I'm not a doctor but…
Cycling injury, recovery and health issues.
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Hey, just wondering if anybody else is/has been dealing with Sacroiliac joint (SIJ) pain? It's the bit where your pelvis joins to your spine.
I aggravated it about a year ago, lifting my heavy-for-his age baby son. Physio got it going again. Then, following a crash in October, the glute muscles have tightened up, aggravating the pain again.
Just wondering if other people have similar experiences, and if they kept riding at a reduced rate, or stayed off the bike.
I hurt mine picking up a compressor ten years ago, but it didn't really go bad until 2006. Now it gives me a dull ache if I don't ride every day or two. In my case, my chiro reckons I tore the supporting ligaments, but all I know is... from Jan 2006 to Dec 2008, something was out of place, couldn't sleep on my front or back and woke up in pain every morning, and when I found my current chiro and he managed to get a 'pop' out of the lower back, it was bloody wonderful.
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Something I have sufferd with badly even resorted to a pregnancy support belt. The best thing I found ws "muscle energy " physio work. This uses the surrounding muscles to move and free up the joint. Chase up a physio who does this it fixed me. If it ever goes out I get my wife to do it and the pain is gone.
Yeah, I have a good physio (who is also a cyclist) working on it. Dry-needling has gotten the best results so far. My question was more aimed at how much it affects riding. Suffice to say, if my physio's diagnosis is correct (locked up glutes causing the pain), then I'm not going to be getting max power without fixing the problem.
It hurts when you don't ride? Wow, I'd love that prescription
Currently struggling with SIJ pain.
Working with physio to improve core muscle strength to brace pelvic structures, but finding whenever I engage the hamstrings, glutes or lower back (eg, extended power-on seated climb, riding with bum off saddle in the mtb 'attack' position over surface obstacles) it gets uncomfortable pretty quickly.
Celebrex is helping to keep me sane while the strategy has time to kick in. I'm using a Com-Pressor pelvic brace when riding.
It's been a known issue in the past, so I started seeing the physio about 2 months ago as a preventive measure before the Mont 24, but it's looking like doing the WSMTB 4 Hour last month was definitely premature, and has irritated the left SIJ and stretched the ligaments.
Ahh Yes welcome to my life don't ignore it! I did ended in emergency spinal surgery after the disc ruptured . You sure its not L5 S1 ?? I'm no medical specalist but I belive my jammed Sacrum caused my disc issue. Really go try muscle energy stuff with a good physio it will work really well, I tried all sorts of things to free the joint up this is just great.
ps mine is fine now no pain no jammed sacrum.
I thought I might reopen this topic.
• Post ride swelling/fluid on the right side at the sight of the Sacroiliac Joint
• Deep radiated pain in my right gluteal
• Occasional slight groin pain
• Lying on my back, feet together, knees out (breaststroke kick like position) I get a rotator-cuff like pain in my hip flexor
• Previously, in the morning I would have a very stiff lower back
• Poor core strength,
• Poor sitting posture (slumper)
• Penchant for doing Strength Effort climbs (generally like driving a bigger gear)
Diagnosis and Remedies
The physio is able to relieve the gluteal pain by massaging me mid back. I can replicate this through self-massage. Her diagnosis was excessive hamstring engagement during pedalling. She proscribed gluteal engagement exercises. Glutes then hamstring. These work quite well.
My diagnosis. I am right side, pedal dominant. I always power off using the right foot and I am unevenly powerful on the right side. This causes me to hyper-extend my down stroke on the right side creating an imbalance. To prove this I noted extra discomfort when doing one-foot pedal drills on the right side, but none on the left. To correct, I have focussed on strengthening the left side pedalling.
This year I am focussing on core strength.
Self-massage, gluteal exercises and pedalling retraining mean I can ride pain free and remain so post ride. Any thoughts or additional experience out there? The swelling is still a bit of a worry, but I guess it will stop swelling in time as the remedies start to become more effective.
Interesting FTC that you've noticed a difference between R and L. I've also noted a difference between legs, influenced by cleat position, previously L dominant, now R dominant after new shoes and cleats.
Changing the rotation of the shin can change activation of thigh muscles etc (turning shin out activates thigh muscles more), can be achieved short term by a subtle rotation of cleats or longer term by employing wedges - would be interesting to see if Steve Hogg has anything to say on this (I don't know enough about it).
Maybe discuss with your physio, would be interesting to get their thoughts.
I had one physio tell me that this joint was my issue... But MRI was fine.
Personal opinion is that it is never one thing in that area... But multiple problems that finally cause one area to fail.
For me they only looked at the problem, not the cause.
18 months back on the bike and I still have issues... I am doing regular core work but am starting to add in a lot more hamstring exercises as well... Just stretching my legs / hips feels nice but doesn't really solve anything long term. Doing strength work on the problem area seems to loosen up everything much more than the stretching.
FT... How tight are you in your legs / hip / butt ? .
That is the bit that would worry me, to my understanding fluid and swelling indicates some sort of tissue damage at that site.
If I was in that situation I would opt for an X ray or scan of that area.
I had the joint Jam on me I believe this was a major factor in my L5 S1 disc rupture but that's another story. I found one Physio who helped free this joint up (some even argue its not mobile) she used a technique called muscle energy technique. It uses your own muscles to mobilise the area worked for me, I now get my wife too do it if I get that familiar pain. Don't know of this helps but I found allot of miss information/opinions about this joint amongst health professionals.
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It'll depend on what you mean by "free this joint up". If you have ever held a bony pelvis together and seen the contact surfaces and ligaments , that "free" will have to be pretty liberally defined. What's more important is a treatment worked for a particular individual. Just don't take that as sufficient proof of the "theory" behind it.
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Thanks for the comments.
CoffeeandWine, I was fitted up by Steve Hogg myself. I haven't been back since my refit about 1.5 years ago.
Not sure how to tell? I can easily touch my hands flat on the ground in the hamstring stretch. The pretzel stretch that you did pretty well. Tell me some ways to tell and I will try them out?
Yep, I am concerned. If it persists I will be off to see a chiro who is highly recommended to check for any bulging discs.
Googled that, yes, that would be one I would have to learn from the physio first.
The point being some said it was fixed did not move, slide, glide or what ever terminology you want to use to infer movement. Others who solved my issues said it did move and from them I got relief specific to the area. I've never held a pelvis together, if you have can you please explain in detail what does move??
Here's a very good video which I found when I had my back / hip problems ... it is a very complex area, with me it was mechanical, psoas was the main problem but many other areas were affected... resulting in inflamed nerves in the lower back.
BTW...my completely unqualified test for mechanical pain relief... when you are not suffering too badly, take a superduper long hot bath, if pain reduces and movement increases after the bath then time to look for mechanical reasons .
Bit of an update on me. So I went to the physio, rotated right hip. Went to Thailand, Yogalates, swimming, for two weeks. At the end of it, I was much, much worse. Anything that made me do butterfly legs and stretch forward or put too much pressure on my SI Joint was bad. Even too big a kick swimming. The swelling was there often and I was getting worried. Especially with all the L5 S1 herniation stories on here - very sorry to all those suffering. But because there was no pain below the upper glute, the physio was very, very confident it was just stiffness. TLL, kudos to you, you are completely right.
Back in Sydney, I essentially narrowed my exercise routine down to just loosening up the quads. Simple quad stretch (foot behind, pull into the bum) and Sun Salutation. I started with rocking into and out of the sun salutation. When ever I did these two the pain in my glute and the one in the SI Joint itself went away.
Weekend, I thought there was a bit of a click from the SI Joint. Then two nights ago it was a big click. It suddenly felt way better and the swelling has all but subsided. I have continued to ride a bit. Riding doesn't hurt, it is the post ride stiffening that is uncomfortable. I even did a little bit of interval work.
The physio was amazed. My hip alignment was nearly correct. Physio said we are done. Keep working this and the tight hip flexors and in 3mths you are good, 1yr fixed.
Now as a racing cyclist, I only heard the 3mths as this fits nicely with my base period.
So I almost never stretched. Physio said, I have to roll in 15min early from training and do my stretches - must, have to. I believe her.
Cause: Stiff quads, hip flexors and psotas have dragged my hip forward. Symptoms: Glute pain dull/deep at the top of the glute, dull pain where the SI joint and hip interact and local swelling there. Worse in the morning, no effect on rides. Cure: Stretching.
Hope this might add to the wealth of info on the forum. Though yet again, without professional guidance, I would not have solved the riddle, I would have made it worse.
I had both, first the SIJ and then the disc L5S1, sciatica, The pain drove me to drink and take lots of happy pills. Are you ready for this? 3 back ops, discectomies. The disc kept on leaking, rupturing, slipping whatever you want to call it.
I am good now but I need to be careful, I changed my surgeon for the last op and that was 3 years ago. Every so often if I go hard or work in the garden it will get irritated up
I had an MRI to make sure the diagnosis was correct. Good luck and take care.
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FT... good news mate!. You have to keep working the area, I get lazy and it tightens up. If you haven't already got one then get a foam roller... the pain is heaven. I work on my butt, front and back of thighs,itb, inner thigh is a bit hard but I can manage and also top of calves just below the knee. Just do it in front of telly at night etc... although the wifey might give you some strange looks... " why are you humping that blue roll while moaning " .
Too funny. I should have just come to you. The foam roller came out and she showed me how to use it and explained all the moves I need to do as a cyclist. Including some for the mid back. I truth though, I still needed to go to her to be told what muscles to stretch. If anything I have been over stretching (or more precisely only stretching) hamstrings.
So feeling a little more confident about having a racing season this year after all. Thank goodness.
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