T Nation

Understanding Sacroiliac Instability


#1

I've been dealing with a hypermobile sacroiliac joint following a back injury in June '10. I find the joint will come out of allignment and cause pain, inflammation, and occasionally in more severe instances of misallignment I will experience mild tingling sensations in my big toe.

My current understanding of sacroiliac instability is that trauma to the ligaments causes a laxity of the tissues, thus making the joint more hypermobile and prone to misallignnment. I'm under the impression that healing the damaged tissue and correcting any movement deficiencies is the course of action required to recover from this injury. Does anyone have any experience or information to either reinforce this or suggest otherwise?

My current approach takes into consideration the following components:
1. Performing exercises that challenge my ability to stabilize the SI Joint (such as bird dogs, bent-knee unilateral reverse hypers with no added load, etc.) in order to develop proper motor patterns.
2. Overloading tissues (I perform light squats, RDLs) to cause tissue adaptatiton and induce tissue healing. Another added benefit to this would be the strengthening of surrounding muscles (I'm most focused on the glutes and abdominals).
3. Soft tissue work and other mechanical stimulation (eg. palpating the joint frequently) to improve tissue quality and induce tissue healing.
4. Joint reallignment - I do this on my own, and it may not be very effective. I use low-velocity "pressure" across the ileum while stabilizing the other hip. I also try to mobilize the SI joint of the non-affected side.

I feel like this is a fairly comprehensive approach, but the progress I've been making for the past several months has been excruciatingly slow, causing me to worry about my prospects for full recovery and return to normal training.
I am curious if anyone else has experience rehabilitating a similar injury, and what they found to be effective.


#2

Who diagnosed you as having a hypermobile SIJ? How did they diagnose it? I'm not saying you don't have some ligament laxity, but those are the strongest ligaments in the body (in cadaver studies the bones would fracture before the ligaments gave way).

If you haven't gotten better in over half a year, I will tell you what my head clinician told me in school: "You're missing the diagnosis"

Go get checked out. If returning to training is that important, pay a professional to fix you.


#3

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