# SI Joint Dysfunction-- lower back pain



## Radioface (Jun 22, 2010)

not a post about a crash-- just a nagging injury I wanted to see if anyone else has encountered

Ive injured my lower back 4 or 5 times in various skiing, biking and hockey crashes, but the pain would always go away and never affected my riding. About 10 weeks ago I was finishing a ~25 mi. x country ride and my lower back was screaming at me. After 3-4 weeks the pain was still significant so I went to the Dr who diagnosed me with "SI joint dysfunction." Ive been in PT for 5 weeks and it isnt helping, at all. working on my hip extensors and and core muscles to take pressure off of my lower back. Im in Philly currently and my therapist at PENN doesnt know ***** about biking posture etc. really just seem to be giving me a few things off the standard low back pain chart

Anyone encounter lower back pain and have any advice? Id like to find a therapist who can work with me on my posture on the bike. Ive never had my bikes professionaly fit, Ive always just gone with what is comfortable, now nothing is comfortable.


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## Radioface (Jun 22, 2010)

Damn-- after scrolling down on this board-- looks like lower back pain is an epidemic. Someone needs to complie a comprehensive "lower back pain for the mountain biker" treatment regimen.


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## bbbr (Nov 6, 2005)

i tweaked the hell out of my lower back/hamstring in the spring and have pretty much been in PT ever since. The focus has been on keeping the entire spinal column aligned (neck to arse), flexibility and boosting core strength. Only in the last month or two has the pain gone down to a more manageable level. At the height of the issue, I did get a nerve pain drug to help control it at night so i could sleep (it and i didn't really get along and was stopped)

Fit wise, I wound up with a very upright position on my road bike and avoid riding in the drops for more than a few minutes as it still hurts. My xc bike is an old Cannondale M600 with the original stem (really stretched out), fork and a riser bar. That setup is fairly comfortable for me, despite it being so different from the road bike.

There have been other times where I tweaked my back, including getting launched over the handlebars at speed more than once. The pain always went away pretty fast seemingly with out any long term consequences. My PT thinks this latest one is the end result of all the minor ones tweakings not quite healing right, leaving me more vulnerable and weakened than i would otherwise be.


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## spinarou (Oct 4, 2005)

DonTigny method has worked some for me. Bear in mind, I have not had a doctor's diagnosis and I have not done the exercises as much as I should.


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## MightyDingus (Jul 31, 2010)

I had something similar years ago that was from a pinched nerve in my back. 4 weeks of PT did nothing at all for it. One day the PT got fed up at the lack of results and wanted to try something different. He had me lay flat on my back on one of the PT tables, hold onto the top of the table, and pulled on my ankles. He leaned back at about a 15 degree angle, so there wan't a ton of pressure. I could just barely feel him pulling. He stayed like that for 5 minutes, then asked how I felt. I stood up straight for the first time in weeks. I walked out of there and never went back because my back didn't bug me from that point on. 

Now when my back is bugging me, I have my wife pull on my ankles for a bit (instead of vice versa) and that helps a ton. I've thought about picking up one of those inversion hangers, but haven't dumped the money into one yet. 

Give it a shot. You really don't have anything to lose by trying it.


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## superdylan (Oct 4, 2007)

If you're in San Diego, you should check out my office. I work a lot with SI joint dysfunction and pain. 

If you've got injury to the back from a single event, you've got a few things going on.

Possible fracture or chip (need x-ray to diagnose this one unless it's blatantly obvious)
Possible dislocation/subluxation of vertebrae and/or sacrum (si joint)
Muscular tightness to protect the area of injury
Muscular weakness/imbalance due to structure or nerve impingement
Swelling, bruising, etc.

Radioface...you're right. Back pain is not that uncommon in bikers. Most of us have shortened psoas muscles that contribute to lower back pain and spasm. We also have a tendency to only strengthen our legs and lungs rather than our core.

If you guys have any specific questions, you can email me or PM me. And if you're in the San Diego area, you can visit my office.


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## c-lo (Jun 12, 2006)

foam rollers, the stick, stretching, and doing my core exercises (when I'm consistent) have helped keep my back pain in check. I've recently increased my arsenal of pain tools to include tennis balls and baseballs to dig into tight areas in the glutes, legs, and back.

I've found I'm particularly tight in my glutes and when they are really tight it effects my low/mid back (as it should).

recently I stumbled across this mobility blog and really like it. it's helped my out a lot.

http://mobilitywod.blogspot.com/sea...-max=2012-01-01T00:00:00-08:00&max-results=24


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## Radioface (Jun 22, 2010)

thanks for the link--I'll check it out.

Ive also been working on my hip extensors--glutes and hammies a lot. both strengthening them and increasing flexibility. combined with some core strenthening and it seems to be improving my alignment and taking some of the strain off my lower back.


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## c-lo (Jun 12, 2006)

no problem. lots of good mobility stretches etc. in the blog. funny...when you don't stay on top of your stretches/core strengthening/corrective exercises is when all the back problems, etc... come back. PITA.


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## jeffscott (May 10, 2006)

Radioface said:


> thanks for the link--I'll check it out.
> 
> Ive also been working on my hip extensors--glutes and hammies a lot. both strengthening them and increasing flexibility. combined with some core strenthening and it seems to be improving my alignment and taking some of the strain off my lower back.


I have been fighting SI joint for about 6 months now...lots of Yoga, core execises,etc.

All the exercise and therapy in the world won't help if your not in correct alignment.

See a really good chiropractor, I went in twice in September, slipped on ice in December, so I went one more time....

I felt great after the adjustment...but the pain started creeping back...

Finally early January I tried a stretch, head between the legs feet point top the outside, hands behind arms behind the legs, hands on the feet.....

Bingo the SI joint let go (like an adjustment) and the back muscles relaxes so I could bend about 3 inches more...

I have been doing that and Yoga, stretching, and exercise and still pain free.
I continue to ride 15 km/d, curl, and XC ski on the weekend.

See a Chiropractor, and find a streach that works for you.

I


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## jnails (Jun 1, 2009)

Does anyone have a link to some Yoga exercises they like that may be good for someone new to it??? My back has gotten better lately thanks to lots of stretching and the foam roller, but i'm looking for something to continually help besides the just the core exercises.


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## jeffscott (May 10, 2006)

jnails said:


> Does anyone have a link to some Yoga exercises they like that may be good for someone new to it??? My back has gotten better lately thanks to lots of stretching and the foam roller, but i'm looking for something to continually help besides the just the core exercises.






 Easier





 Harder

It will take a few rounds to get the alignment right, you want to really pay attention to the alignment.


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## jnails (Jun 1, 2009)

Thanks Jeffscott. Looks promising, especially the easier one for now. Watching the second one I now know why my back is jacked up. My 14 month old is 31 lbs. (future middle linebacker) and when I carry him I'm always shooting my hips forward to support his weight. From that video she explains that this directly puts pressure on your low back. I figured the back problems were from him, just didn't think that leaning back was the problem. I would have thought that bending over to get him was the issue not the reverse.


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## Doggity (Mar 27, 2007)

Doesn't everyone? I've got SI joint dysfunction because a.)I've got scoliosis which b.)caused my pelvis to rotate and thus caused c.)tight as hell hamstrings and low back muscles. Look up the piriformis muscle stretch...that one feels SO good, helps a lot. Look to your fit...too low, too stretched out, not good. You gotta ride like a Fred, then be a Fred. You'll know when you're there. Core muscles are key also...if I work them enough, the low back doesn't hammer me so much.


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## Radioface (Jun 22, 2010)

just youtubed that muscle stretch and rolled around on the office floor a bit. very nice.

I definitely think I have some fit issues I have to work on too.

anyone ever try a chiropractor for the SI?


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## jeffscott (May 10, 2006)

Radioface said:


> just youtubed that muscle stretch and rolled around on the office floor a bit. very nice.
> 
> I definitely think I have some fit issues I have to work on too.
> 
> anyone ever try a chiropractor for the SI?


Yup, mine cracks me then it is good for someperiod of time, but it has always come back...hence the stretching and exercising I need to get rid of my muscle imbalance...


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## jeffscott (May 10, 2006)

jeffscott said:


> Yup, mine cracks me then it is good for someperiod of time, but it has always come back...hence the stretching and exercising I need to get rid of my muscle imbalance...


I should add there are two types of SI joint dysfunction.

Hyper moblie think young pregnant women....(loose)

Hypo mobile think old geezers...(stiff)

loose women need to be very careful when they stretch especially a forward fold.


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## carter1 (Jan 30, 2004)

I was diagnosed with SI joint disorder by 3 doctors.  I had numerous x-rays and an MRI. They were all wrong. Found a good PT guy, started doing the cobra (Yoga move?) and the pain was gone-that day!

Now if he could figure how to heal a grade 4 ac shoulder separation without surgery.

c


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## GregB406 (Dec 19, 2005)

I think Jeffscott is correct. 

I have a left SI issue. Had it about 10 years. It is hyper mobile but now permanently inflamed. There are several streches that help me, but the goal is to get the head between the knees, feet bent back, and arms stretched forward. Sorta like praying toward the east. It stretches the lower back, buttocks, quads. Afterwards I can stand straighter and usually my SI immediately feels better. This relief can sometimes last for several days at a time. Beats eating pain meds.


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