Sacroilliac sprain/injury

[bikelet]

Hi all newbie here,

Yesterday evening i was balancing on a fitball on all fours. I thought i was really getting the hang of it but then i overbalanced and flicked off to the right, landing on my back on tiles. Silly i know. Anyways i landed flat on the sacrum, mostly on the left side. It's been niggling since then till now (about 24 hours). I tried various flexion exercises to relieve it which seemed to work okish. Then i extended and heard a bit crack (not unusual for me) and it felt better. Now it's on off localised pain around the left joint (right side seems pretty good). No referral though it does feel like a ligament or nerve root is sore coming laterally out of the sacrum. Pain isn't bad prob 2/3 out of ten more annoying, just wondering if i should get it checked out.

I have had previous trouble with the left side giving me sciatica though that has settled and i haven't got it for about a year. (I previously treated with piriformis and glut stretches and by not sitting too long). The sciatic nerve still feels more tight on the left when i do hamstring stretches (if i slump i can feel what i presume is the nerve tight like a cord all the way down the leg). Sometimes when i walk i feel that the SI (esp left) is kinda out of joint though not painful and it eventually reduces by itself. My right leg is also longer than the left- functional or real diff i'm not sure.

Any advice? I haven't seen anyone as yet because it feels like it's going to resolve by itself. I'm trying to rest as much as possible cos walking aggravates it. Thanks in advance

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[Dr. Norris]

Sorry to hear of the S-I pain. A couple of questions for you. When lying prone, can you raise each leg of equal height with the knee straight?
Can you have someone test your hamstring and gluteus strength? Is there weakness present?
Why I ask is because pain in the S-I joint can either come from the misalignment of the S-I joint... which would be shown as loss of motion when you raise your leg while lying prone, or it could be coming from the Lumbar spine... which would be indicated by the loss of muscular (motor) strength in of the Hamstrings and Gluteus Musculature (L4-5).

Dr. Tracy Norris
PainReliever.com® Features Braces, Neck & Low Back Pillows, Massagers, Magnetic Therapy Products, Pain Gels, Hot and Cold Therapy.

[bikelet]

When lying prone, i can raise my right leg to about 85 deg and left to about 90 although when i lift the left it gives a nerve tension feeling like when you do the slump test. On the hamstring/ glut note haven't been tested yet, once someone did tell me i seemed to have right glut weakness when i was learning to do a supine bent leg raise. I think that may not be accurate as i was just learning the movement and now i can do it equally well on both sides. I do find it difficult though because of tight ITBs.
I 've just realised that you said prone leg raise not supine. Did you mean lying on my back testing h/s length because that's what i've just done.

Also i've just kinda grown up assuming that the dominant side is stronger and less flexible without really thinking about it. Could part of my differences be attributed to this as well as to more serious issues?

Thanks

[Dr. Norris]

When lying on your stomach you should be able to raise each leg equally into extension with a straight leg.
To test the muscular strength of the Glut's and Hamstrings lay on your stomach and have an associate assist you in the test. Raise your leg off the table into extension and have the assistant attempt to push your leg back down towards the table with a graduated resistance from a small amount to almost full force. If a weakness shows up during the graduation of increasing resistance the assistant should back off as the point is not to overpower but to find the level of muscular strength. If one side is different than the other there may be lumbar nerve involvement.
Try again and let me know the results.

***The information, including opinions and recommendations, contained in this forum by Dr. Norris is for general educational purposes only. Such information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. No one should act upon any information on this Web site without first seeking medical advice from a qualified medical physician with whom they have a confidential doctor/patient relationship.***

Author: Dr. Tracy A. Norris D.C., C.C.E.P.

[ashishnagar]

Dear Dr. Norris,

i think the person asking you is a superman, he can lift his leg, upto 90* without support while lying on his stomuch!! i think i've even heard this for the first time. probably might be possible.

Well i think he can even go for a SI stress test along with the one described by you to rule out SI. probably.

[bikelet]

Yay i get to be superman/woman. Please read the bottom of my previous post, where i clarified my mistake. As yet i haven't tested with a partner however at the gym today i did some testing of my own.

On the hip ext machine at 60 kg, i found i could do around 20 reps on the right side (with some right sided SI niggles) and about 30 reps on the left. It just felt easier. I stood with straight legs and started the movement with my legs together, mimicking a SLR. It was hard for me to tell the relative contribution of hamstrings to gluts. I know the hamstrings were working, but this is also affected by the setup of the machine itself with the pad behind the knee. I also really felt the hip abductors of the support leg working hard- no differences noted though. An interesting feeling happens when i extend the hip- i feel like almost bruising between the lower sacrum and the pelvis but it feels good to keep extending and tensing the gluts it lessens.

On the seated leg curl machine, i did single leg curls. I'm not sure of the exact weight as it was just numbered. The left and right sides were approximately equal, i could get a rep or two more out of the right than the left if i pushed it. I think that's pretty normal though, a leg dominance issue. However, i had a harder time controlling the left leg, returning the weight smoothly without jerking or stopping in random places.

I tried leg ext machine and could actually do about 5 or so (i say or so because i wasn't 100% motivated!) more reps on the left than the right. I think this may be because about 3-4 years ago, i injured my left ITB and did heaps of VMO exercises on the left side. Like before, the left side was jerkier and less controlled than the right- i think this is a motor learning/control issue from not using that side as much.

Thanks for all your help