I apparently have an inflamed sacroiliac joint and have been advised to give the bike a rest for a bit.

Has anyone here ever suffered from this? How long did it take to heal? Was there anything you did to help it calm down a bit?

Yes, came to a head March last year. Been seeing chiropractor ever since, had me sorted enough to do SITS solo last year then I injured it again in car shunt. The chiro worked wonders though and still does every couple of months.

Sorry to hear that. I can certainly sympathise.

Follow any professional advice given it’s not something you want to get worse. If the pain goes on for more than a few months push your doctor for referral to a specialist and get an MRI, don’t piss around with people essentially taking guesses about what the problem is.

I’ve had SI issues since 2008 and it’s been very disruptive to my overall fitness not just cycling. At times I’ve found it very disabling. Episodes of inflammation and pain come every 3-6 months lasting for 2-10 weeks making it impossible to exercise and sometimes even walk (on occasion reducing me to tears)

Usual cycle begins with SI pain, and then pain in glutes followed by sciatica type pain with muscles in spasm.

Lots of money spent on chiropractors, osteopaths, physios and the odd trip to the doc.

Chiropractors, Used to swear by them, now I’d never go near one again. I do feel that they turned this into chronic problem by all their aggressive clunking and clicking.

Physios: Hit n miss.

Osteopaths: The best for me. Soft tissue work being the most beneficial. Even then it’s taken more than 3 years and 4 different osteopaths to find right one.

Things I’ve learnt on my SI joint journey and the possible causes / aggravations:

Tight IT bands
Tight piriformis
Tight psoas
Leg length imbalance
Tilted pelvis
L5 S1 disc issues
Labral tear
Traverse tear
Sitting down for a living
Running
Walking on uneven ground
Muscle imbalance
Breaststroke swimming

Things that benefit SI pain:

Ice
Foam roller – IT band and piriformis
Psoas stretches
Osteo – soft tissue work
Hamstring stretches
Weight loss

I’m now in the hands of a very good Consultant Rheumatologists. Last week I had an MRI and tomorrow I’ll found out the results. Then, all being well, I’ll get a definitive diagnosis, then I can begin my rehab with clear knowledge about what I can I can’t do.

Good luck.

Great posts, thanks. Mixed opinions on the chiropractor then! It is one of these who has diagnosed the cause of the pain in that area.

chipsngravy – it sounds like your pain has been much more severe than mine is currently – I hope I’m not at the start of a very long journey.

I believe the cause of mine is of a tilted pelvis ilk. My chiropractor has always done wonders for me before when I have had other issues (all stemming back a long way), so I will give him a chance to put this right.

I will start with the ice pack. Not heard of psoas stretched before but there are plenty of videos available to watch. My chiro did mention something about strengthening hip flexors – is this a similar thing?

Do you use the foam roller just on your lower back? I have been thinking about getting one of these anyway as they are good for ITB tightness which I do have a little of.

Thanks for the advice.

Go and get a real diagnosis from someone medically qualified. Do not trust a chiropractor on this one. They could well be the cause of the pain

I’ve seen docs and physios for years for chronic back pain and the chiro was the only one to sort me out. Takes your choices. I am wondering if it’s just helping the symptoms and not the root cause.

If it really is your Sacroiliac Joint its possible to work them back up your self. Buts its quite difficult to do.

You might need to do it several times as the sacroilliac joint is a bit like your knuckles together so you can work it up back up over time.

This is one video of how to do
link1

But I think that would only work if the ligaments holding it in place are very stretched. In my case the ligaments are still quite strong but it can work down during football if I do I a certain shot. If I leave it out of place I get the sciatica a few games after and my hamstrings seem to become tight.

I had it really bad for a few years on my right before I learnt home to sort it.

I think in my case the main reason is my quads were very tight and it tended to tip the front of my pelvis.

If you can work it back into place you need to do loads of sit ups to strength your core to stop the front of your pelvis droping. Stretching quads and your lower back will help too.

Its important to do this right. IE stretching quads you need to engage you butt and stomach before you stretch or what will happen is your pelvis will drop and you wont actually stretch your calf your’ll just rotate your pelvis which will make it worse.

Again stretching your muscles on your back you need to anchor your pelvis with butt and stomach first before retching your arm round to stretch the muscles on your lower back.

These exercises would be good for SI joint and are kinda how I work the joint back up. But I use alot more force and put my foot right up to my butt.

link2

Like I say once you have it worked back up you need to treat the under lying causes to stop it slipping again. Ie core exercies + strenght butt +strech quads and lower back muscles (not the spine the muscles this is quite a difficult movement you dont want to be putting pressure on the spine so dont bother if you think your going to hurt you back

Bugger, I’ve just been diagnosed (well, after one trip to the physio..) with SI inflammation, the above does not make happy reading 🙁 Might need to rethink two sportives and a fortnight’s camping and hiking in September..

I get this so sympathise, for me road cycling tends to ease the pain if anything – however mtb’ing on the hardtail does not. Things which aggravate it are, top of the list standing for long periods of time then long periods driving. Stretching seems to help a bit

Same here: built up slowly over a few months then had a short period of excruciating pain three months ago. In my case it’s caused by sitting at a desk hour after hour but it still really effects me on the bike. Had to take a few weeks off completely and am only just now starting to get back into a couple of gentle rides a week. Even now it’s pretty sore: I can spin but I can’t really put much power down on the flat or climbing. The good thing is that at least I can run.

I started off with sports massage. That freed up the muscles in my lower back but actually made the pain much worse. Since then I’ve been seen an osteopath regularly. He’s done a great job in improving the state of my back and general flexibility and has also got me to the point where I can be comfortable during the day at work and at home. It’s taking longer to reduce the inflammation and pain though. I’ve been addressing that through ice and Ibuprofen. He also gave me a set of stretches to do each night which seem to be working. Now that I’m a bit more comfortable I’m going to start work on building up core strength I think.

Bloody frustrating though: after just about getting through the Welsh Ride Thing I’ve had to bail on everything else I had planned and was training for including the BORS and Kielder 100. Guess next year will have to be my midlife crisis fitness year…

Today I was told my issue is unilateral sacroiliitis. MRI showed inflammation on the left side of the SI joint. I’m really pleased to have definitive diagnosis It’s gonna make focusing on management & rehab much easier.

Consultants advice: Improve flexibility, keep exercising and riding my bike is OK.

I’ll also continue with osteopathy and the foam roller. Plus a few dietary changes, eliminating inflammatory foods at the same time shifting some weight.

Mattie H I sympathise with binning your plans,, I’ve had three years of cycling plans and holidays being shelved due to SI pain.

Like I said in the first post, I would encourage anyone with these issues to get a medical diagnosis. Physios, osteopaths, chiropractors all well and good but they are all taking educated guesses. Once you and they know exactly what it is, then they come into their own.

Good luck to all of you with this.

Great news. Glad you’re making progress. Let me know what those inflammatory foods are!

Good news Chipsngravy — and best of luck with the rehab.

Fingers crossed I can manage this successfully…

Right, doctor’s appointment booked, going to get this diagnosed properly, think the work healthcare will cover MRIs so fingers crossed I can get an accurate diagnosis pretty promptly.

No-one’s mentioned swimming as a form of rehab/maintaining fitness, is this not recommended?

Maybe a good reason to bin all the ambitious cycling/hiking holiday plans and go visit that girl I know in Vancouver instead 8)

My chiro said no swimming, especially breast stroke – the hip movement can aggravate the inflammation. Front crawl/back stroke with limited leg movement could be ok.

As wallop said, avoid breaststroke.

From experience avoid: Bending backwards too much. For instance cobra yoga pose, this sends pressure down the spine into the SIJ

theres a good article in Dirt this month on Timo Pretzel (i think) who had this issue and resolved it with yoga.

Avoid breaststroke Bending backward

Surely you want to able to do these movements eventually ?

What you need to do is get the SI joint back inline.

Then you should be able to do all movements with out the nerves which run through the joint being affected.

The difficult bit is keeping it in place once you’ve done this, thats the point of all the core exercises/streches.

Im never completely convinced by the hamstring streches although tight hamstring are a sign of SI joint problems. Ie the sciatic nerve becomes inflamed and hence the hamstring tighten.

In theory the tight hamstrings should help pull the back of the pelvis down just like a strong butt will also.

Although having tight hamstring is nt a great idea presumably once you’ve sorted the SI joint and sciatica they will begin to loosen by themselves. Stretching them after the SI joint is sorted also will be more effective as the sciatic nerve will do longer be inflamed.

What you need to do correct the joint first here is a good description of how to do it.

SI joint correction

Personally I cant get the first 2 methods to work, but the one shown in the third picture works for me.

I can hear/free the SI joint realign when done properly.

Not quite along of traction is required though and you wont do it first time. Unless the ligament across your pelvis are very lax then your screwed.

You need to keep practising to get the right movement. you need to make sure you buttocks/abs are tight as you do it as they will help pull your pelvis up at the front and down at the back as realign it correctly.

SI joint correction

This video shows the method, again I would get my foot right in by my butt though and put alot more force in. I think this is because I dont actually have a problem with the ligament round my pelvis it just lines up incorrectly due to muscle imbalances.

Link

Ah here is the guy who came up with the corrections website. This is the only really explanation of the mechanics of the SI joint I’ve seen that doesnt seem like mumbo jumbo. Also he’s given the self corrections out for free and ask for donates rather than keeping them to him self.

The only thing he does nt really mention is I reckon tight quads can be a problem as they encourage the front of the pelvis to drop, so they need to be stretched while engaging you abs/butt.

And a lot of cyclist have tight quads because they are needed for cycling but your leg doesnt fully extend so they are not streched.

THIS IS THE LINK YOU WANT IT EXPLAINS ALL

From the link:

The ilial ridge just cephalad to the S3 sacral segment prevents any cephalic movement at S3 and forces the location of the axis to the posterior aspect of S3. A bony transition point at that location has been verified by Gracovetsky.

Translation: Go see a doctor. 8)

(thanks for the links scu98rkr, will read properly later!)

If you can understand the what is actually happening it give you a much better idea of how to fix it.

At heart it is a simple biomechanical problem not some complex biological process.

If you dont want to read the whole thing go here
FIX LINK

Do the SELF-TRACTION SUPINE and plenty of sit up afterwards and do what ever core exercises your physio recommends

Update: After the diagnosis of the rheumatologist I ended up be being no nearer to the actual cause of the SIJ pain. Pelvic asymmetry and muscle spasm seemed to be secondary. On the advice of my osteopath, who suspected it was caused by hip, I went to an orthopaedic surgeon. The subsequent MRI of my hip shows a laberal tear.

Surgery booked for Nov 30th, then start the journey of getting my life back after 3.5 years of pain. So relieved to be getting some closure and extremely thankful for the help and advice of my osteopath.

I hope the other STWers with SIJ pain are making progress, if not don’t give up. Don’t be afraid to question the opinions of even the most respected doctors/consultants.

Bring on Spring 2012.

Really sorry to hear that chipsngravy: hope the operation goes well and you can get back on the bike and get your life back. I’m still sore – sometimes worse than others and occasionally in a way that limits my mobility. Still working at the stretches and some basic core exercises. I’ll see the osteopath again next month and see what he says. I have to take it very easy off road but on road and on the turbo trainer is going pretty well. Slow and steady…

SI joint inflammation gone, now I think I have piriformis syndrome

😥

How dit the surgery go, chipsandgravy?

Mr MC got diagnosed with this after an unlucky episode at work when he got out of a car to get into a foot pursuit and collapsed in agony. As usual lots of tooing and frooing between Dr’s and hopsital consultants, he spent 18 months on toxic drugs (salazopyrine a disease modifying drug, which he had to have monthly blood tests for to check that it wasn’t damaging his liver function and an anti-inflammatory, Vioxx (which got withdrawn the month he came off it for giving people heart attacks) eventually be told he had “sacroilitus ” mm latin for swelling of the sacroilleac joint (ever so useful these Dr’s on occasions). He doesn’t know what causes it although does know what aggravates it .. wearing a belt on trousers, or hot water from the shower hitting it. At times right at the start he was flat on his back for 2 weeks in bed, he had to sel his much loved Ti hard tail and for about 6 years he didn’t own a hard tail as it aggravated his back, he can still feel it now on occasions.

I would recommend you get a test for Ankylosing Spondylitis, horrible disease but it can be done via a blood test, as it’s a genetic marker which is a strong indicator (98%) that you have AS. Worth getting checked out as it has similar symptoms.

Mr MC had acupuncture which he feel didn’t work, as it’s bones rather than muscles, but I guess it depends why you have the swelling and as MR MC didn’t know he didn’t accept. He has been lucky in that it has got better over time, he still has issues, long periods sitting down but it’s easily controllable with Ibuprofen. MTBing he doesn’t have an issue with really and motorbiking seems to help it as his R1 has such a stretched out position.

Good luck though in finding out the cause and finding something that helps you deal with it. Mattie_H hope you are getting better, didn’t raelise that was the issue you had, if you wany to chat to Mr MC about his, drop us an e-mail.

Get well soon everyone with this!!

I have a mobile SI due to nerve compression at the L5-S1 joint leading to muscle weakness and its exacerbated by a kickboxing injury. Since my mid 20’s its really brought down my quality of life in general, being in constant pain and not being able to stand at times. Physiologically, my coping posture led to scoliosis, poor core strength and piriformis syndrome, with tight psoas thrown in to boot, which started to pull me even further out of alignment.

The NHS were useless, diganosing it as a series of muscle pulls, ligament strains. etc. Eventually I was sort by a chiropractor who put me right over three or four years and assisted me with a program of rehabilitation exercises and integrated treatment.

I have a permanent weakness in my left SI joint – the cause is reckoned to be stretched ligaments, but I have a series of exercises that allow me to cope and rehabilitate myself. They’re pretty simple, but theres a trick to doing them right.

The one that singly does the most is the ‘superman’ and the ‘plank’. These two pretty much sort me out these days when it kicks off. Those and heavy overnight doses of Ibuprofen.

had this, due to compressed disc on L4/5 caused mega problems with the nerve even after a long rest and did everything described by anyone above…
almost went insane…
after 2 years went and got a series of prolotherapy injects in the area,
8 weeks of injections and riding like a demon – no problems since, that was 4 years ago.

“The Wharfedale Clinic, otley, leeds” will give you contact details via google search.

fantastic clinic, guy i had was a fell runner and cyclist.

whatever happens – hope you get it fixed soon,

injuries like this SUCK.

SCU98RKR

the sacroilliac joint is a bit like your knuckles together so you can work it up back up over time.

what on earth does that mean? +..that link you gave must be a wind up if you seriously think it isn’t mumbo jumbo to the average joe ..you’d need a degree in anatomy to understand most of that !

Always amazes me how much confidence people place in chiropractors – they must spin some really good stories.
Sacroiliitis is the most difficult to diagnose of all inflammatory joint conditions.
I would not accept the diagnosis from anything short of an orthopaedic or spinal surgeon.
By the sounds of things many of you above have spinal problems rather than SI problems.
TJ + 1.
Do yourself a favour and get your problem properly assessed.

mrs djaustin has this. after several years of osteopathy she went to a rheumatologist. steroid injections bilaterally have helped. hers was probably the consequence of an infection a few years ago leading to a rheumatic episode.

see a specialist. to the osteo’s credit, she did say that she felt it was more serious than could be treated by simple manipulation. this led to the diagnosis.