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 . 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/showt...ghlight=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!

[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!