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“Is It My Low Back Or My Hip? Is My Exercise Routine Making The Pain Worse?”

“I have right lower back pain, that is kind of in my hip. It feels like a deep ache in my BUTT. It gets so bad sometimes that I feel like I can’t even walk.”

Said Brandi, a worried 32 year old who can’t recall a specific event where she hurt herself but is now experiencing unbearable pain.

She is worried because she is due for a promotion at her work and she hasn’t been able to perform as well lately because she is so distracted from her pain. Her running schedule is now off track and she is unsure if she will be able to run the half marathon she is training for. She’d been suffering from the deep achy pain in her buttock, sometimes it’s on the front of her hip and is in her lower back when she sits at work.
She tosses and turns at night as she just can’t get comfortable no matter how many pillows she uses. She takes ibuprofen but even that has stopped taking the edge off. Could this be happening to you? Sacroiliac joint problems are very common in people who find themselves sitting a lot during the day but doing more intense workouts and activities outside of sitting 8 hours per day.

Sacroiliac joint dysfunction is the diagnosis that is defined as your joint being inflamed, moving too much or moving too little or being out of alignment.

Often times we hear people that had surgery or babies a few years prior and recently increased their activity end up with a sacroiliac dysfunction. This often occurs because they upped their training, say to run a marathon or started a new fitness routine. The increase in training then caused the pain. This can happen if they are stronger on one side of their body than the other. Therefore, they run harder on that one side. They also never truly healed their core after kids so they have imbalances happening and a weak core. There are many misconceptions today about how to fix sacroiliac pain in women…. Unfortunately, like Brandi, I’ve found too many people that fall victim to poor medical advice when treating sacroiliac dysfunction. “I have tried rest, stretching, heat and ice and nothing has helped. I am almost to the point where I will have to take pain medication. Maybe they have even been to your standard physical therapist around the block but things only got slightly better.”

​Why these treatments didn’t help? Brandi was focused on stretching her hip. She was stretching the side she was running lighter on. Her non-dominate side hurt the most. That is where her pain hurt after all. What she didn’t realize is because of all the laxity in her joints, stretching was only making it worse. You see she had a baby 5 years ago. She never had pelvic floor physical therapy to help her restore her core. A few other things that came out was that Brandi said things never felt normal after her baby but she couldn’t put her finger on it.  Finally Brandi was able to get some relief by taking pressure off of the sacroiliac joint and addressing other areas of her body that were compensating and contributing to making the problem worse. This is a phenomenon known as compensation. And for Brandi here is what we identified.

  • Tight “hip flexor” muscles (These are the muscles in the Front of the hip which can pull on the back.) This was happening because as her belly was growing her posture was changing and the muscles were getting over used.
  • Pelvic Floor Dysfunction (These are the muscles are the muscles that control pee, poop and sex) they are inside your pelvis. These muscles were so tight and she had scar tissue in these muscles. When these muscles were touched. They re-created the exact same pain she was having.
  • An OLD Ankle injury from high school. This created one leg that was more dominate and stronger which was causing the pelvis to twist.Tightness and tension on her good side.
  • Body changes from Having Her Baby that were never healed. The pelvis is naturally going to expand 5-7mm during pregnancy that alone can predispose you to having discomfort as the muscles attaching to the pelvis are stretching and pulling. This is why it is so desperately important that you get adequate healing after child birth and not just follow some online exercise routine or head back to the gym.

Addressing these problems with a mix of:     

  • Hands on therapy techniques to the tighten muscles of her hip and pelvic floor     
  • Improving the motion of her ankle from her previous injury
  • Alleviating the tension in her tightened muscles
  • Teaching her proper core balancing exercises, coordination and techniques

As a Result?

  • She’s back to working with NO pain.
  • She never needed to take the pain medication
  • She is even a faster runner than she was prior to her injury.    

By taking a big-picture, full-body approach to rehab, Brandi was finally able to heal and enjoy her life with her 5 year old. She is even contemplating having another baby. This time she knows how to properly heal after the babies to make sure this never happens again.
If you have been struggling with pain in your pelvis, low back or hip for longer than a few weeks and you want to learn more about what the ‘root cause’ could be…At Body Motion Physical Therapy we offer a free wellness screen at our ‘Discovery Visits’ you will have a private session with a movement specialist here at Body Motion Physical Therapy, where you’ll get a chance to: share your concerns, problems and frustrations you may be having. Meet us in person, to see if we’re a good fit before you ever decide to work with us glimpse into your own health to help you see exactly what could be causing your injury and tell you the root cause of WHY you may be hurting. All you need to do is request a Discovery Visit!


Allison Feldt

Body Motion Physical Therapy

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