Hello all,
For you stretching and soft tissue minded individuals…does anyone have any suggestions on how to manage this small and sometimes problematic ligament 
. We’re getting ART/Chiro weekly, however, I would appreciate ANY suggestions on how to handle it between ART/Chiro sessions.
Thanks
Randy aka frustated coach :mad: :o
Randy, do you have an unstable SI? How old are you? How did injury occur? How old is the injury?
Tom
Thomas,
I’m the coach. This is my first year with the athletes. The athlete is a tall (pushing 5’10) 18 yr old female short sprinter. Flexibilty has been an issue of hers over the years leading to a number of a little problems ie, super tight gracilis, hamstring, IT bands, etc all of which leading to knee problems. Anyways, we’ve received treatment as mentioned and she has noticed her hamstrings “quieting” down, adductors released and increase mobility in the her pelvis. However, shortly after receiveing her most recent adjust (first since the treatment began) she has experienced discomfort when striking the ground (jog, jump, run etc). I’ve wondered if maybe the new discovered mobility and or flexibility without improved pelvic stability is some how creating the problem (just a thought :o )…
What comes to mind Thomas???
Randy, to begin, I think a person can improve flexibility and mobility without creating an unstable SI joint.
This is a tough one without seeing the athlete. And the battery of tests is difficult to administer through cyberspace.
If you’re or the person treating her is positive it is her sacrotuberous ligament, I’d be interested to know how they came to that conclusion, not that I’m doubting them, just that there is never just one thing “wrong” when it comes to injury, especially when there is no acute trauma.
From her history, it reads like she could possibly be having “soreness” from the adjustment. Or perhaps with the new found freedom of her hips she attempted a difficult workout and could possibly have injured her SI joint.
I’ve found that to be true with for example a baseball player that gets ART for his throwing shoulder and goes out and throws hard. The body doesn’t immediately recognize the new ROM and the propriocepters don’t fire when the arm and shoulder are pushed into the new ROM.
Their is nutation and counternutation around the SI joint with the biceps femoris, glutes, spinal erectors, thoracolumbar fascia, obliques all being involved and transfering and absorbing forces.
If anyone could lend a hand in this, I’d appreciate it.
Maybe a little more history, symptoms and tests could be helpful.
Tom
just my opinion (past S.i. joint issues)
eliminate all plyos, jumps ,etc till So hips get strong!
jus sprint & strength train
cure “strengthen hips (erectors, low abs, glutes, hams)” do every type of strength work with a neutral spine, with the possible risk of an SI issue never go into posterior tilt.
have her do a 1 legged squat (keep a neutral spine)if she can only do down 4-5 inches all the while her knees moving back an forth THAT is causing your issues. weak hips will cause tightness. Her knees cave in while landing in jumps? or squatting? if yes weak hips/glutes
why not?
Tom,
I agree whole-heartedly with everything you have said. I took a year to work in the rehabilitation setting full-time to increase my knowledge in this area. Although I was not working with an athletic population (I was mainly working with individuals in heavy lifting professions) everthing that you have stated I found to be true. The soreness you describe ater having an adjustment was often felt to some extent for 2 to 3 weeks after the locked-up SI joint had adjusted and restored to its normal position. Although the Si joint remained in its properly alignment, and was ‘moving’ properly, the pain remained.
I am also curious to how the ligament issue came up, and how it was diagnosed. The only time I have seen laxity in this ligament was after a fall onto one hip (usually landing directly on the ischial tuberosity) or in car accident victims when they had one leg fixed during a high-impact collision.
Providing information on this type of injury/pain without being able to directly assess the athlete tends to be very difficult.
I’ve been a little busy…I’ll provide more history a little later.
Thanks
The thing is the sacro. lig. wasnt’ an issue at all until she received an adjustment. Until then hams, gluteals, adductors, psoas and gracilis were being ARTed. We were acquiring good range/length in all muscles previously listed. However, when she was walking we could still detect a slight limitation on her right side (hip)causing her to “kick out” or reach just before heel strike when walking. So we adjusted her and her walking immediately improved.
From that we concluded that since her pelvis/back was “locked up” she wasn’t receiving sufficient rotation which led to the tight hamstrings (there was also the occasional burning in her hammy’s) and with it the discomfort.
Now, going into the first practice following the adjustment things feel good. We’re doing some 10m accels from various starting pos. to reestablish rhythm and get back to sprinting. When it came to some easy/technical 60m runs she said upon finishing the 4th rep that she could feel a little tightness on the right side of her back. We stretch and then do another rep. It’s not as bad but it’s still there. On the 6th rep the discomfort increases and we move to strength endurance, 60m skipping A’s. Now after the first rep we stop because the tightness and discomfort is too great. The next day she tries to jog and when doing so the pain immediately shows itself when she strikes the ground.
So when palpate the area she says the tenderess of spots is right in and around the area where sactub. lig and into the sacroilliac lig…
So there you have it… :o
Do explain further please… :rolleyes: as this is kinda what I was initially thinking.
I can now better understand what some of you have been saying… 
http://nzsp.org.nz/index02/Publications/JournalPDF/33(3)Nov05_p91-94.pdf
RG
I’ve had me SI illio psoas sacrum etc etc adjusted numerious times over the years. THe most serous of the issues came after a car accident but some just from my lockedup hipflexors,
The first few adjustments I found i’d be sore for over a week but having had it done numerious times now the soreness has lessend. I have however recently had my psoas completely lockup from a slip on the ice during a skeleton start and its taking over a week for it to release after and adjustment and is sore as hell.
I wonder if after the sirt SI join or something related adjustment if you will be initially sore but with repeated treatments to get the movement pattern back the soreness decreases?
Every time i have injured my SI joint in strength training is due to allowing my hip to go into posterior tilt while producing force while it is happening. (bottom of a squat/ concentric phase of a deadlift)
this may help
“An excessive or uncontrolled pelvic tilt increases the forces through the lumbar and sacroiliac joints, and forces the knee of the stance leg to internally rotate, which in turn may increase the pronation forces on the ankle. It is possible to observe a correlation between excessive pronation and excessive pelvic tilting in runners, and it is a good illustration of how one unstable link in the biomechanical chain can have an adverse knock-on effect and increase the risk of injury.”
http://www.sportsinjurybulletin.com/archive/biomechanics-running.html