likely si pain

Discussions relating to Lower Back Pain.
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Joined: Sun Feb 22, 2009 7:17 pm

likely si pain

Post by clynesn » Sun Feb 22, 2009 8:45 pm

Hi Bill,
I have read your suggestons and have some questions

First some backround.
55y.o. male, execrcised my whole life, lots and lots of soccer...still playing. otherwise occasional skiier and tennis. I am 5'9.5 and about 148-150

had back pain as young adult treated with abd stengthening and changing to sleeping on side (never belly which had been routine)

have had anterior groin pain emanating fromiliac crest one side or other for few years and persistent back pain lateral to spine (basically over si joint)...goes from one side to other more on right. left hip fasdcia lata tender at times....

gpt MRI which showed spinal stenosis of moderate degree in Lumbar area with dessication of some pain down legs (no sciatica) even with straight leg raise....however have always been extremely tight in hamstrings....which are weak compared to strong quads (at various times able to do three minutes of wall sit exercise for skiing)....

found that pain in back was immediatiely brought on by standing for any period of time in one position and changed work habits to sit much more...

however persistent groin pains and back pain intermittent.

tried your exercises tonight
resluts: able to do #1 and #2 (kept pressure reasonable with legs bent)
next exercise
when tried leg raise on right ....not able to fully extend due to hamstring tightness and about to 80 degrees at hip noticed several things
1. pressure dramatically increased to 100 and beyond and progressive clicking in area of SI as raised from 45 to 75 degrees ...distinct separate clicks about three pain with clicking

the pressure rise was about the same in either leg ...the clicking only with the right leg

it seemed that to try to control the pressure I needed to increase the lordosis of the back this correct ?

by thje way the orthopedist at work said that he did not think I had symptoms from the spinal stenosis since I did not have pain down leg...he said it was SI disease (but he was only a in the hall consult)..

I did get physocal therapy and the therapist did not mention SI disaes but I noticed significant pain when he would manipulate my hips with pressure on the SI joint (when I was in the prone position)
thanks , neville

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Joined: Sat Sep 13, 2008 12:05 am

Post by Bikegirl » Fri Feb 27, 2009 4:36 pm

Hi Clynesn,

I have a couple questions for you:

1- what was the level of the physiotherapist you saw? Was she or he an advanced manual therapist?
2- When you do the active straight leg raise, have you tried compression on the illiac bones? and compression on your thorax?

I have been suffering from SI joint pain for 6 years now. I met an advanced therapist and I have been seeing him twice a week for the past 6 months. I have come such a long way!!! My problem was not only in the SI joint area but mainly from head to toe! My thorax was a major part of the problem so was the abdomen, lower back and si joint. I had a few atrophied muscles and alot of muscular imbalance.

Most of it is fixed now and it feels so great!

So anyways, good luck to you!

Bill P
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Joined: Sun Mar 04, 2007 7:48 am

clynesn - likely si pain

Post by Bill P » Wed Mar 04, 2009 5:44 pm


Here are some things that stand out from your post:

1. Almost certainly, you have very short, tight, psoas muscles that are contributing to your back pain.
2. Your hamstrings may be weak, but probably aren't tight. While the test you performed may indicate so, it may not be the correct test.

I need to know the answers to the following questions:

Q1. Do you kick mostly with your right leg? In other words, do you dribble with both your left and right foot, but make your longer, harder kicks with your right foot? If that is the case, it's probably the reason you experience a click when you raise your right leg during the blood pressure cuff exercise.
Q2. With regard to the blood pressure cuff exercise where you experienced the dramatic increase in pressure to 100lbs +, was that with your knee flexed or extended (locked/straight)?
Q3. Which test method did you use to determine that your hamstrings are tight? The Straight leg raise test or the Forward Bend test?

I would highly suspect that the reason you have back pain while standing is because of your very tight psoas muscles. This is confirmed by the fact that you stated in your post that you felt relief from the back pain when you are in a seated position. Remember, when you are seated, your psoas muscle is relaxed, and in a shortened position. Tight psoas muscles are very common in soccer players and runners.

To answer your question, to control the pressure requires you to be able to maintain a consistent lordosis throughout the leg movement. The change in lordosis increases pressure as your spine moves closer to the floor. Conversely, the pressure in the cuff decreases as the spine moves away from the floor or there is an increase in lumbar lordosis.

The object of the exercise is to let your Transversus Abdominus muscle figure out how to maintain a consistent relationship between your pelvis and ribs. It defeats the benefit of this exercise to try to hold your lower back in a fixed position. Remember to breath as you normally would while performing the blood pressure cuff exercise.

Hope this helps.

Bill P


Post by TBone » Fri Mar 20, 2009 8:18 am

Bill P,

Do you have any exercises that will strengthen the hamstrings?


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Post by devaneym » Wed May 13, 2009 11:21 am


Posts: 7
Joined: Wed May 13, 2009 11:15 am

si joint pain

Post by devaneym » Wed May 13, 2009 11:34 am

Bill I would appreciate it if you could offer guidance to a 56 year old male who is experiencing the above. I have been running for many years until the above issue surfaced. I exclusively use the elliptical machine doing relatively hard interval work and was wondering if this is hurting me or not. I read you post about the blood pressure cuff and was wondering if this might help me.

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