Puzzling Injury Prone + SIJ injury

Last Tuesday I had a one hour workout with my personal trainer watching. She and my remedial massage therapist were advising that my hip flexors were tight and I should stretch them. So I did 2 x 20 second per leg, hip flexor stretches (knee on ground, gentle-moderate level). This was the second time in a week. I also did some bicycle crunch exercises (right elbow to right knee, left elbow to left knee), the second time after about 10 days off of it. I had told my personal trainer her number one goal was to help me prevent injury, and we had to baby step everything new. This exercise was from 6:30am to 7:30am. At 5pm I was just standing, and suddenly my lower left lumbar back seized up. The next day I went to a physiotherapist. She said she could not detect by touch heat or inflammation in the SI Joint, but suspected my problem was tight, spasmy glutes and tight hamstrings pulling on my lower left lumbar area. She said she could not differentially diagnose it as SI Joint or as lower lumbar problem. She recommended moving my body ‘in a block’ (keeping knees together) during the acute phase. She recommended to ease the tightness in the glutes and hamstrings. I said that my body didn’t seem to react well to stretching or self-foamrolling. She recommended using tennis balls to release the glutes and hamstring, which I have done for five straight days without any adverse reaction. My greatest remaining soreness from 3 or 4 days after it started is from sitting too much. Walking and standing are fine.

EARLIER HISTORY.
1) Two weeks ago I was lifting my head as part of the bicycle crunch, again under the supervision of my personal trainer, and my left neck got sore. My hypothesis is that I had been feeling the neck tighten the prior week, so I did some neck stretching, 3 x 30 seconds in the standard ways (left-right, ‘smell armpits’, forward-lightly backward) a day before, and I suspect that was too much, even though I only used the weight of my head and never pulled on my head.

2) The day after the neck soreness, I felt some flashes of what I thought was sciatic pain on the left side. It was in the left lower glute and hamstring. It was like a lightning strike, three times. I had never felt anything like that before. I went to a remedial massage therapist the next day. Upon examination he said that my glutes were tight and spasmy, and he said the cause of the sciatic like pain was probably piriformis syndrome. Overall, he believes my body core problems are due to poor posture of the forward rotated hips type, and he recommended the hip flexor stretch, and long adductor stretch (which would also get some hip flexor), and quad foamrolling to loosen the rectus femoris quad.

3) One month ago, about 3 hours after a routine 25 minute morning jog, my right lower hamstring in the semitendinosus or semimembranosus area seized up. My hypothesis is this stemmed from the introduction of more hamstring stretching including for the first time, straight knee hamstring stretching. In sum, my fitness is going backwards, due to repeated injury, from non-obvious causes (i.e., not acute injury but injury arising from tightness or RSI or stretching).

FIVE YEARS AGO HISTORY. Getting up from a chair, felt a sudden acute pain in lower left lumbar area. Had all the examinations, including X-ray, and was labelled Chronic Non-Specific Low Back Pain. Eventually it healed up to 98% health, but never fully recovered to 100% health. My exercise physiologist of last year thought it was left SI joint syndrome, which he diagnosed by digging his hand under my abdominal muscles to feel the SI joint. I had not re-injured my lower left lumbar area for the four years since it healed, until now.

Overall, the last month has been puzzling to me, my personal trainer, one physiotherapist, and one remedial massage therapist. I am looking for comments as to 1) DIAGNOSIS, and 2) TREATMENT. My hypothesis is that my general tightness combined with hypersensitivity to stretching means I should only do gentle stretches (2 x 20 seconds very gentle). Also, for the next month, my hypothesis is to go back to easy abdominal exercise, such as prone hold, side holds, and leg holds (Abdominal Strengthening Exercises - Core Exercises - Abdominal Exercises - PhysioAdvisor) starting in two days (one week after the re-injury of the lower left lumbar area) and starting those with baby steps.

Happy to answer any questions. Would also welcome to be pointed to websites that would have relevant information.

Basic background: 60 year old male, desk job, no known medical conditions, taking no medicines, had for some years a modest fitness program of alternating exercise one day with walking or jogging the next day.

Thanks for reading this.

Frank

Hi
I think , you have disc degeneration with disc the bulge or herniation towards left side, and with exercises you irritated the sciatic nerve
allthe best
jk

Thanks, Yarok.

What's the solution? How do I exercise to stay fit and rehabilitate the left lower lumbar area to prevent future injuries, without further irritating it? If there is a web page of safe low back exercises that you recommend, let me know.

Frank

Dear Frankie,

I agree with Yarok.

I would recommend you transverse abdominal activation exx's, neural glides exx's to mobilise the sciatic and you need to improve your core stability.

You would benefit of Pilates exx's and you could join a class once your symptoms settle.

Good luck!

Nicoleta

Well, your problems seem to be all related to tightness, increased tone...posture....so, I would advise you to look up on "Alexander Technique". It's not a popular thing, but has been found to have long term benefits for chronic pain problems.
If possible, take a few sessions with properly trained Alexander technique instructor(s). It can be pricey, but if it can help for long term, then it's worth it.
Do be mindful that teaching technique is quite varied, so you may need to try a few different instructor until you find one that fits you.

The Complete Guide to the Alexander Technique

I'm not sure how update these are :)

While the problem isn’t new, counterfeiters have become cleverer in their operations, manufacturing knock-offs that appear to be similar in every way. The problem reached fever pitch in 2010, when, following an undercover operation and subsequent series of raids in Egypt, officials discovered counterfeit medicines worth hundreds of millions of dollars, Apotex. The extensive, multi-continental investigation exposed a criminal network tricking consumers across the Middle East and resulted in European customs officers seizing 34 million counterfeit pills in just two short months.

I've always been a fan of massage therapy and very much believe in the benefits it brings. For any ailment, increased blood flow is the best. Things like massage therapy, acupuncture, bfst, ultrasound, etc. So whether it is your hip flexor or you SI joint, focus on things that help with the circulation. It's so important. With what your describing and how it goes down to your hamstring, I think it seems more like your SI joint. Here's some great info on how important good circulation is for any injury. Improving Blood Circulation