Question:
SI JOINT
I would appreciate any guidance that can be offered to help me with an si joint problem(left side only) that I have been having for a while. Although it is not debilitating it has prevented me from running. I was a fairly competitive runner (now 57 years old)and I believe that if i can properly assess muscle imbalances that I have and develop a strategy to address those issues that I can put this behind me. I should add that I am in the process of getting custom foot orthotics as for one thing i have a functional leg length discrepancy 3/8" (left side longer). There are a number of other functional issues with my feet that prevent the normal dissipation of impact stresses properly and the orthotics will address those issues.
Asked by devaneym - 3 answers - 2 years 21 weeks ago
I would say that you are on the right track with getting your leg length discrepancy addressed. That will cause the forces going through the SIJ to be skewed, and no matter what else you do, you will always have a force imbalance at the SIJ. If you have a current flare up, you should have someone check for any upslips, rotations or flares of the innominates (ilium on sacrum). Once you are settled and out of the acute phase, you can be more aggressive with addressing soft tissue imbalances and restrictions. Get good mobility in your adductors and hip flexors. Work on establishing some good core stability. Look at your single leg squat right vs. left and try to equalize the quality and quantity of moevement. Slowly work your way back to running longer distances.
Submitted 2 years 21 weeks ago by matt0Hope this helps.
Matt Swift, DPT, ATC
Thanks Matt, There is so much info out there about muscle imbalance issues that one easily gets overwhelmed and what the injured runner needs is a solid game plan. I have been reading a lot from a physical therapist in the UK named Chris Norris who illustrates a number of tests to assess imbalances and related routines to address these imbalances (just wish i knew someone with his competence). The problem is finding a professional that really knows this stuff. Without knowing whom to approach for help you wind up going from professional to professional without getting what you need with the added benefit of wasting your time and resources.It sounds like you are saying that a properly designed orthotic will spread the impact stresses more evenly or naturally which should make my si joint happier and following that address the other issues.
Submitted 2 years 21 weeks ago by devaneymAs Matt has mentioned sounds like you are headed in the right direction. I would also recommend seeing a chiropractor. I send almost all of my patients with SI dysfunction to both a chiropractor and a PT. Chiropractic will address the structural issues at hand along with PT addressing the soft tissue components along with long term home exercise program. You must be very careful in placement of a heel lift and how this was evaluated makes all the difference. Structural vs. Functional short leg is the key. Discuss this with both the chiropractor and PT for their thoughts.
Submitted 2 years 20 weeks ago by sportsdoc