Allison,Alison Cross wrote:Hello all - stumbled across this site while trying to find out what the heck is wrong with my hip and have paid for and downloaded the RYB book today.
I've been to the doctor and had an x-ray taken - nothing seems to be wrong bone-wise (which is good!). He signed me up for 6 sessions of physiotherapy and I've been attending religiously, but to be honest, my pain didn't improve. So, I went to an osteopath who said that he reckoned it was my SI joint.
I went twice - got a jolly good cracking up and down my back - but nothing improved.
From what I've read on the internet, I reckon that it is my joint. I'll give you a potted history.
Had my appendix out in mid eighties - nast big scar still there. Had my son by caesar section in 2000 - so abdomen has been well cut up! Developed sciatica whilst pregnant and attended a sports physio after son born - this helped enormously (left hip - down leg, heel pain etc).
Everything pretty much ok until last August. Dancing with son, swung hips out to right side, heard a bit of a crack on right side....no pain....but ever since then, hip pain and back pain been gradually getting worse.
When I lie on my back with my knees up to my chest and rock over my right hip, I can hear a click (not all the time). No noise on left side.
Got a bit of a flat back thing going on (no bottom!) but being doing the cobra to improve that (the physio helped me with this bit).
I spend a lot of time sitting at the computer - and sitting really makes my hip ache. I sometimes feel like I've got a groin strain in my right side too, not all the time though. Walking and cycling are fine - lying in bed and sitting are hellish though. Bed situation improved by putting pillow between my knees.
Just feeling very despondent that this doesn't seem to be getting better. I can't sleep with a pillow between my knees for ever or my hubby will leave me!
Can you wonderful people a) confirm that this joint is the problem and b) that the damned thing can be put right?! :wink:
Best regards - fabulous site btw!
Heck - forgot to say that when I stand and try to curl forward a vertebrae at a time, I get to my lower back and everything just seems to bend forward as a single unit and my pelvis hurts (stretches?) on the right side.
Also, when I lie on the floor and try to let my spine drop onto the floor, vertebrae at a time, by the time I get to my lower back, it just flubs onto the floor like it's all welded together.
I feel like an old lady and I'm 44.
From reading your history, it sounds as if you have a classic case of a transversus abdominus muscle that is not functioning or at best, is very weak. It is not possible to say whether or not your SI joint is the cause of your back pain. The beauty of Dean's exercises are that they will help most folks that have back problems because of deconditioned musculature in the lower back and abdomen which happens to be a high % of people that have back pain. For example, the "Prone Cobra" is excellent for developing the intrinsic stabilization musculature of the back. Very often, in folks that have back pain, these smaller stabilizer muscles have lost their ability to help stabilize the vertebrae of the back which can eventually result in various back conditions.
Allison, did your doctor check you for anklylosing spondylitis? Ankylosing spondylitis is an inflammatory condition of the spine which predominantly affects men about twice as often as women. I am mentioning this because you wrote (relating to your description of your lower back) "Everything just seems to bend forward as a single unit". Ankylosed means immobility of a joint. Also, did your doctor say you had a flat back or a sway back? They are different, but look very similar when viewed from the side; both have the flat butt appearance. In either case, I would refrain from doing the Prone Cobra exercise at least until you have developed greater strength in the iliopsoas musculature. This course of action will benefit you whether you have a vertically aligned flat back, or you have a sway back. The reasoning behind my recommendation to avoid the prone cobra are taken directly from "Muscles, Testing and Function" by Kendall, McCreary & Provance ": 1) "Careful consideration must be given to examination findings when planning a course of treatment. It is a mistake to assume that extension exercises are indicated. They may be unnecessary or may be contraindicated. The flat back posture is one in which the hip joint is in extension, and the hamstrings are strong, and usually short. 2) If this type of posture exists without low back pain, it is not necessary to change it. If the back is painful, and restroring the normal anterior curve is indicated, the measure of choice should be strengthening the weak hip flexors. The problems with back extension from prone position are that it involves strong hip joint extension, and extensor muscle action to stabilize the pelvis to the thigh in order for the trunk to be raised, and the hip extension stretches the already weak illiopsoas."
Here is a little information on pain. Central Pain syndrome, which I think most back pain falls under, is damage or disfunction to the brain, brain stem or spinal cord. This type of pain is typically characterized by a constant level of pain; whether it be moderate or severe. With back pain, the level of pain is directly related to the severity of disruption to the nerve(s). Central Pains actions should not be confused or compared to that which is normally felt in peripheral pain.
An example of peripheral pain would be if you stubbed your toe; the amount of pain you feel initially is much greater than what is present 2 or 3 minutes later. In short, as time passes, there is a diminishing quality to the perceived level of pain from the trauma. On the other hand, with back pain or central pain, because of the initiation of mitogin-actived protein kinase within the body, pain can remain at a constant level much longer.
With central pain, the body initiates a complex process that places a high-energy phosphate (kinase) bond on the pain neuro transmitters which can make the affected nerves fire out of control signalling pain. You can feel pain locally or referred (feels as if it comes from one place, but actually comes from somewhere else) or radicular pain, which has that shooting sensation radiating from a nerve root towards its' periphery.
The point I'm trying to make here is don't despair - you may actually have made progress, but your pain level is telling you otherwise. I think when a spinal injection has a successful outcome in alleviating pain, the groundwork had already been laid by the events previous (i.e. exercises, stretches, rest, massage). In cases where the spinal injection is ineffective, the cause (etiology) may still be present, hence the pain eventually returns. However, in cases where the pain is so severe as to be physically debilitating, an epidural may serve to provide sufficient relief from the pain to allow the individual to perform the physical exercises that will form the foundation for the best chance of recovery.
The following is the course of action I would take:
1. Ask your doctor whether he found any indications you may have ankylosing spondylitis?
2. Hold off on performing the Prone Cobra.
3. On days you want to take corrective action (hopefully 3 or 4 times per week), first stretch your hamstrings, followed by an exercise for your illiopsoas muscles.
4. Follow the illiopsoas exercise with a transversus abdominus exercise.
5. Then follow the exercises in Dean's book.
Allison, if you want to follow my suggestions, I will be happy to provide the stretches and exercises.