SI Joint Pain...Frustrated.

[daisylubob]

OK I know this has been discussed ad nauseum, but if anyone else has any tips, I would appreciate input.

To get to my point. I have had ongoing low back pain for close to a year, w/ it mainly occuring on the bike (road & mt). The pain starts approximately 12-20 into a ride, it originates in the low back/SI joint area, and progresses to my thighs and outer quads. At first I thought it was cramping. The pain gets to the point where I totally lose strength in my legs, and I can barely pedal. Once I am off the bike, it disappears within 5-15 mins. Very frustrating. I go to chiro regularly, she thinks it is coming from the neck area, as I have lost curve there. I went to a massage therapist who said I was very tight in the front-hip flexors, psoas, quads, IT band. Saw him 5x, no relief. My PCP recommeded PT, did 4 weeks 2x/week, they think it is the SI joint, hip girdle asymmetry (L is higher than R) and leg length discrepency (R is 1/4" shorter than L). I have lifts in my shoes, but not in my cycling shoes....yet. I have been doing more X training this winter, including yoga, Pilates, specific stretches for psoas/piriformis/quads/hammies, wtlifting, swimming, XC skiing, snowshoeing, and trainer about 1x/week. Also foam roller. Monday, I went for my 1st outdoor ride since November (live in Michigan), and had the exact same back pain :mad:. It was not as severe, and I could kind of fight it off, but nonetheless, it was present and irritating.

I am 5'6" 128# 50 yrs old, have been biking for 6 years. The medical 'experts' keep saying this took a long time to develop, it will take a long time to fix. Well, I don't have a long time, spring is coming! I am practically at my wits end. I feel as though I am running out of options, and would HATE to give up biking (I also do mtb racing). Would accupuncture be an option for this? I am willing to try anything at this point.

Thanks.
Janet

[TryingisDying]

Hmmmmmmmm.....wow i can understand why you are soooo frustrated. Have you tried PT yet? I did PT for some neck issues that were really irritated when I was riding. It did help alot. But that is different then what you had. There is a PT by me..I'm in Michigan that races Mt bikes...maybe she would have more knowledge of what you need. Im not sure where you live in MI..she is out of Commerce Twp.

[daisylubob]

I am in Traverse City. Did PT for 4 wks. thanks for your empathy, it sucks to get old:(

[KnottedYet]

Is there anything in this thread that might be useful for you? http://forums.teamestrogen.com/showthread.php?t=36464&highlight=sacrum

Did anyone look at you on the bike? If this is only happening on the bike, I'd suspect you are getting into posterior pelvic tilt and lumbar flexion on the bike beyond what your body is happy with. Fix the positioning and fix the bit of your spine that has been taking all the stress and ends up yelling on the bike, and all is good.

Pain is not a normal part of aging. It doesn't suck to get old, it sucks to be in bad positioning.

Can you get to Manistee? Sally Somsel PT Dip.MDT is there at West Short Medical Center 231-398-1166. If she's too far, maybe call her and ask if she can recommend someone who is a Cert MDT or Dip MDT closer to you.

[daisylubob]

I will read every word of that thread!
Yes I have had my road and mtb fitted at the bike shop where I bought them (the Specilaized Bdoy Geometry fit). They put some shims in my shoes, adjusted the saddle a bit. Other than that, the fit was good.
What is 'posterior pelvic tilt' and 'lumbar flexion' on the bike? Can it be remedied?
KnottedYet, I am glad you replied, you have a TON of knowledge! :D

[KnottedYet]

I just know enough to be dangerous...

(for example, I'm quite convinced that I know exactly what is going on with you and exactly why and exactly how to correct it... dangerous! Hubris! Run away!)

Bike shop fits are nice, but when you are having a medical problem it really helps to have a medical person check you over on the bike. Most PT's can see what your body is doing if you ride on a stand in their office until the pain starts, and they can see what needs help even if they don't know much about bikes.

[daisylubob]

Would Sally be available to look at me on my bike(s)? If she can help, I would be willing to travel to Manistee for that. It is about 65 miles one way, so not that far.

What do you think is going on w/ me? Many other people seem to 'know' but can't seem to correct it, or help me correct it.

[KnottedYet]

Call Sally. She's a Dip MDT (Diplomate in Mechanical Diagnosis and Therapy, which is years of study beyond the regular PT degree). I worship at the feet of Dip MDT's.

She will want to look at your body first, and after she finds what is up with that and teaches you how to fix it, she may then want to look at you on the bike if the bike continues to re-derange your back. She'll look at you first, then the bike.

Honestly, I can't tell you anything about your back and your bike because I haven't seen you or worked with you. The best thing I can do for you is recommend you contact Sally or another Dip MDT near you. (Cert MDT's have also studied beyond the regular PT degree, but not as much as Dips)

[artifactos]

I was going to post a thread similar to this, but I experienced SI joint pain for the first time EVER on my first outdoor ride of the season on Monday. I have been seeing a chiropractor for the last month, and I suspect that my bike fit needs to be adjusted because when I was fitted I likely had quite a bit of tilt in my pelvis. Now that it is straightened out, the fit isn't working?? It also may be the new saddle, however THAT needs to stay because it's the only one I've tried that doesn't hurt my girly bits.

I'll be watching this thread to see if you get any relief! I'm hopefully going to get re-fitted at the bike shop this weekend (when I got the new saddle, he said he had lowered it by about half an inch, so that might be the only issue to work out?) and I'm crossing my fingers that I can get back to riding without pain. I'm undecided as to whether I'd rather deal with very painful girly parts (including tears) or a painful lower back. Preferably, neither!!

[daisylubob]

I have an appointment/evaluation with Sally on 3/18/10 :)

[daisylubob]

SO now, after doing Pilates on Wed, yoga on Thurs, 1 hr bike ride on Fri....sore lowback, mainly on the L, w/ pain on the outside of the hip, and down my left leg in the back near the hamstring. It bothers the back of my L leg to sit on it. Hurts to bend. I could hardly do my wts on Sat (which I probably should not have). My PT appt is Thursday.....Sheesh what next??

[KnottedYet]

Pretty much exactly what I'd expect given what appears to be going on with you. It's the same problem.

Sally will show you how to work on fixing it. You'll probably leave her with one exercise (to do multiple times a day, and when you feel symptoms) a lot of posture corrections to maintain at least until the symptoms are gone, and a pretty thorough explanation of why.

[daisylubob]

Pretty much exactly what I'd expect given what appears to be going on with you. It's the same problem.

Sally will show you how to work on fixing it. You'll probably leave her with one exercise (to do multiple times a day, and when you feel symptoms) a lot of posture corrections to maintain at least until the symptoms are gone, and a pretty thorough explanation of why.

I can't wait to see her. I am really tired of this pain, little relief and no answers from the experts I have seen...

[daisylubob]

I saw Sally this morning. She asked me questions and had me do some different moves/bends that no else had ever done. It is apparently a bulging disc, L4-5 or L5-S1. My chiro had mentioned that before. Anyway, she is having me do a modified version of cobra, every 2-3 hours 10 reps. At home, I am to use a towel or strap holding my back down while doing cobra (husband can hold towel or I can lay on a board, wrap the strap around it and me). I am to do this until Monday, then hop on the bike and see what happens. Also keep track of the pain intensity until then. And use lumbar foam roll in chair while sitting. I go back to see her on 3/25. There may be hope.....

[KnottedYet]

Hooray!

That's what it sounded like from your description in your first post. I'm so glad you went to Sally!

Do everything she told you, be diligent! The motion is meant to push the discs back into place... but they are slippery little fish and you have to push them back every couple hours and whenever they start squeaking at you. (if you have symptoms, don't wait 2 hours, do the cobra right now!)

Different discs behave in different ways, so if you start wondering if your cobra is pushing them back well enough be sure to call Sally right away.

I'm so glad you went!

[daisylubob]

So, these are probably stupid questions, but I am impatient when it comes to healing up.

How long before the little disc goes back into its place? Will the pain go away gradually, or overnight magically disapper? And how will I make sure it stays there once it is back in place? What are the chances of it coming back out, especially if the biking position (flexion) may have exacerbated it?

I really hope this works.....

[KnottedYet]

Sally is the best person to answer these questions, because she's seen you and observed the behaviour of your disc.

But, in general:

The disc goes back into place immediately with the corrective motion, or at least partly into place with one set and the rest of the way with the next set or two. The tests Sally did when she had you bend every which way told her how well your disc was going back into place and she based her choice for your first corrective motion (cobra and cobra with overpressure) on what seemed to put your disc back where it belongs.

However, the little booger doesn't stay there... That's why you are doing the corrective motion a gazillion times a day. You are essentially herding cats; chase it where it belongs, it starts sneaking out, chase it back in, etc. and so on.

Your body has been trying to glue the wayward disc where it belongs all this time. But the disc wasn't staying there, so it kept tearing up the glue before the glue had a chance to set. Imagine it is glue that takes a week to dry. If the disc shifted even once during that week, the glue didn't have a chance.

Your corrective motion lets you keep the disc in place long enough for the "glue" to "dry."

If you keep it mostly in, the edges of the bulge will "dry" first. Pain over all begins to decrease. As the glue gets a chance to build up, the disc becomes more and more managable. Eventually the disc is stable enough (the bulge has gotten small enough) that you can get the whole thing into place and it stays for awhile. When it's all the way in, you have no symptoms. You keep it in place for a full week, using the corrective motion prophylactically and your posture. You need to stay symptom free for a full week. Usually by that point the disc repair is complete (the glue has dried undisturbed for a week) and you do a maintainence exercise for a few months to make sure the body gives you the most beautiful repair possible.

Pain is pretty unpredictable. Sometimes irritated neighborhoods stay irritated for awhile. Sometimes relief is immediate, but pain comes back as soon as the disc shifts. More important is your overall sense of "better, worse, or the same," and Sally's evaluation of the quality of your segmental motion as "better, worse, or the same."

Once you have repaired the disc, talk to Sally about ways to keep it from happening again. In all likelihood the biking DID NOT cause the disc to wander out in the first place. Usually the cause is poor posture, and then something else is the final straw. If you are concerned about your biking posture at that point, ask her to check your bike positioning for you.

Really, it will get better! All you are doing is using your body's own corrective motions and processes, and doing them more often than usual so that the process your body was already working on can proceed faster and more efficiently.

Be diligent. If you feel unsure, call Sally and tell her how your back is reacting. The first week is a little rough because the disc bulge doesn't really want to go back into place and it sure doesn't want to stay there. The more time it spends in place, the more fresh collagen builds up without getting torn, the smaller the bulge gets, the easier it becomes to manage.

[daisylubob]

That all makes perfect sense. I have been DILIGENTLY doing the modified cobra positions since 3/18. Back feels better, still bothers some when I sit at work, so I am trying to avoid that for long time periods. After work, I am going for a trial bike ride to see how I feel! Fingers are crossed!!!!

[KnottedYet]

Just remember that there is no way the disc could be completely glued down yet. This test ride is just to let you know if you can be biking (or how much you can be biking) during the repair process.

(We never tell someone they can't do an activity, you have to try it and see.)

I'm glad it seems to be helping! Keep on herding that critter back where it belongs! After this first week is over, it will start to stay in place better and better, so hang in there!

Symptoms tell you the disc is wandering off, so when you feel them immediately get off the bike and chase the disc back into place. This is one of those situations where "no pain, no gain" is a COMPLETE AND TOTAL LIE!!!! :eek:

[daisylubob]

The test ride did not go well, I gave up after only 20 mins on the bike. And I have some soreness this morning. I guess that tells me I need to stay off the bikes for a lllloooonnngggg time. This is not going to be easy, I don't handle injury/ lack of exercise very well......My husband suggested trying a different bike (upright, old-lady type) and I about bit his head off. I know he was just trying to help, but it did not sit well. I mean, c'mon, how am I supposed to go out and ride 40, 50, 60 miles on this...

http://www.giant-bicycles.com/en-us/bikes/model/gloss.purple/4207/36648/

[KnottedYet]

Not a long time!

A couple weeks, a few weeks!

Get the back fixed (remember, I said there was no way the disc would be stable yet?). Once Sally is certain your disc is fixed, and if you try the bike again and it hurts, then you will know you need to address bike fit and positioning issues.

Clearly something is pretty off with your bike fit or bike posture right now, because the bike is what really hurts the most. However, you can't address that until the disc is healed, because right now it's just confusing the issue.

When you can sit at work without pain, try the bike again.

It hasn't even been a week yet.

Keep chasing that disc back into place.

(if you had gashed your hand open with a kitchen cleaver, would you expect it to be healed up and functioning perfectly after 5 days?)

[Kathi]

Patience is the key and raising your handlebars, although the common solution was not the answer for me.

I had a locked SI joint and went through 4 mos of pt etc. but still in major pain (for me) after PT ended. 3 visits to a wonderful pt settled everything down. Before I met this PT I thought I was doomed to a lifetime of pain, today, less than a year later I'm back to full activity, right now, for me it's downhill and xc skiing, snowshoeing and hiking.

My wonderful bike fitter found my saddle was too wide for me and pushing me forward so he put me on a different saddle. He also changed the pedals on my mtn bike so my knees wouldn't cave in. If you haven't had a professional bike fit please do so, it can make a huge difference in how you feel. A good bike fitter can help you, working along with your PT to work out issues dealing with your pain.

[daisylubob]

Not a long time!

It hasn't even been a week yet.

Keep chasing that disc back into place.

(if you had gashed your hand open with a kitchen cleaver, would you expect it to be healed up and functioning perfectly after 5 days?)

Yeah, yeah. I am very impatient when it comes to healing. But, I will persevere and get this figured out!! Maybe I will end up mtb racing on one of these.....
http://www.giant-bicycles.com/en-US/bikes/model/gloss.purple/4207/36648/
:D
Thanks for all of your advice, and support!!!

[Chile Pepper]

Wow. I have learned so much from reading this thread. Knot, you are amazing. Thanks for all your input!

[daisylubob]

I saw Sally this morning, she is 99.9% sure that it is a bulging disc at L4-5 or L5-S1 due to the symptoms that I get. And when I do the cobra movement, it improves. Next appt is 4/5, I am to stay off the bike til then, and continue the stretches. She said an MRI would not be a bad idea, just to confirm or rule out disc issues.
As for bike fit, I have had 2 done by the Specialized BG fit system. At this point, it may be helpful to be more upright on my bikes. And I have put mtb racing out of my mind til I am 'fixed'.

[KnottedYet]

As for bike fit, I have had 2 done by the Specialized BG fit system.

Ah-ha.
After your disc is healed up, lets have a little discussion about bike fit philosophies.

[lisathew8lifter]

you will definitely not like the answer that i'm going to give you but the ONLY way to ever fix this is to take the time to heal and to strengthen your core.

on august 21 i went to a sports med doctor in the twin cities that also treats olympic athletes. i was desperate and in massive pain. i mountain bike, i run, i lift weights and i did classes at the fitness center. i couldn't lay down, i couldn't sit, it hurt to do everything. EVERYTHING. i got a new bike, i went back several times to adjust it. i took 4 motrin before every ride...nothing cut it.

when i went to see amy, she could tell immediately what needed to be done just by looking at me stand, sit and walk. i was skeptical...really...you're going to help me after seeing me two minutes? she said women are prone to pelvic instability and she knew it was SI joint. i had never heard of an SI joint much less thought mine hurt. we started with xrays and went from there.

the xrays didn't tell the full story so we went for an mri. stress fracture in right tibia (running) and disc degeneration. the mri was the worst since i had to lay for 1.5 hours...that is soo not right.

she said the degeneration could be causing pain or maybe not, but i proceeded to have two shots of cortisone in each SI joint. i have never been so happy as the relief i immediately felt after each shot. again, i was desperate..not going to live on advil, not going to quit exercising. when the doctor told me i needed to quit, i cried. it was august...summer still...bike season, i had vacation plans and they involved biking. BUT...i wanted to heal and i knew that i needed to treat the condition or i'd be talking about this forever.

soo...my point is that it takes time. this is NOT a quick fix. not even close. if you want to enjoy yourself and become better at the sport, whatever your goal may be, you need to resign yourself to the fact that you need about 6 months of very low impact (or no impact) activity WHILE you do PT. i am lucky, i had the means and the time to do PT but it was a long road. i was fortunate to get in the hands of the best PT in this area...specializing in this type of injury. it was a long time coming, many years of abuse and over use and using the wrong muscles. i had no core strength, was breathing through my back, using my back for everything i did. i started with limited ranges of motion and no strength and now i have stregnth. this is going to be a life time of PT (on my own now) and continuing to build on what i already do an know.

yes august 21 until february 27...that is SIX months. i walked outside and on the treadmill and did my PT. six months. no biking, no running, nothing. if i lived to tell about it, so can you. i am running, haven't yet started biking (mn - still colder here - but soon) and i am so excited to start because i know that i'm going to be pain free when i do.

bottom line, you know what to do, now do it. if i can, anyone can!

[daisylubob]

UPDATE:
Xrays show disc degeneration and bony changes (arthritic type) in the lumbar spine. MRI is next, and I have an appt w/ a neuro DR who is a cyclist on 5/17. I am not liking the sound of this....scared.

[yellow]

UPDATE:
Xrays show disc degeneration and bony changes (arthritic type) in the lumbar spine. MRI is next, and I have an appt w/ a neuro DR who is a cyclist on 5/17. I am not liking the sound of this....scared.

Don't be...EVERYONE has some amount of disc degeneration and, yes, even arthritis. Some people are asymptomatic their whole lives. Others, not so lucky. The xrays probably show narrowing between the vertebrae, which usually indicates degeneration. Only the MRI will tell the extent/level of degeneration. Deep breath, and wait for the MRI results. Talking to a neurosurgeon is not a bad thing, but you also might want to consult a physiatrist (non-surgical).

After years of pain and trying to fix it on my own, I ended up having lumbar fusion. Life is way better now, and I'm still early in recovery. I'm not saying this is the answer for you...I tried just about everything out there you can try and would be happy to go on and on about it all via PM if you'd like.

Above all, you need to have patience. Take your time. Open your mind to solutions that might not be something you ever thought of.

I hope you find relief soon.

[KnottedYet]

UPDATE:
Xrays show disc degeneration and bony changes (arthritic type) in the lumbar spine. MRI is next, and I have an appt w/ a neuro DR who is a cyclist on 5/17. I am not liking the sound of this....scared.

Don't be scared. Your xray sounds perfectly normal. Remember, the "standard" is a 20 year old male. If your spine doesn't look like a 20 year old male, you are degenerated.

Don't pay any attention.

If your problem required surgery, it would be giving you unremitting agony. As it is, you only have pain on the bike after 20 minutes and if you sit at work too long. If your symptoms are absent some of the time, then you just need to let the body heal so they can be absent all of the time.

(And you need to have someone with a PT background check your bike fit and biking posture.)

[daisylubob]

Don't be scared. Your xray sounds perfectly normal. Remember, the "standard" is a 20 year old male. If your spine doesn't look like a 20 year old male, you are degenerated.

Don't pay any attention.

If your problem required surgery, it would be giving you unremitting agony. As it is, you only have pain on the bike after 20 minutes and if you sit at work too long. If your symptoms are absent some of the time, then you just need to let the body heal so they can be absent all of the time.

(And you need to have someone with a PT background check your bike fit and biking posture.)

That is crazy to compare me to a 20 yo male. What is the point???? Anyway, I am degenerated :(

The symptoms of pain in the low back seem to be there more now, not just w/ sitting at work and on the bike. Feels like a constant,dull, sometimes crampy-like, annoying ache in the low back. Never sharp or take-your-breath-away stabbing sensation. It is at the spot where you put your hands to do a standing backbend, right where my middle and ring finger are on my back (did that make sense?).It does NOT hurt when I am in my bed sleeping, thankfully. I am so aware of that pain now, it has kind of taken over and I am obsessing about it:rolleyes:
I see Sally again on Monday.
DH is going to attempt to modify my bikes a bit. Raise the bars w/ a headset extender on the road bike. Raise the bars w/ 2 more spacers on the mtb, and flip the stem over.
I also started taking Tissue Rejuvenator from Hammer, 4 caps am & 4 caps pm. Figured it would not hurt!

[daisylubob]

Saw Sally today. She thinks it may NOT be a disc now, due to:
1. little to no relief w/ the cobra maneuver.
2. I can walk and stand w/out a lot of increased pain.
3. Forward flex bothers me, whereas a disc problem the patient would get pain relief w/ forward flex.

She gave me a new exercise: Lay on L side, L leg straight, R leg bent up. Pull up on L arm so L shoulder is all twisted around. Lay that way for 5-10 mins.

We may also try oral steroids to see if it takes away the pain, if it does, then there is inflammatory stuff going on. But we still do not know the origin. MRI is Wednesday at 6am.

[nscrbug]

Saw Sally today. She thinks it may NOT be a disc now, due to:
1. little to no relief w/ the cobra maneuver.
2. I can walk and stand w/out a lot of increased pain.
3. Forward flex bothers me, whereas a disc problem the patient would get pain relief w/ forward flex.

She gave me a new exercise: Lay on L side, L leg straight, R leg bent up. Pull up on L arm so L shoulder is all twisted around. Lay that way for 5-10 mins.

We may also try oral steroids to see if it takes away the pain, if it does, then there is inflammatory stuff going on. But we still do not know the origin. MRI is Wednesday at 6am.

Hmmm...that's interesting. I was always under the impression that forward flexion increases pain in those with disc problems present...and that the cobra relieves pain. I have a totally different back condition called spondylolisthesis, which is a forward vertebral slippage. I'm actually NOT supposed to do any kind of back extension exercises (like the cobra) because it can cause further slippage and instability in my lower spine. But bending forward (such as leaning on a table or countertop, brings me instant relief.

Your upcoming MRI will pretty much indicate right away, whether or not your issue is disc-related or something else. Good luck and I hope you find some answers soon!

[KnottedYet]

It depends which way the disc is bulging. (forward, backward, or to the sides)

I have a disc that bulges forward and slightly sideways right now. Bending forward (forward flexion) pushes that darn disc back into place for me.

60% of disc problems are discs that are bulging backwards. Bending forward pushes the disc farther out of place for those folks.

What Sally has given you now is the "million dollar roll". It works for discs that are bulging out at a different angle (not straight back or straight to the side, for example) or that are bulging in multiple directions.

If you run into trouble with it, or if you feel it is making you worse, call Sally.

(ETA: 2 and 3 would be typical of a posterior derangement, 1 would be typical of a posterior-lateral relevant derangement. Lack of lasting relief from a cobra could indicate a disc that is blooping out backward and sideways at the same time. Sally will work you thorugh the steps of various movements until she has exhausted disc behaviour as a cause.)

[daisylubob]

I seem to be doing OK, stable for right now. This "million dollar roll" feels really good :) So it must be doig something! The MRI was done on Wed, and I am patiently awaiting the results.
I did the trainer for 30 mins on Wed, and will do 30 again today. Sunday, it is supposed to be a little nicer outside, so I may attempt an EASY 30-45 min road ride!

[daisylubob]

MRI shows 'diffuse annular bulge w/ L posterolateral disc protrusion L4-5 encroaching into the neural foramen on the L. THis appears to be effacing the exiting nerve root.'

Not the greatest news, but Sally kind of knew this anyway. I saw her today, as the million dollar roll did not really do any long-term improvement. She is perplexed, and calls me her 'challenge' :rolleyes: I am to have DH push w/ heel of his hand on the L4 area, 10x twice a day. And go back to her in a week. Appt w/ neuro guy is 5/17. I have not read/ heard great things about steroid injections or oral steroids (wt gain, puffiness, emotional issues, etc). They also just take away the inflammation, and don't fix the problem. This is somewhat discouraging....

on the other hand....I did a road ride w/ DH on Sunday for 1:10, slow and easy. Stopped once to stretch, and I did not feel too bad :)

[daisylubob]

Still having pain, still frustrated. Trying to be patient....this is not easy.

[NbyNW]

I haven't commented on this thread before but have been following it . . . just wanted to tell you to hang in there!

Do you at least feel like things are improving a little?

I'm not a professional health care anything, I just know from personal experience that it can take a LONG time to feel some relief. And it's frustrating when you can't have a day off from the pain and the limitations of your injury. So if you feel like you're in good hands, stick with the program.

I had a back injury a few years ago that took a long time to rehab. And it's just part of me now, that's something I've had to accept. I doubt I will ever NOT be aware of the trauma to that part of my body. So it's something I account for in my daily routines or any time I'm training for anything. I have to pamper it and condition it properly in order to do things that I love. And afterwards I have to be kind to my body and thank it for cooperating.

Good luck!

[Kano]

my sympathies too -- I just found this thread tonight, and see that YOUR doctor, PT or whoever did the XRay stuff says you're a degenerate,:rolleyes: and now Knotted says you're deranged!:eek:

:DHere you just thought your back hurt!:D

Karen in Boise

[tulip]

Still having pain, still frustrated. Trying to be patient....this is not easy.

It's likely that your back situation did not occur overnight, but rather over a lifetime of posture issues. That's the case with me. The "cure" will not happen overnight, either. Patience and consistency are key with PT. It sounds like you have the best PT one could ask for.

[daisylubob]

Thanks Tulip, that is most likely true. I have been working on posture improvement w/ my chiro for over a year, and it is much better. I am in a different PT program, and was referred to a Pilates specialist/trainer who showed me the correct way of doing Pilates exercises. This past Sunday, I learned the hard way that I have to stay off my mtb til healing has happened. Went out w/ my sis for 7-8 mile EASY mtb ride (it has been 6 months), and paid the price in pain :mad: and getting yelled at by the chiro and PT :rolleyes:

[lisathew8lifter]

daisy,..listen to the doctors that are telling you what to do and that is to NOT exercise right now. sounds like you are on your way with the posture, and instruction on doing the exercises correctly. i was doiing everything wrong and the right muscles were not firing and the wrong muscles continued to fire. i had zero core strength since my back took the brunt of what i was doing.