Torn Glute?

[alophysio]

Hi Lucas,

If lying on your back and lifting up one leg felt the same on both sides in terms of effort and strength, then it is unlikely you have done an SIJ joint. Don't get me wrong, i absolutely love treating SIJ problems but yours sounds like a disc problem.

Some reasons why from what you have written (limited informatino clinical reasoning ):
1. Discs are the main restraint to twisting - this seems to be the worst movement for you. Facet joints can also be inplicated but they tend to be sore in backward bending...
2. Disc injuries are most commonly sore in forward bending - like you describe
3. SI pain from ligament injuries are usually sore from the PSIS down to the sacrotuberous ligament. This is most commonly referred to as Fortin's area of pain. He determined SIJ pain referred into this area by using injections into painful SIJs.
4. SIJ pains rarely refer into the hip joint. This more likely to be the L/S discs/nerves/joints doing this
5. A SIJ ruptured ligament will be difficult to stand on one leg - the main job of the SIJ is to transfer the load from your foot to your pelvis and up your spine and vice versa. An unstable SIJ will not let you stand on it.
6. Hip movement is likely to aggravate the sciatic nerve as it passes near the piriformis muscle.There are also other muscles nearby that can tension the sciatic and other nerves. SIJ pain is over the SIJ.
7. Crossing legs on the floor usually posteriorly rotates your pelvis which would strain the disc.

Quite simply, i do not believe (from the limted information we have) that you have an unstable SIJ. You would need SIGNIFICANT trauma to disrupt the ligaments there. You may an SIJ dysfunction but i do not believe it is causing your current pain. You sound like a classic disc patient to me. An MRI or CT scan can quickly solve this problem. From the sounds of it, the disc has probably herniated which is why you are in so much pain - the noxious chemicals of the disc are irritating and sensitising the nerves.

My money is on a disc problem - anyone else??

[karen.hankey]

2. Disc injuries are most commonly sore in forward bending - like you describe But doesn't there have to be trauma for a disc injury to occur?

4. SIJ pains rarely refer into the hip joint. This more likely to be the L/S discs/nerves/joints doing this I see numerous patients with SI joint problems that are getting pain in the hip area. Whn assessing their hips no positive findings and all points to the SI joint.

6. Hip movement is likely to aggravate the sciatic nerve as it passes near the piriformis muscle.There are also other muscles nearby that can tension the sciatic and other nerves. SIJ pain is over the SIJ. SI joint problems can cause spasm especially in the gluts/piriformis which can cause sciatic type symptoms.

7. Crossing legs on the floor usually posteriorly rotates your pelvis which would strain the disc. Which also involves movement at the SI joint causing pain.

Quite simply, i do not believe (from the limted information we have) that you have an unstable SIJ. You may an SIJ dysfunction but i do not believe it is causing your current pain.

I don't believe the SI joint is unstable. It could just be inflammed due to the stresses but on it. I may be that the stretching technique needs to be altered as it is incorrect. It would be very hard to say without a physical examination.