[Izzy]

About a week ago I near the end of a medium-long run I started to feel left sided lower back pain. It was uncomfortable but I was able to complete the run without issue. The next day I attempted to go for an easy shake out but felt significant sharp non-nerve pain whenever I landed on the left foot. I felt some discomfort for a day or two with daily activities, so I did not exercise for several days. After 3 days completely off I started doing hip mobility and core exercises. I tried to go for an easy run today and within 5 minutes the pain returned and I was unable to keep an even gait, so I stopped and walked home.

I cannot point to a single moment when the pain started, but definitely during that day. I’ve been consistently and slowing building miles, taking a down weeks every 4-5 weeks. I currently run 70-80 miles/week about 50/50 pavement/trails.

Given the location and nature of the pain, I’m assuming it’s my left SI joint. I was wondering if you have any recommendations on exercises or general recovery approach?

Thank you!

Topic

[Pete Dickinson MS,PT]

Pete Dickinson MS,PT on April 7, 2020 at 10:49 pm #40307

Izzy,
No fun having this pain crop up without a real reason! Sounds like you’re doing a lot of things right with periodizing volume/terrain etc. When I see this situation in one of my athletes, I also look at the miles in their shoes, sometimes you are at the end of life in them. When the easy stuff doesn’t work, it really comes down to…..wait for it….strength. It takes an inordinate amount of strength to attenuate the repeated impacts traveling up your leg into your back. A 6 week block of true strength loads involving squats/deadlifts/single leg step up-down will help take the stress off the SI/Lumbar spine. Muscles are your shock absorbers for these crucial structures. True strength training is also core training. Learning how to create tension through your core, helps you pick up heavy things with your legs. It’s not a quick fix, but will make you more resilient to the repeated cycles of movement with uphill athlete activities.
Cheers,
Pete

[depeyster]

depeyster on April 8, 2020 at 9:15 am #40309

Izzy,

Pete has surely given you the most valuable advice: find the root cause and fix it.

I can merely relate my personal experience treating the symptoms.

I had some more or less continuous low-grade discomfort that I too self-diagnosed as SI joint pain. I have found that using an SI belt helped a lot with minimal cost. I used to wear it almost all the time, though I didn’t use it when exercising. That means, I usually wore it to bed as well. At this point I don’t worry if I miss a day or two. So, I often use it a lot less on weekends.

I wish you a speedy recovery.

[Rachel]

Rachel on April 9, 2020 at 2:10 pm #40352

There are a few exercises that really help my back out — I have some sort of ongoing SI joint issue/pelvic rotation that I’ve been working on now for a while but it’s mostly under control. I find doing core work & back work especially helps (I do a lot of Pilates exercises) but the following two exercises have really helped: bird dog and dead bug.

Bird dog is the one where you are on hands & knees and point opposite arm and leg while keeping your back flat.

Dead bug. Lie on your back with hands and knees up in the air (dead bug). Then lower opposite arm and leg so they are hovering over the floor. I like to do this on my foam roller for an added challenge (put one arm on the floor to stabilize so you don’t fall off!)

Also, for some reason for me, I find doing leg & glute work helps as well. It seems to get me all lined up again. Pilates in particular has helped. I also have a corrective exercise but you’d want to get that direct from a PT I think. The exercise is one sided to get you back in alignment.

[JWTM]

JWTM on April 25, 2020 at 3:14 am #40892

Hi Izzy,

SI joint pain is no fun – I’ve had it pretty bad for a year now following a nasty fall. I can only speak from my own experience, but I’d highly recommend seeing a professional such as a sports physio for a proper diagnosis – you may find that there may be something tight/out of balance ‘up’ or ‘downstream’ that’s putting more strain on that area. I’ve had knock on effects as other muscles and soft tissue took the strain to compensate for the injured area, and am still working on trying to get everything back in proper balance. As with RachelP, I’ve found bird dog helps (will be adding dead bug to my list – so thanks Rachel!), as does child’s pose and working on adductors + abductors.

Good luck and I hope it settles down.

[dmk5n2]

dmk5n2 on July 18, 2020 at 2:40 pm #43690

Escogue exercises helped me with this. Check it out on youtube.