T Nation

Lower Back / Pelvis Problem

Hey T-Nation!

Firstly I would like to say that the reason I like T-Nation is because the great articles that are written - which i almost read religiously. And secondly I have been a lurker on the forums for a while and I like how the community works here.

Down to my problem:

2 years ago, I had a twisted/tilted pelvis which was quite painful and I got it sorted out. But now 2 years later, it feels like my left SI joint is “loose” I don’t know how to explain that, but it always aches when I’m sat down, I don’t think that it is actually loose since its a very very rigid joint, but I’m sat down a lot because of college and being in lessons all the time. The pain/dull ache i always on the left side, feels like its my SI joint. Another important note is that my left leg is actually smaller, in terms of muscle mass, than my right leg.

I am hoping in a few weeks that I can see a physiotherapist close to home or a sports clinic. The pain alleviates when I do a simple glute bridge and hold it for 30 seconds. When lifting and doing sports it doesn’t bother me.

I was wandering if anyone could provide some feedback for me.

Some personal information:
Age 18
Weight 110kg - 242 lbs
Height around 5 10 /5 11
Main sport : Rugby
Been lifting since age 14

P.S Anyone who reads this and gives it some thought, your time is very much appreciated :slight_smile:

People who develop sacroiliac instability or pain in one side of the SI will often develop instability and/or pain on the other side of the joint as well.

The ligaments that make up the SI joint don’t have very good bloow flow (nor do any other ligaments) and when you mess them up, or “throw out” your pelvis, they don’t ever heal as strongly as they once were. That’s why when somebody “throws out” their back, it’s always much easier to throw it out again. That’s also why people who say they messed up their lower back or SI joint say it has never been the same since their first injury.

Don’t dismiss the idea that a joint that is supposed to be so stable and strong can become unstable. Especially as a rugby player. One really tough tackle onto one side of your pelvis can be enough to overstretch and damage the ligaments that stabilize the pelvis. Most people who develop chronic low back pain (a large percentage of the population) have ligament instability upon examination. If your pelvis/SI joint pops or cracks a lot, or you find it easy to crack your low back, you probably have ligament instability. The ache you experience upon sitting down is most likely your weakened ligaments being strained in the sitting position.

How did you “sort out” your twisted pelvis? Chiropractic? Physio?

Firstly, Thanks for your reply Ray.

First time, I went to see a physio, I don’t know the procedure he did, but he cracked all my vertebrae, then he pulled really hard on one leg, at that time it was my right leg and my right side of the pelvis which had the problem. Right now sometimes my Si joints will pop when I stand up form sitting down for a while,this doesn’t really happen very often, but generally my lower back doesn’t crack at all, it just seems that my left SI joint seems weird and my OP was the best way I could explain it.

Any way I could strengthen these ligaments? Is that even possible, since I have heard once ligaments become stretched they stay that way? Would it be more efficient by attempting to sort out the muscle mass on my left leg, which is noticeably less than my right leg.

I can’t remember any noticeable event which caused my pelvis to become tilted, however that obviously doesn’t mean it did not happen.

Thank you again for your post.

No problem Gcortese. The muscle imbalance in your legs probably has a role in your problem. I forgot to mention that in my last post.

It’s hard to say whether it is a cause or effect of your pelvis/SI problem. Depends on how big the imbalance is, and how long you’ve had it (before/after first pelvis issue?). How significant is the imbalance in muscle? Any difference in strength? Sorting it out is something I’d definitely recommend. Even if you do strengthen those ligaments, that SI joint, a significant muscular imbalance can pull things out of position again.

Most doctors will not give you any way to strengthen your ligaments, or say it can’t be done. Heck, most doctors tell you to, upon injuring a ligament, to take anti-inflammatories, elevate and compress it to reduce blood flow and inflammation, and to ice it. All these things lead to a weaker ligament, but are recommended because it will leave a shorter time frame where the ligament hurts (until later down the road). If you go to your family doctor he will likely tell you do one of these things when it hurts, and to do physiotherapy. Maybe recommend surgery if the ligament is severely damaged (don’t!).

The only way I have found to strengthen a ligament or tendon or other connective tissue is with prolotherapy, platelet rich plasma, or stem cell injections. Look up prolotherapy or PRP first, as stem cells are a particularly expensive hassle. Stem cells are usually only needed if you’ve got severe arthritis in a joint.

Strengthening surrounding musculature of unstable joints can also help, but not to the degree that thickening and tightening that connective tissue does. Considering you’ve been lifting for 4 years, the surrounding muscles are probably already very strong though.

Do you ever get any pain, discomfort, or cracking around your pubic symphysis? Or any inguinal pain, groin pain, recurring groin strains, or athletic pubalgia? Also, have you ever had a hernia?

Ray, at age 15, I had a moderate groin/hip injury, I didn’t get this checked out, but i couldn’t flex my Hip properly for about a week or two, today it doesn’t give my any problem except its always tighter than my left hip flexor. I started doing some mobility drills that was posted in the most recent article on T-Nation home page which I think were called Frog Rocks with rotation. I’m not sure but it felt like my pelvis felt instantly more balance, I don’t know if this is even possible, but when sat down it felt more balance. However when I do these there is always 2 clicks from my hips.

The muscle imbalance is significant enough that I am consciously aware of it, by that I mean say if I’m lifting weights I can feel that my left leg is smaller than the right one.

I will look into prolotherapy, but I’ve never heard of this, how hard would it be to get this treatment on the NHS? I assume next to impossible because of doctors simply recommending anti-inflammatory which I hate simply because they stop protein synthesis dead, and therefore I always suffer pain rather than take them for minor injuries if they occur. normally I don’t get injuries very often. If not, Do you hknow how expensive proloterapy or PRP therapy is?

I don’t get any pubic symphis pain, inguinal pain or dont have recurring groin strains, but have recently sustained a hamstring injury when simply sprinting, which is on the mend. Should be back in another week or 2.