SI Joint--How to "Work Through" the pain

[A Large Hand]

Hi All, new to the board.

I have and have had back issues for ~17 years. I can always manage it with good stretching and good form. I Injured it recently and can't seem to fix it.

I have been to ortho and PT (both OK but didn't actually fix anything)--currently going to chiropractor who is helping a great deal with my discomfort. However, still not immediately "fixing" the problem.

In Rip's podcast he says to "work through" SI pain, but what does this mean exactly? Should I increase my weekly DL and squat frequency? Should I just do them at normal program frequency but with lighter loads? Should I take 2 weeks and work through the Starr rehab plan? Does SI joint pain feel better after rest and maintaining proper pelvic alignment?

I did 3X5 DL this week at 155 lbs. First 2 sets were uncomfortable but manageable. Last set I dropped the weight after the 2nd rep because my back hurt so bad. I think my back felt better after the DL, but it has been so uncomfortable it is hard to tell what feels good anymore.

For the record, the ortho didn't diagnose me with anything. The chiro has diagnosed me with facet tropism. My pelvis was jacked before going to the chiro!! He has since got me in good alignment, but it was way out of whack before I went to visit. Also, prior to this injury I had not lifted for about a week and a half because we had a newborn. I got a cold in that time and must have injured myself with some violent coughing. I haven't been able to DL pain free since. I can only squat about 95 lbs with absolutely no pain. If I go into flexion at all in the bottom of the squat the pain is intense. I have determined at least part of my problem is SI joint pain because after I have stretched and gotten rid of any pain I have while standing, I can localize the pain directly to a "boney" area right above my right butt cheek that's about 1"-1 1/2" wide. The pain comes on when I bend forward. Very localized to that one point but radiates to my groin area as well (mainly only when bending forward. Nothing else seems to bother it). Ortho also suggested I "might" have SI joint issues several weeks ago.

Any feedback from other's experience is greatly appreciated!

(For the record, I've done quite a few forum searches, listened to Rip's podcast on back injuries, read his articles on pain/rehab and specifically back injuries, read BBST, etc.)

Thank you!!

[Ryan Arnold]

My Non Medical Professional thoughts:

1) I have yet to hear of stretching being a good idea for back pain
2) Have you been checked for a leg length discrepancy?
3) Are you able to go see a Coach to get your form checked, or at least post here on the Technique forum?
4) At least for now let pain be your guide. Don't squat to a depth that gives you pain. If 95 feels good, just go to 100 next time. If you have to DL 95, DL 95. Use weights that don't hurt and just slowly build up

[SteveL]

A couple of years ago I hurt my SI joint deadlifting. I went to my Chiro who helped a lot. I took off two weeks from deadlifting and just light squats. I rolled on a lacrosse ball right where it hurt and across the lower back using it as trigger release. I also realized I was going up too fast in the weights which my then 58 year old body could handle. When I went back I continued to increase the weight each week as I was in LP then but I made smaller jumps for both the squat and DL. It's all worked out as while I am always hurting somewhere I haven't been actually injured for well over 18 months.

[A Large Hand]

My Non Medical Professional thoughts:

1) I have yet to hear of stretching being a good idea for back pain
2) Have you been checked for a leg length discrepancy?
3) Are you able to go see a Coach to get your form checked, or at least post here on the Technique forum?
4) At least for now let pain be your guide. Don't squat to a depth that gives you pain. If 95 feels good, just go to 100 next time. If you have to DL 95, DL 95. Use weights that don't hurt and just slowly build up

1.) Thanks for the input. I do get very temporary relief (all of about 5 minutes), but yes, stretching is definitely not fixing the problem.
2.) The first time I went to the PT my right leg was shorter than my left, but the right side of my pelvis was also sitting up around my ear. My hips and pelvis were way out of whack! I'll ask my chiro on Monday.
3.) I will post a DL video from a month ago. I'll have to get a squat video. I just saw that SS does seminars. I will have to make an effort to attend one.
4.) Thanks! I will go by this. For next week I am going to DL 3X5 Monday to best of my ability. Squat Wednesday 4X5 to best of my ability. Friday I plan to squat and DL in same session.

I'll post back on how I respond to lifting. I'm 34 and I first had this when I was 17 playing football. It is something I always deal with off/on, but it has never been as persistent, or life limiting, as it is now.

Funny how I suffered the injury NOT lifting (just as Rip says most often happens).

I appreciate the response!

[A Large Hand]

Thanks Steve! I've had some relief rolling on tennis ball but it's not "fixing" me. I am hoping DL and squats will get me back to normal. My form could definitely use some work so this is a good reason to start at the bottom and build up. Thanks!

[A Large Hand]

Update, I did deadlift today:

bar--10 reps
bar--5 reps
95 lbs--5 reps
115 lbs--5 reps
135--5
135--5
145--4
155--4
165--4
175--1 rep and this felt like too much to attempt again, so I called it quits. I'm thinking maybe I was a little spent at this point (I haven't DL for 2 months).

I had slight pain in my sacrum/tail bone area. Interestingly, the first rep was always pain free, but by about the 3rd rep I would have a slight burning sensation in tailbone area. Right hip/butt area hurt, but that's been consistent now for almost 3 months. It felt better to deadlift.

I'm going to squat tomorrow and keep it very light. I'll try my working reps for DL at 175 lbs on Monday.

Last week I did some DL, squat, and back extensions and the back extensions were a bad idea! I couldn't even change my kid's diaper, so I had to take a break till I could at least change diapers again. Anyways, DL today felt pretty good. Also listened to Rip's podcast about how important setting the back into lumbar extension is and incorporating the cues from that podcast helped immensely!

[Ryan Arnold]

You'll want to be cutting this off way before 175 right now, especially if there is ANY chance your form is not perfect. You need solid lumbar extension on ALL reps if you want to rehab this thing properly. You'll be back where you were soon enough. Bad reps will just keep setting you back. Without knowing what your normal programming is like I would say, aside from getting your form checked, just go up 10lbs/week for now. Something like:

Monday: [95, 115, 125, 135] x5
Friday: [95, 115, 125, 140] x5

Monday: [95, 115, 135, 145] x5
Friday: [95, 115, 135, 150] x5

You can go up quicker or even add an extra top set but ONLY if all the reps feel good. You'll have to self monitor this obviously - if you are always in some form of pain then you'll have to work through it a little. Just make sure its improving, not regressing

[A Large Hand]

Ryan,

thanks a lot for this reply and sorry for the late response. So, I tied my problem to a tight or possibly strained QL. When I deep massage my QL and do some stretches that "target" the QL the relief is like night and day. I can get into decent lumbar extension at my starting position if I have loosened the QL.

That said, I have a meeting with a starting strength coach in Atlanta next week. We've got a 1.5 hour session to work on Squat, DL, and Press. Until then I am just working out with the empty bar, re-re-re-reading SSBT and trying to be as perfect as I can.

I will worry about adding weight from the ground up after my meeting. Atlanta is a 2 hour drive for me, but hopefully getting over to see him every 3-4 months for form check is something I can fit into my life.

As an aside, the ortho, PT, and chiropractor I was seeing said NOTHING about my QL! The chiropractor had me doing the couch stretch which has given me some other minor problems I'm working through. Idiots. I'm done with them.

Thanks again, I'm really appreciative of your feedback!!

[Ryan Arnold]

You're very welcome!

[A Large Hand]

So this took a bitter turn for me. I was scheduled to get coaching in Atlanta 3/22. I live in Birmingham so it's a 2 1/2 hour drive for me. Anyways, I get up at 5 AM, am pulling my underwear on and something in my right butt cheek/hamstring just clinched up. I stood still for about 5 minutes thinking about what I could do to make a 2 1/2 hour drive with a numb driving leg and decided to try something to stretch it out. When I tried this I hit the floor in pain and crawled back to my bed where my wife helped me heave my body onto the mattress. The pain over the next 24 hours was BLINDING. As of now, 4 days later, I have radiculopathy down into my foot (right heel is completely numb) and some pain if I am up and moving for too long. If I laydown and rest the pain passes and I can get up and move around for quite a while--several hours or more.

Anyways, I have an MRI tomorrow. I know I'll learn all kinds of horrendous things from that--most of which I'll have to ignore. My plan is to go and see the coach when I am cleared to start PT. Don't want any shots, surgeries, or other garbage.

What fucking luck! I'm trying to take it as a minor set back. I know I need to get my back stronger. I used to have a DL working set of 235 at my strongest. Over the past 4 months my eating and "training" (though I was always more "exercising") took a dive. I lost about 15 pounds and got way weaker. I know that's my problem. If my back had been stronger when I encountered whatever irritated my SI joint I think I would have handled it and recovered. At least all this shit will make this thread more interesting!