexors, and IT band.
Clients report they have to change positions frequently to remain comfortable.
Complaints associated with SI joint dysfunction include:
- Low back pain
- Buttock pain
- Hip or groin pain
- Radiating pain down the leg (even into the knee)
These pain symptoms are frequently misdiagnosed as coming from the back.
As much as 25% of low back pain reported to a physician is actually as a result
of a problem in the SI joint. One reason is that the problem doesn’t usually
show up on an X-ray, MRI, or CT scan.
So people are being treated instead for:
- Herniated disc
- Arthritis of the spine
- Degenerative disc disease
- Sciatica
If you are receiving treatment for any of these conditions and not seeing
improvement by treatments addressing your back, ask your clinician to
assess your SI joint. Unfortunately, despite research supporting the need,
it is frequently overlooked.
If you have a problem with your SI joint, yoga and Pilates can be helpful due
to their focus on muscle stretching, balance, and core stability. It’s also important
to use good body mechanics to ease stress on the joint.
This could include:
- Avoiding postures that put uneven weight on one side
- Standing with equal weight on both legs
- Not crossing your legs
- Not bending at the waist to pick up children or objects
- Not carrying children or heavy objects on one hip
- Avoiding walking on steep inclines
Exercise ball (swiss ball) exercises can also help develop muscle strength in the
core, back, and pelvis. These muscles improve spinal stability. Try using the ball
to do wall squats or bridges. While sitting on the ball perform slow, controlled
movement of your pelvis forward/backward, side to side, and in a circular motion.
If pain continues, seek attention by a certified manual physical therapist.
Treatment should include:
- Mobilization of the joint to restore correct alignment
- Stretching of tight muscles causing imbalances
- Strengthening of the surrounding muscles to provide stabilization
- Body mechanic training to avoid improper strain on the joint
- Temporary use of a a belt or taping technique to provide support
All of these treatments are appropriate even during pregnancy to decrease prenatal
and postpartum pain. If you have any further questions about your particular problem
or possible misdiagnosed back pain give us a call today at 901-316-5456.
If you are a runner, with low back, hip, or knee joint pain limiting your performance and
training regimen, click HERE to download our FREE E-Book “8 Proven Ways for Runners
to Stop Hip and Knee Pain“.
