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Let us be realistic and keep in line with some of clinical practice guidelines for back pain:Originally Posted by m_sporkboy
https://www.chiropractic.ca/wp-conte...es-for-LBP.pdf
https://www.chiropractic.ca/wp-conte...-pain-2016.pdf
Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration - Wong - 2016 - European Journal of Pain - Wiley Online Library
https://www.chiropractic.ca/wp-conte...d-sciatica.pdf
https://www.chiropractic.ca/wp-conte...BI_POC_REF.pdf
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How long did you aggressively massage the piriformis for? My SI pain was fixed by the aggressive massage but I had to do it 5 times a day for a week before I really noticed a difference. Now, I just massage it a few times a week when it gets stirred up. Chiro did nothing for me.
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Pretty much right above my ass crack. The pain is worse on the left side and doesn't radiate much anywhere.
I'll be damned... I'm not entirely sure anymore if it was during the descent or ascent. But it definitely occurred during the lower part of the squat. Trying to replicate the incident with an air squat I'd say it popped just before the ascent.When you felt the “pop” was it in the descent or ascent?
I did have a muscle strain a few years ago in the lumbar region. Didn't feel anything in the sacral region back then, but it most definitely hurt like hell. Managed to get rid of it with ibuprofen though. A muscle strain would certainly be more favorable in my opinion, but how would that make my sacrum "pop"?It sounds like a muscle strain, barring any neurological signs which were not described. Could be glute max or erector spinae aponeurosis or multifidus muscle, only way to know is a physical exam. An SI joint manipulation will not help if this is the case.
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A muscle strain is a stretching or tearing of the muscle fibers depending on the severity and can present with a popping sound with certain physical activities.
Based on your description of the location of the pop, I would surmise a strain of glute max, erector spinae aponeurosis or multifidus muscles – this comes with the assumption that your squatting technique is as prescribed by SSBBT.
A sacrotuberous ligament sprain is possible, but I would assume this would more likely be the cause in people performing ATG squats, which would also increase the likelihood of the aforementioned muscle strains.
Here is an image of the sacral ligaments:
sacral ligaments
And muscle attachments to the sacrum:
gluteus maximus
short external rotators
http://www.eorthopod.com/images/Cont..._anatomy11.jpg
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Massaging it more often certainly sounds like something I can do. Maybe that will help.
A muscle strain sounds a bit more appealing, I'd say. I'm going try squatting with the bar and very low weights as long as my back permits.
Thanks for your input, guys.
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I have found this to be true most of the time. Could it be once the joint is injured, in some instances, it will never be the same? Things like laxity or faulty arthrokinematics occur that causes pain periodically or chronically for those who do nothing about it. I've seen it on both side of the spectrum too. People who are "overly tight" i.e. sedentary, and those "flexible cats" who yoga pose all day. I see the former much more, but both get chronic low back pain or SI pain. However, the common denominator usually comes down to lack of strength for both of them.
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I've dealt with this exact issue for years. The first "pop" happened while running when I stepped in a hole unexpectedly. Ever since then it seems to randomly "pop" about once a year. Back goes into spasm for a few days up to a week. After a few days rest, Deadlifting with just the bar at first seems to help, then gradually adding squats back in and working your way back up.
Planks and "glute bridges" while squeezing a foam roller or something similar between your legs seems to help with alignment some and provide some relief. I can't comment on preventing future incidents other than to say - never ever stop squatting, ever.
Also - in my case, I found that trying to get a massage to relieve the spasm in the first few days makes things significantly worse, so don't do that. Just let it be for a couple days, then go in and try doing some RDLs with just the bar... then the next day try deadlifting with like 40kgs for higher reps, etc.
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Good point. Massaging a muscle strain or contusion is a bad idea because it can lead to the development of myositis ossificans, which is a form of metaplasia resulting in calcification at the injured muscle site.
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Does this hold true for other SI joint injuries/ailments? I have suspected SI joint issues that appear to resolve with the recommended massaging of the piriformis. Do you think it's better to wait a couple of days after it gets stirred up before massaging?
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This mechanism of calcification within muscle occurs following acute trauma and then receiving aggressive physiotherapy/chiropractic/massage therapy too soon because of differentiation of mesenchymal stem cells resulting in bone growth in the muscle. Surgical excision is warranted if non-surgical modalities do not alleviate the pain associated with this development and in some cases decrease in size of the calcification.
With respect to chronic or recurrent SI joint issues, it is unlikely that the same mechanism holds true. Then again, you have not provided a history of specific trauma to the area followed by immediate treatment. Given the limited information provided, piriformis massage should be fine.
I should note that while I am happy to offer insight on rehabilitation and management of musculoskeletal conditions, it is best to see a health care professional in your area who will take a history and perform a physical exam of your presenting complaint(s) as I cannot make or provide health care recommendations online.
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