SI Joint Pain...Frustrated.

[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!!!!

[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/...le/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/...le/4207/36648/

Thanks for all of your advice, and support!!!