T Nation

Hypermobile Sacroiliac Joint and Nagging Pain


#1

Hi all,

so here’s the issue:

No history of any injury during lifting years and this is the first one.

During deadlift PR felt a thud sort of sound/sensation in my left SI-joint. No pain or anything, did my workout and went home where I felt I was standing somewhat crooked or “of the line”.

Then the nagging pain started. Left quad, glute and hip flexor into semi-severe spasm/cramp and decided to take a 1,5 week of training and hit the swimming pool few times.

Felt better and it was the time of year to start 5/3/1 BBB 3 month challenge again. Weights ok, doing sumo-style deadlifts now. But when the last set of 5 came the thud was back. As a Finn I yelled PERKELE (the most powerfull swear word in the world) and went home. Did mobilization, some parts of DeFranco agile 8 and vualia got it back to normal. Next morning no problems. All this started 1 month ago and again TODAY same thing with deadlift; last set of 3 and thud and whole left leg above knee into spasm. So the pain and discomfort goes away every time I get the joint alligned again, for example getting out from the car, or allmost slipping in ice (Living in Finland again…) or something similar ( sometimes i can self-manipulate it).

Also, I feel in squats that my hip travels to right and during longer sets the weight is mostly on my right leg/ I squat mainly in it, due to the SI-problem.

Reserved a time for physiotherapist on Thursday this week, lets see what he can do to it.

I know I have tight posterior chain on my right leg and tight anterior chain on my left leg (adressing it as we speak) and started doing more stretches and DeFranco agile 8 before and after every gym session.

SO the question is. What can I do to stop my left si-joint from ruining my training? (childish yet simple question).

Should I take a “abdominal training prescription” and address my abs (deep and superficial ones) hard or something else?

Long post, I know.

Thanks in advance!

Ville From Finland


#2

I used to have the same problem when I deadlifted, my fix was easy though I just had shitty deadlifting form. Between not being able to properly brace and using a mixed grip every single set I used to mess my right SI joint up every couple months. Make sure your form is solid before adding on the weight to a deadlift. Yes you can add some core work (reverse hypers would be good) but nothing will beat just learning how to brace properly and keeping a neutral spine.


#3

Yes. Thats what i thought also.

Funny tho, dl max is 250kg and before that no problems have occurred.

Need to fix the grip. At least try to switch sides (left/right).

Ill check the form and grip.

Will also include full defranco agile 8 and more abs.


#4

Everything you describe is a symptom of a Left AIC pattern, as described by the Postural Restoration Institute. Unfortunately there are no PRI certified therapists in Finland. Trust that the problem is extremely common, especially amongst lifters, but it will be difficult for you to have it properly diagnosed.


#5

[quote]TrevorLPT wrote:
Everything you describe is a symptom of a Left AIC pattern, as described by the Postural Restoration Institute. Unfortunately there are no PRI certified therapists in Finland. Trust that the problem is extremely common, especially amongst lifters, but it will be difficult for you to have it properly diagnosed.[/quote]

Could you describe aic more and possible treatments for it?


#6

[quote]TrevorLPT wrote:
Everything you describe is a symptom of a Left AIC pattern, as described by the Postural Restoration Institute. Unfortunately there are no PRI certified therapists in Finland. Trust that the problem is extremely common, especially amongst lifters, but it will be difficult for you to have it properly diagnosed.[/quote]

Could you describe aic more and possible treatments for it?


#7

See sections 3 and 4 here: https://www.posturalrestoration.com/the-science


#8

So,I need to fix mobility on my legs? In other words stretch them so that mobility is equal on both sides?


#9

Stretching is unlikely to help. PRI uses neuromuscular repositioning techniques to address the root cause of the issue rather than simply manage symptoms. Without an assessment, it is impossible for you to know which repositioning exercises to use. That said, you can try these for 3-5 sets each:

https://www.youtube.com/watch?v=9B7u9_CEQl4 (with or without band)

Technique is very important with these exercises, so I suggest looking around online to find explanations from the postural restoration institute. Be sure to maintain diaphragmatic breathing throughout the duration on the exercises; in through the nose, out through the mouth.

*NOTE: I’m not a physical therapist and I am making no attempt at diagnosing you or prescribing exercises. I’m just offering my opinion based on the limited information that you provided in your original post.


#10

Yes thanks for the videos. Will try them and discuss this matter also with pt on thursday.

Is there any other possibilities for the problem? Like tight something or hypomobile something?

Just thinking other possibilities.


#11

SI joint might just be out of alignment. Depending on how bad that can then make a lot of little muscles( erectors, piriformus) tight to compensate.


#12

[quote]WilhodFIN wrote:
Yes thanks for the videos. Will try them and discuss this matter also with pt on thursday.

Is there any other possibilities for the problem? Like tight something or hypomobile something?

Just thinking other possibilities. [/quote]

Sure, it could be lots of things. I suspect a Left AIC because (1) it is an extremely common issue rooted in natural and normal human asymmetry and (2) all of your symptoms point to it-- the right hip shift during squats is a dead giveaway.

As for the tight something and hyper mobile something else, yes: you are likely experiencing tightness and laxity at various places. I suspect that you’re actually what is considered a Patho Left AIC, which is to say that your left hemipelvis is anteriorly tilted and rotated, and the ligaments in your hip that limit extension and external rotation of the femur have become lax. Now, you are asking for mobility from a joint that isn’t meant to give it to you (your left SI joint), hence your pain.


#13

Yes. Makes sense.

Tightnes from my legs puts the pressure on si-joint.

I have 10 visits to my physio (thank god employer pays half). I think the pt will involve alot of stretching problem areas, strenghtening of deep abs and gluteus medius and possibly manipulation of right si-joint.


#14

Yes and no. The problem is not one of tightness, but one of position. In a Left AIC, your pelvis is literally in an asymmetrical position. Feelings of tightness are secondary to this position. Treatments that do no recognize and attempt to improve this positional issue are unlikely to give lasting relief.

Your physical therapist may not be aware of this issue and the associated treatments.


#15

But what causes the faulty position? Is it tightness or just way human is built (side dominance etc.)?


#16

Update from the physio visit:

-Mobility imbalances in leg muscle
-gluteus medius weakness / pelvis control
-Deep ab control

So the same things I thought.

She prescripted clamshells, ag exercises and control exercises.

Also she did some soft tissue mobilization.

Will contact and meet up next week again for si joint manipulation and exercises.


#17

[quote]WilhodFIN wrote:
Update from the physio visit:

-Mobility imbalances in leg muscle
-gluteus medius weakness / pelvis control
-Deep ab control

So the same things I thought.

She prescripted clamshells, ag exercises and control exercises.

Also she did some soft tissue mobilization.

Will contact and meet up next week again for si joint manipulation and exercises.
[/quote]

most back problems among lifters come down to this. Weak glutes and core, shite mobility in the legs and hips.

I have pretty much the same issue as you, and getting a lacrosse ball into my piriformis (ouchie!) and a piriformis stretch is a life saver


#18

[quote]WilhodFIN wrote:
Update from the physio visit:

-Mobility imbalances in leg muscle
-gluteus medius weakness / pelvis control
-Deep ab control

So the same things I thought.

She prescripted clamshells, ag exercises and control exercises.

Also she did some soft tissue mobilization.

Will contact and meet up next week again for si joint manipulation and exercises.
[/quote]

Did you attempt the exercises I suggested to you?


#19

The clamshells yes, other not yet. Will do when getting out of work


#20

Btw, tried switching the grip on DL. Holy shiet what a difference. Felt actually good on lower back!