I hurt.

[KnottedYet]

The PT has me doing a couple of exercises that twist my pelvis as I do them, and that seems to provide immediate relief, but it doesn't last.

Excellent! You've already got your corrective movement!

I assume you are doing this 10 repetitions, every two hours? (so 8 or more sessions a day)

How long does the relief last? You may need to do it more frequently for a few days: for example, if relief lasts for 35 minutes, you may need to do the movement every 30 minutes, etc.

The more time the bones spend lined up right, the faster the collegen your body is throwing at the SI can get it stuck back down. It's like spiderweb. You don't want to stretch or tear it and you want it to build up.

It may take a while and a lot of work, but if you can chase it down and keep it symptom free for a week (that means in place for a week and doing your corrective movement that entire time) that is about enough time for the collagen to build up. It may take a few weeks to get to that point.

[Pax]

...Knot, thanks so much for your input....Can I put you on retainer???

I think Knott could make her fortune treating the women here!


sfa - that cobra thing saved my quality of life. My lower back was feeling so good I sort of stopped doing it, then I hurt my knee and was walking with a limp, it has flared up again so bad it makes me cry. Back to doing the cobra thingy religiously!!

[NbyNW]

Knott, all that talk about collagen has me wondering -- is there anything nutrition-wise that helps that process along?

[KnottedYet]

Knott, all that talk about collagen has me wondering -- is there anything nutrition-wise that helps that process along?

Not really. The body wants to heal the area, that's part of why it hurts. It hurts because it's out of place and it hurts because it is inflamed. Inflammation is your friend: it is increased metabolism and circulation and collagen production and white blood cell excitement, etc.

If you are not eating adequately, the body will borrow from existing healthy tissue to supply the repair. Robbing Peter to pay Paul.

That's why we jump all over athletic folks who decide to cut down their food intake while they are injured, because they are afraid they will gain weight. No, no, no! You need continued performance-level nutrition to fund and fuel the repair! Repair is expensive! Eat good food and lots of it, no dieting during repair.

The best way to help repair is to keep the parts of the joint functioning and lined up where they belong. It's like a slow setting glue. You gotta keep them lined up for at least a week (no symptoms at all. pain = not lined up) before you can begin to assume the glue has "set." If they keep coming apart, all that glue goes to waste and the body has to start all over again.

SFA mentions not being fused. THIS is the fusion process. This IS the repair. Put them where they belong and work on keeping them there until you can keep them perfectly there for an entire week. Any time a sypmtom shows up, you start your week over. (symptom = oops, we lost it, start over)

[sfa]

I assume you are doing this 10 repetitions, every two hours? (so 8 or more sessions a day)

How long does the relief last? You may need to do it more frequently for a few days: for example, if relief lasts for 35 minutes, you may need to do the movement every 30 minutes, etc.

Hmmm, more like just three times a day (once in the morning, right after work, before bed). I'll up the frequency, even if it means looking like a fool lying down on my office floor! One of them involves an exercise ball, so that's not happening at work. The relief lasts about an hour or so, but can be longer depending on my overall activity level.

Thanks so much for your help!

Sarah

[KnottedYet]

Hmmm, more like just three times a day (once in the morning, right after work, before bed). I'll up the frequency, even if it means looking like a fool lying down on my office floor! One of them involves an exercise ball, so that's not happening at work. The relief lasts about an hour or so, but can be longer depending on my overall activity level.

Thanks so much for your help!

Sarah

Oh my goodness!!! You DO have your corrective movement! Fabulous! If you know relief lasts about an hour, then I'd suggest you try to do the movement every hour. Your goal is to never let it slip awry enough to hurt, chase it back into place before it even THINKS about slipping awry.

This is so exciting, you've already got everything you need to fix it! Choose the one exercise that works the best (gives the best relief) and do that one 10 times every hour. Don't wait for the SI to hurt (by which time it's already awry), fix it before it gets the chance to hurt. Doing a movement 10 times will take about 45 seconds out of your hour, well worth it to get the healing process rolling.

After a few days you may find the SI is less sloppy, and you may be able to decrease the movement to every 2 hours. It gets less sloppy as collagen builds up without getting torn asunder every time the SI moves.

You know how to put the SI right, you know how to make your pain go away. Don't put up with any pain! Get rid of it! You have the power!

[Pax]

Knott - I LOVE your enthusiasm for your work!

[tctrek]

Wow! I've had SI problems for several years after falling down oak hardwood steps on my butt and back. It was so painful to sit down that I worked standing up at my desk for 1.5 years. Visit and visit to the PT's and chiropractors and icing it down. After about 4 years I have it mostly under control, but it will flare up if I don't sit up straight or sit in a soft chair.

I've been doing Feldenkrais lessons for a few months now and it is also helping me. Another funny thing that helps me when my back gets tight is to get on my hands and knees and totally relax my stomach muscles.... kind of like those yoga poses where you make your back convex and concave.

But no one has ever explained it like Knot did. That was absolutely awesome.

sfa --- I really hope you find the clues from your body about how to get past this.

[Pax]

...But no one has ever explained it like Knot did. That was absolutely awesome.

I know what you mean, when I ruptured a disk in my back last year I came here and asked Knott to help me understand what my PT was talking about...she made it crystal clear for me and I got sooo much more from my PT sessions after that!

[colby]

Knot: You rock. That is all.

[KnottedYet]

I'm glad all my ranting and raving is useful. I work at a clinic where the major emphasis is on educating the patients. I don't heal anyone, I teach them how to heal themselves. I rarely touch patients. I don't use modalities (ultrasound, electrical stim, traction) other than hot or cold packs every once in a great while. People already have a good idea what is going on. The body is already working like sixty to fix itself. They just need some guidance to make it happen faster and more efficiently.

Another funny thing that helps me when my back gets tight is to get on my hands and knees and totally relax my stomach muscles.... kind of like those yoga poses where you make your back convex and concave.

Yoga is cool beans. Here's an exercise program that's been refined over 3,000 years. How can PT beat that? (ummm, by stealing yoga poses... which we do shamelessly) Here's a system that's been studied over generations. Lots of attention paid to aging bodies, injured bodies, and what happens to them over years and years. Student learning from mentor, and then watching mentor's body change until death. Incredibly valuable stuff. Yogis had disc problems. Yogis had SI problems. They knew this stuff over the lifetime of the patient.

TCTrek, if doing the cow part of cat/cow feels good, consider doing the cobra as well. Both are extension of the lumbar spine at the sacrum. Remember, the only way we can reach the pelvis (ilium and sacrum) is through the bones that meet it (femur and lumbar spine).

[tribogota]

whining is underrated!

[Kathi]

Knot: Thank You so much for this information. Due to your post I now have a better understanding of what is going on with the SI joint and that this issue may not magically go away. My second PT gave me a basic understanding of what the SI joint does but didn't go through the detail that you did.

Last year I suffered with pain in my right hip, knee and foot. Several different Drs., 4 mos of PT and an MRI didn't shed light on the problem. The 1st Pt said my right side was weaker than the left but he couldn't figure out why. When I'm in rehab for an injury I faithfully do my exercises prescibed by my PT but the prescribed exercises to strengthen my right hip made me hurt more so I quit doing them. I resorted to bracing my knee when I exercised because it made my hip feel better. The MRI showed osteoarthritis in my right hip and SI joint, which was attributed to the source of my pain, except my PT said I didn't move like an arthritic person. When I was released from PT I was still experiencing pain and had no resolution as to the cause.

I saw a PT who did bike fits because I couldn't ride. Instead of a bike fit he decided to check me out and found my left SI joint was locked. One exercise prescribed and 3 visits and all the issues went away, including the knee pain which had been diagnosed many years ago as chondromalicia.

I copied your post to my exercise blog so when I do things that make my SI joint angry I have reminder of what is going on. Please continue to share your wealth of knowledge with us. It is very much appreciated.

[wavedancer]

I want to tell him to just get a meat mallet and whack the joint into place. Somehow I don't think that'll be too helpful, though.

My SI joint went out for the first time last fall. My chiropracter tried some adjustment, but it was still giving me grief. It didn't hurt while I was riding, so I went to a cyclocross race the next weekend. I had one crash, and when I got up, the pain was gone. Maybe meat mallet is an alternative !

And thanks, Knott for the in depth info.

[KatzPajamas]

KnottedYet! Thank you so much for your expertise! I injured my SI joint in July 2012. I could barely ride 8 miles after a summer filled with 40-50 milers. I tried anti-inflammatory meds, began working on my core strength and regular visits to a kinesiology chiropractor. I even had a steroid injection in June of 2013 and a perfectly normal MRI. The steroids helped for a few weeks, and I have tried every stretch and exercise that I can find to help the pain. I am often awake off and on at night due to the pain. I read your recommendation of gently squeezing the pillow...so I tried it. The immediate relief has lasted about 6 hours so far! It is miraculous! How could it be so easy and simple?!?!?! The last few days have been difficult due to the pain, and here I am as tho the pain never existed...without the help of medication or chiropractic adjustments!!!! I will definitely be doing this as often as your post suggests! After a year and half off of my bike, I may just be able to get back out there in the spring!
THANKS!!!!