Back Pain

[Donjman]

In January, i went to see a private physio he said that my left SIJ was unstable i had atrophy on the left side of my back and was reffering pain to my hip, also my thoacic spine was tight, lumbar spine was very flexbile on extension and my glutes were underfiring

My glute exercises were:

Glute Bridge, making a point of tensing the glutes for 10 seconds X 30
Shallow squats against a wall, again tensing glutes X 30

My Hamstrings were tight and overworking due to my poor glute activation, i did some static stretching for them

My Back Exercises were:

"Mule" Or "Superman" Exercise, kneel on all fours left leg out right arm out and visa versa X 30

Forward leans, simply bending 10-20 degrees forward

These exercises all progressed over a 9 week period, eg glute bridge turning to single leg, then single leg on a swiss ball.

The hip pain never decreased with the help of these exercises, while the physio said he saw a nice progression in my stability and the left side of my back was building up.

So i gave up, and went to see a chiropractor, who told me i had a genetic brain imbalance he said rather than there being atrophy on the left side of my back, that is was underfiring and the right side was overfiring and that some other muscles are overactive some are underactive, we proceeded with some strange treatment methods in his clinic and he sent me home with static stretching of specific muscles, my right psoas, my right side/lower back. All the time when in his clinic he looked for my leg length, and he said my right leg was short due to the right tight psoas. He would proceed to stimulate various muscles in my body by appling a small push to an area.

I beilive he was wrong with his diagnosis, it sounds whacky to be honest, however i did notice a reduction in pain, and i saw with my own two eyes a short right leg when he pointed it out to me in his clinic.


Has someone assessed your SIJ using the Gillet / Stork test? Results?
I dont know, to be perfectly honest if i have been tested, i underwent various tests with my physio, im unaware of the names, sorry.


Does it hurt to cough or sneeze - in particular pain in the ribs?
No never.

How did the physio decide you have an unstable Left SIJ?

He saw atrophy on the left side of my lower back and tagged the hip pain to a lack of stability and strength in the area. Im guessing to him it all fit nicley.

Is your SIJ now stable?
I dont know if it ever was unstable


How is your "scar tissue" that you have been rubbing?
I left it to be honest, i found a dynamic warmup with some stretches to the sides of my body really stopped it twinging when i exercise, so i leave it.


In general, would you say you are a motivated-type of person or are you really laid back?
Very motivated, and still after a year distressed about this injury

How do you know the right psoas is tight? Did they do a Thomas test? Is it tight or overactive?
Chiropractor said overfiring.

Same with hamstrings - are they tight or overactive?
Overworking due to poor glute activation and tight probably due to working so much.

Have you had a CT scan?
Never No.

This thread does indeed look a mess, and i apologise, theres just so much information and i really do give my thankyou to anyone that looks over it and gives me there thoughts, and thankyou alophysio for taking time to read my previous posts, i hope my awnsers can help you. If there are any more questions or anything you wish for me to explain for you any further or anything ive not explained properly ive no problem explaining in more depth, thankyou again.

Justin

[alophysio]

Hi Justin,

Ok, i don't have long so i might post more later...

Basically it seems you have a lot of different and conflicting opinions. The back exercises sounded like they helped your back but not your pain - it is not good us fixing things if it doesn't solve your problem, right!?

No what the chiro said sounds plausible in that your right sided muscles may be overactive. I am not sure if this is from the genetic thing. However, i do see a lot of people who have overactivity as a problem and it gives them pain.

The most interesting thing you mentioned in the post was that you only get the pain after exercise when you sit.

You see, I am thinking that you have what is classified as Non-specific low back pain (judging by your pictures) with a classification of motor control impairment - active extension. What this al means is that your muscles are way overactive and squashing your ribs, spine, pelvis and hip.

Think of it this way, when you squeeze your hand, especially the knuckles like in a handshake, it doesn't hurt that much right? But if kept squeezing and squeezing all day, by the end of the day, that hand is going to be very sore [sorry - it works better when i am with you in person!!]

The same thing is happening in your back (I am only guessing ok). The muscles that are overactive are putting extra load onto the joints and bones and then the weakest areas start to hurt first.

I asked the questions about motivation because people who are highly motivated tend to have this problem more in my experience because they persist with exercises, even when it hurts whereas people who give up easily have a different type of classification of back pain (again in my experience).

I wonder what happens when you lounge around being like a slob - do you ever do it? How does it feel?

Are you conscious of your posture? When you try to stand up straight, do you feel tired from holding the position? Do you feel good when you slouch? Do you feel bad when you catch yourself slouching?

It will be interesting to see what is wrong...Are you able to post pictures of your posture from side on, the back and the front please?

Thanks!

[Donjman]

I have been a slob for 2-3 weeks, just to try the total rest approach, the pain really was the same when it came to sitting down.

Since the physio back in Jan told me to sort my posture out i have done, when sitting and standing, but i am also carefull to not sit for a great deal of time taking regular standing/walking breaks. Im careful not to stand to straight, not overdo it. I do feel a little bad when i see ive slouched

Chiro said it was an imbalance pattern, imagine looking at me from the back.

Left Glute Overactive, Right Glute Under (Explains why i pull my right ham alot)

Left Lower Back Under, Right Lower Back Over (Explains why i pull my lower back slightly at the drop of a hat)

Right Psoas Over, Left Psoas Under (I guess its near my hip pain)

Another thing that may help with the hip pain diagnosis.

If im sitting, and i bring the left leg up,



Like that, probably not as much as that, but the same motion, the hip pain comes on worse, if i slouch, the hip pain REALLY comes on worse
If i slouch and lift my neck forward and back, it gets really agrivated.

Id think by lifting my leg like that, id be shortening my psoas? But the pains not really where the psoas muscle is....

And i know what you mean about fixing things that arnt the problem, i mean after all this is said and done it would be cool to fix anything outstanding, but for now its good to solve the hip,

Maybe its all linked I dunno, Ive spent the last year reading everything it could be and anything i thought it could be, to see if i could figure it out myself, I have a great interest in health and fitness, I guess it makes sense its an imbalance pattern.

[alophysio]

Hi,

Thanks for that interesting post - about that hip thing - is it possible to have a photo - you don't have to ID your face...it is just that a photo shows many more things than you can describe.

Can you clarify what you meant by "If i slouch and lift my neck forward and back, it gets really agrivated". Do you mean when you slouch and put your chin onto your chest or when you slouch and look up to the ceiling? Photo?

Now is it when you slouch and move your neck only that you get the pain or when you slouch, bend your hip up and then move your neck?

Slouching and lifting your head either forward or backward is not a sign of psoas being a problem. It is usually a sign of spinal cord tissue issues.

By this, i mean the by moving the spinal cord, it is giving you pain. This makes sense if you think of your spinal cord being like an electrical cable in a conduit - it is getting caught so whether you move it at one end (bending the hip up) or move it at the other end (moving the neck), then it will pull/catch/tug the cord and so give you pain.

Do you have any pins and needles or numbness anywhere? Any areas of increased sensation or decreased sensation? Are you more ticklish than before? I am sure there are many other symptoms that indicate possible cord problems. These also include muscle power (think underactive in your case!) or decreased reflexes - can't do those by yourself!!

Anyway, lets see how things go - pictures would be nice!

Thanks