Member Case Study: Sprained/Strained SI Joint

author : AMSSM

comments : 0

Yesterday I was a little sore, and today, whenever I bend over to pick something up, standing up again hurts badly. Have I done some sort of permanent damage? What can I do to rehab this area?

Question from kimj81

In December of 2003, I sprained/strained (can't remember what the doc said exactly) my SI joint doing squats (poorly). I was laid up for a week or so, then slowly the pain went away and I felt better and better. But now, well over a year later, whenever I work out hard enough to get my bum sore, get tight in the lower back, or do anything else that happens to affect that area, it hurts badly again. For instance, I wore high heels (which I rarely do) two evenings ago. Yesterday I was a little sore, and today, whenever I bend over to pick something up, standing up again hurts badly. Have I done some sort of permanent damage? What can I do to rehab this area? Do I just need to get stronger?

Answer

You give a very good history for a low back strain that likely involved your sacroiliac region. This condition is referred to by many names including sacroiliac dysfunction, lumbosacral strain, or low back pain syndrome. It can be a fairly common condition that causes pain and tightness in your low back, buttocks, and sometimes hamstrings. Several factors are involved with this condition. First, poor flexibility (tight hamstrings, hip flexors, back, etc.) or relative core weakness (abdominal and trunk muscles as well as hip and butt muscles) can contribute to this if you overwork, overstretch, or overfatigue those muscles. Second, slight differences in leg lengths or problems with your mechanics when lifting can create an overload and imbalance that strains the muscles. Also, being overweight or pregnant can affect your posture and center of gravity, creating more low back strain. When a muscle is irritated, its natural reflex is to contract and not relax when it should. A contraction that doesn't let go is a muscle spasm and can be very painful and further weaken the muscle (this is likely what caused you to be laid up initially).

So, to answer your questions...

1. Have you done some sort of permanent damage? Likely no. If you have symptoms of numbness or tingling or weakness going down your legs, this may represent a disc problem and should be evaluated by a physician. If it is only periodic tightness then you should respond to treatment.
    

2. What can you do to rehab? A physical therapist or certified athletic trainer can help get you started on some core strengthening and stabilization exercises and a program to improve flexibility. If a leg length discrepancy were discovered, then orthotics for your arches may be extremely beneficial for eliminating future problems. A physician might recommend anti-inflammatories to help with pain and inflammation during the healing process.
    

3. Do you need to get stronger? In general, I tell people that they do need to get stronger but more importantly they need to achieve more balance between their strength and their flexibility. Also, there is a big difference between training for a specific activity and training for general fitness or lifestyle. If you set your training regimen for your overall goal, you will more likely be pleased with the results of your program and lessen your chances for injury. The bottom line is that you are far ahead just because you are an active person who is interested in recovering. Some small changes in your training can provide huge benefits.

Hope this helps.

Douglas McDonald, MD

P.S. I went to school at Colorado State so Hello to Fort Collins!

Douglas McDonald, M.D.
Team Physician, University of Florida
(352) 375-4683 x4830

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date: July 17, 2005