T Nation

Pain in Sacrum Following Back Injury


Hi all.

I've been rehabbing a back injury that I incurred while working this past June. I never got an MRI or official diagnosis of what my injury was, but judging by the symptoms, my best guess was a mild to moderate L5-S1 disc injury.

While I have no more nerve pinching symptoms, I find that what still remains is a pain in my sacrum. The injury is somewhat sensitive to touch, especially in the area just above the glute origin, moreso on the left side. (Here's a visual: http://upload.wikimedia.org/wikipedia/commons/e/e7/Gray96.png )

I find that I also frequently experience painful and "tight" sensations between my sacrum and coccyx, which occur mostly after prolonged sitting.

Any clues of what might be wrong, and how I could best resolve the issue?


Impossible to tell without an eval and workup, but from the very brief decription you're giving it sounds like it could be your sacroiliac joint. Go get it checked out by a reputable chiropractor in your area, if you have one who is also an Active Release Technique (ART) Provider, that would be your best bet, as they are typically more biomechanically minded and usually won't try to sell you on a bunch of care that you might not need like some chiros do.

Again, this is just a stab in the dark without having more information.


Thanks for the response. I was apprehensive to make speculations without having an accurate diagnosis, and also didn't want to write a big long wall of text, so if there's any other information I could give that would be helpful, let me know.

The SI joint was one of my first guesses too, although the topical area in which I feel the pain is a little bit medial and inferior to my left SI. Your suggestion makes me want do some reading about the SI joint to better understand what conditions might affect it.

As far as ART goes, is that mostly tissue quality work, or does it involve any other aspects such as muscle length and joint alignment?


It depends on the provider you go to, just like anything else there are excellent providers, and those that are so-so. Depending on the root cause (muscle length, tissue quality or joint motion/alignment) an ART certified chiropractor might be your best bet. activerelease.com has a provider lookup and it will list their credentials as well (DC, MD, PT, ATC, LMT, etc). The SI can refer pain all over the place in the low back, hip, leg, butt.

ART addresses soft tissue adhesion/scar tissue which is arguably the most common, and most overlooked musculoskeletal problem. It can happen in one of three ways, a big injury, a lot of little injuries (repetitive stress injuries, training imbalances) or lack of oxygen (sitting for extended periods of time).

Adhesion can glue the muscles together, stick nerves to muscles so they can't glide as they should, and decrease the ability for the muscle to produce peak torque. So before I get on too much of a tangent, yes it is focused on soft tissue quality, but if a muscle has adhesion, it won't be able to reach its normal length. Adhesion can also cause an alteration in joint alignment.