Sacroiliac pain

I am a dance teacher and have been experiencing pain in my sacro-iliac joint on my left side.  I figure it may be due to my demonstrating most exercises with my right leg and being supported on the left.

I have been to a chiropractor who helped me isolate the problem, but none of the treatments really helped ease the pain.  The next step they recommend is to have an MRI done.  Is there anything else I could try or anyone I should see before going through that expense?  I’m finding that the pain is getting worse, and all I can figure to do is to ice it during the day.

Just as an added bit of info:  I started carrying my bag on a cart this week instead of on my shoulder, and for the first time in a while, when I got out of bed this morning, I didn’t notice the usual pain in my back.  Maybe some connection?

You’re the best!  Lisa

fullbody-1-142x300Lisa, carrying a bag on your shoulder most likely didn’t cause the pain – but it may have been exacerbating it!  I’ve seen really interesting connections between movement patterns and shoes, purses, backpacks, bags, you name it:) The challenge with carrying a bag (I’m envisioning a dance bag that hasyour day packed inside of it) is the shift it creates between the torso and the pelvis.  Let’s say that you have it slung over your right shoulder or even crossed from your left shoulder to the right hip – automatically the pelvis shifts to accommodate the extra bulk.  (See image on the right and imagine a bag hanging on the right side of his hip.)  Do you see how the left side of the lower back and pelvis is crunched up?

It’s interesting that you mentioned that you typically demonstrate by standing on the left and having the right leg be your gesture leg.  Same pattern of slight pelvic shift left torso shift right.  I know it is traditional to always start with the right leg – but it might be good for you and for your students to mix it up every now and then and start off on the opposite leg!  Also check when sitting in a chair if you like to cross your right leg over your left more often…. same pattern:)

Now I have no idea if this is your pattern in standing but you can stand facing the mirror and look to see if you have any shifting – and in the meantime, if pulling your bag behind you rather than carrying it helps – keep doing it!  The other aspect of SI joint problems besides a pelvic torso shift is looking at whether or not the pelvis is torqued.  This can easily happen with a tight iliacus muscle (the ilio part of the iliopsoas muscle)

In the short clip below from Essential Anatomy: A Multimedia Course – I demonstrate how to check for a torqued pelvis.  Since I’ve taken this clip out of sequence let me explain that if you feel the bones at the front of the pelvis those points are your ASIS.  Ideally those 2 points of the pelvis should be even with each other.  When you have a torque, one ASIS will be lower towards your knees (generally on the side where you feel the discomfort in the back).  It’s as if one side of the pelvis is being draw forward and down. The torque happens at the sacroiliac joint and can cause pain.  The side that has the ASIS that is lower (in the clip the right side of the pelvis) will have more limited hip flexion.

http://www.youtube.com/watch?v=C_auFs7fYfg

Sometimes stretching the hip flexors will help to reduce the torque on the pelvis, and often I do a triggerpoint release to the iliacus muscle, which can help a lot.  I do teach dancers to release their iliacus triggerpoint themselves, but that is beyond the scope of a blog post.  I would encourage you to ask a physical therapist or the chiropractor if they can see if the triggerpoint is sore and how to release it.

Generally, when the release of the iliacus is succesful, the ASIS are even and you can bring your knee more easily towards your chest.  When there has been chronic inflammation or strain in an area it can take some time to calm down – but you will know you are on the right path – because it feels better!

Best wishes for a speedy recovery!

Deborah

“Education is the key to injury prevention”

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