Sacroiliac joint pain

[toolonglegs]

It's good you found a good physio!... You will remember I went through 15 months of HELL because all the doctors / surgeons / physios / osteos / chiros / osteopaths etc etc couldn't diagnose a mechanical problem!.
In the end advice here and Internet research sorted me out and got me back on the bike... Before I ended up swinging from somewhere!.
We are like sharks ( ? ) we stop swimming we die .... Sooner or later.
Sleep... Fueled by DOM TOM rhum tonight... Although not sure if it is from a DOM or a TOM ... Eek I really am turning Français!!!.

[busted_stuff]

So, two years since I started this thread... a lot of water under the bridge.

After *fixing* my back up, I've irritated it again. Interestingly, however, the second time round confirms some things about the first time, which might be worth recounting. Here's a potted history....

First time around, i developed painful sciatica coming back to riding after broken arms, and couldn't sit down or bend much for ~6 months (flights to the US during that time were hell!).
CT scan revealed a bulging disc at L5S1 - but this was probably not the *cause* according to back specialist.
Cortisone injection calmed thigns down slowly. Followed by lots and lots of physio and pilates and swimming.

Jan 2012 back on the bike, but finishing Phd meant not too much riding.
From June 2012, probably averaged about 50km a week, though it was lumpy - wife had baby in September.
Lifting baby, plus mucking around with bike position, aggravated sciatica again around this Christmas. Pretty p*ssed to be off the bike again.

Findings: Working with physio, confirmed a few things. The sciatic pain is most likely caused by the piriformis muscle getting overworked and rubbing up against the sciatic nerve. Ie. 'piriformis syndrome'. careful dry needling brings some relief. Why overworked? Well, it turns out one leg is about 15mm shorter than the other. How could I have gone 30 years without noticing this? In fact, x ray shows my whole right hip is a different (smaller) size to my left one.

Planning to go see Steve Hogg to see what he can do for that one. Also, got a few tests waiting on - like rheumatoid arthritus and some others to rule out other complications...

[twizzle]

Steve took the piss out of me. I had worked out myself that my left leg was ~ 6mm shorter so had shimmed the cleat by 6mm. And he says "So what do you do when you aren't on the bike?" and all I had was a dumb look on my face.

Doesn't matter these days, I wear Vibram five-fingers all the time, no orthotic option for those!

[ft_critical]

Steve took the piss out of me. I had worked out myself that my left leg was ~ 6mm shorter so had shimmed the cleat by 6mm. And he says "So what do you do when you aren't on the bike?" and all I had was a dumb look on my face.

Doesn't matter these days, I wear Vibram five-fingers all the time, no orthotic option for those!

Funny. When I went and saw him I had shimmed my left foot under the cleat with an old plastic rice spoon (just the spoon part.) flat and a perfect curve.

It was exactly the right size - just a coincidence though.

[Dr_Mutley]

From my experience, I would meet with skepticism any diagnosis of true SIJ pain. Pain in this area is usually referred, and usually more commonly lumbosacral in origin. As sogood mentioned earlier, the SIJ is a large, very rigid, and fairly immobile joint, unless your pregnant, and difficult to acutely injure. "SIJ pain" was certainly the flavor of the month diagnosis some years ago, and thankfully persists less now days. I would recommend anyone being diagnosed with SIJ pain that doesn't settle acutely, to seek further imaging & assessment to rule out other more common causes in this area.

[scotto]

From my experience, I would meet with skepticism any diagnosis of true SIJ pain. Pain in this area is usually referred, and usually more commonly lumbosacral in origin. As sogood mentioned earlier, the SIJ is a large, very rigid, and fairly immobile joint, unless your pregnant, and difficult to acutely injure. "SIJ pain" was certainly the flavor of the month diagnosis some years ago, and thankfully persists less now days. I would recommend anyone being diagnosed with SIJ pain that doesn't settle acutely, to seek further imaging & assessment to rule out other more common causes in this area.

Absolutely correct. And the tight quads, psoas etc etc ate so typical of cyclists due to the posture we're in while riding. Stretching is the key , whether its foam rollers , yoga contortions , or just 10 minutes on your stomach( or someone else's) after riding

[twizzle]

Yes, guess who didn't stretch much for the last month and is now regretting it?


Sent from my iThingy...

[kb]

Yes, guess who didn't stretch much for the last month and is now regretting it?


Sent from my iThingy...

I can relate to that. Personally, I blame the Strava climbing challenge thread :-p. Never needed _that_ much stretching before.

[ft_critical]

So about 3 weeks I go, I became unfixed. Performed some hill repeats and the pain came back.

I decided to go back to the Chiro who is awesome. Diagnosis was strange as was the recovery exercise. He says I have lax ligaments and that my muscles have compensated for this. Overuse in cycling has made them too tight and pulled my hip/SI out of alignment.
So they freed up all the muscles with some horrendous massage and manipulation (no clicking.) Then gave me this exercise that is basically like the traditional shot put. The idea being that we strengthen up all those unused muscles so that I can keep my pelvis/hips all in proper alignment.
After the session I could barely walk properly, everything was so loose.
Every day, bar one, since then I have ridden or swum. If I get symptoms, I back off a little, but it is nothing short of miraculous so far. There is no pain off the bike at all. To be honest, I can’t believe it. I am about 10% down on my best, but that is fine for this time in the season and considering I have had this issue niggling for five months.