T Nation

SI Joint Sprain/Strain Help


#1

Having all of the symptoms of an SI joint issue. I know its not a disc issue , and its not muscular. I get relief form some of the SI joint manipulation/stretches, and I have had a similar issue before on the other side of my back. I have a few questions.

Firstly, I noticed that when I go ass to grass squat, I get tail tuck. I tried stretching and holding form, but no matter what I did, it tucked when I went below parallel. Mostly when I get very close to the bottom of my ROM. I had very tight hamstrings when I got this “injury”. It was during deadlifting. Again, its not a disc issue.

What can I do to prevent this from happening in the future? Core work?.

I know I need to work on my mobility, is there somewhere specific I should target. I had not done leg exercises for over a year (knee issue) my Hamstrings were super tight after working out, and this is when I caused my SI strain.

I know I should avoid squats and deadlifts, bent over rows for now, anything else?

Any specific stretches?

My chiro mentioned something about my SI joint when I saw him last, and when he adjusted me, the pain was almost gone, for a little while, then it came back. Which makes me think I keep pulling my hip out of alignment.


#2

For relieve, you can use the 90/90 position.

If you relax in that position for awhile things should loosen up. If you squeeze something GENTLY between your knees after 15-20 minutes chilling out in the 90/90 you might re-align yourself. But you have to be careful with stretches and weird positions. If your back tissue (ligaments and fascia or whatever ) is inflamed, torching on that stuff is not a good idea.

If you’re tucking tail and having back issues it may come down to some fundamentals you are rushing through.

Here’s a video about pelvic tilt.

And one about pelvic tilt and bracing in the squat

Hip/back problems on one side are super common on TNation. Sometimes dudes just have tight Glute/tfl muscles on one side. Roll those out.


If you feel like you have deeper hip issues, like one just doesn’t move right, check out post 1037 in here.
https://forums.t-nation.com/t/ironones-strength-journey/210113/1072

Does any of that sound relevant?


#3

Yes.
I am using foam roller, and trying to stretch the areas.

When they say neutral hips and spine for squatting, does this mean that your lower back isn’t in flexion?

When I do squats and deadlifts, to prevent rounding, I usually try and keep my lower back in flexion. Is this incorrect? I have wondered if this is maybe causing me some issues. Ill have to wait till i’m at home to watch the videos.

Even in my squat, I try and keep my lower back in flexion. Maybe im over doing it?


#4

First off, let me say that you might have ‘flexion’ and ‘extension’ confused. When you think about flexion, think “leaning forward.” Extension is leaning backward.

‘Neutral’ just refers to the natural curvature of the spine. A certain degree of extension is okay; it’s better to be nice and tight and have a little bit of extension than to be too loose and risk hurting yourself more.

I hurt my SI joint in late April/early May of this year, and I’ve been dealing with some nerve pain and a slight loss of mobility since then, so I have a lot to say about this.

Curtsy Lunges and single leg rotational deadlifts with a DB or KB can help with your mobility. Single leg squats can, too, but go LIGHT. The focus is not strength; it’s teaching your body safer movement patterns. Weight is essentially inconsequential. Core strength is a MUST; look up McGill curl-ups, side planks, bird dogs, and band clams for glute strength. Your core plays a large role in stabilizing your pelvis, as do your glutes, which is why they’re so important for SI joint injury rehab (and most lower back injury rehab).

As for stretches/releases, @FlatsFarmer gave you some great ones. I managed to find a batting cage baseball–the size of a tennis ball, made out of rubber like a lacrosse ball–which is perfect for rolling out my glutes and hips. I roll out my left piriformis and gluteus medius before every workout for about 60sec each, and it helps a lot. After the first 30sec, my back cracks on its own and it feels incredible. Since these muscles are fairly deep, it does take a lot of pressure (and causes a bit of discomfort) to successfully release them, but it’s worth it. (It was trial and error for me; it was very difficult to find where I was actually supposed to be rolling, but once I found the spot, I knew I had it.)

TL;DR: 3 most important exercises IMO: side planks (1), band clams for glutes (2), and bird dog holds (3). The more of the rehab exercises you can do, the better. Roll out your piriformis and glute meds to help with mobility before you go into your loaded rehab exercises.

Disclaimer: I’m not a PT. So when I say rehab, I mean it in the most unprofessional way possible. See a doctor about this stuff. I’m just sharing what I’ve done and what helped me


#5

Thank you. Yes I am seeing a chiro. (obviously will go see PCP if it gets worse or other symptoms)

Its fairly mild. I mean, its painful but very manageable. I can do air squats with no pain.

Hip flexors are always tight, from sitting at work I guess.


#6

I’d agree you’re probably overdoing something.

Starting with too much flexion is almost like starting in butt wink. Definetly get flexion/neutral/extension figured out. Aim for neutral.

A little flexion at the top and bottom of the spine is an Advanced Technique, for strong, experienced dudes with lots of muscles.


#7

Neutral but keeping core braced, tight. Correct?


#8

Get your pelvis right, then engage your mid section. Your lower back will be in the right position.

If your hip flexors are tight, and your pelvis could easily be tilted some weird way. Get that pelvic tilt sorted. Then brace. That’s where your back should be.


#9

Hey @lava2007 Obviously I know most of this is subjective. But when did you start doing squats and deads again? Did you still have any pain?

I am definitely avoiding deads, but it seems like I can squat (air squat) with no problems. No pain.

I have been resting it for about a week now. Just don’t want to re injure, obviously I will start really light.


#10

saw chiro, he agreed that he thought it was the SI joint. Manipulated it and it felt great. Stayed in place all night, no pain. Now I’m at work and I can feel some minor pain, still slightly irritated., nothing like it was. So I’m going to keep up with my PT exercises.

Have another appointment next week for manipulation.

Good to know its not something more serious.


#11

I’m the same way. I was able to resume squatting after 2 weeks–and 2 weeks was a completely arbitrary amount of time–without pain. I decided that keeping pressure off my spine and hips was a good idea. I actually set a new squat and deadlift PR 3 months after I hurt my SI joint for the first time, although I’m not sure how.

Squatting is fine for me for whatever reason. It could be that my leverages are better for squatting than deadlifting, or my squat mechanics are better than my deadlift mechanics. Whatever the case, back squatting doesn’t really bother my SI joint. Deadlifting does, so does front squatting.

I hurt it again one week ago today, and squatting was a no-go today, so I guess I’m goign to rest another week and focus on glutes and core. My advice to you is to give yourself a thorough evaluation of hip mobility as well as glute and core strength. If there are any weak links in there that you don’t address, you’re bound to hurt yourself again at some point. Either lifting within the next year, or in 25 years (although whatever happens in 25 years seems pretty inconsequential at this point).

Also, good on you for seeing a PT so quickly. I hope this issue gets resolved quickly and you’re able to get back to lifting heavy weights soon.


#12

Thanks brother, second day without any flare ups. Can feel its slightly sensitive still but no pain. Am gong to take it slow and easy, and Definitely work on my mobility.

Have a good weekend.