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Treating back pain by exercising certain muscle groups

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I understand that I have an SI joint issue, it makes sense where my pain is, but it seems like everything is treating the pain and not the cause. I have to sit around a lot for school (study, homework assignments, on the computer, etc) but i do work out Mon/wed/fri intensely for an hour and a half every week.

1. Is sitting the worst? should i be taking constant breaks to go walk or run or something, or simply be laying down, I stretch near constantly but it doesn't seem to do much. i do core exercise 2 times a day.

2. if something hurts (eg. running) is it good because it is "working it out" or bad because it is aggravating it more? I want to do something to improve how it is.

3. what are some very specific exercises i can be doing, the more intense the better. I've been doing some core exercises but they don't seem to do enough (abs, plank, leg lifts...). would say swimming or yoga or something like that help?

4. should i start working out tues and thurs as well? or going less?

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replied December 1st, 2008
Back Pain Answer A5015
Here are your questions and answers to them:

1. Is sitting the worst?: Sitting generally is not that much of a problem for SI joint problems, as certain individuals with dysfunction experience pain, while many others don't. Pain should always be your guide. The positions which give you relief are generally safe and will assist in reducing inflammation. Movement breaks in between sitting sessions is a very good idea, if possible, getting up and moving every 30 minutes will assist in getting blood flowing to the area. When there is an SI joint subluxation present, the muscles surrounding the joint will be over active to a degree, which reduces blood flow.

2. If something hurts, is it good because it is "working it out" or bad because it is aggravating it more?: Pain is a signal in your body that something you are doing is agitating to tissues, however, many individuals with chronic back pain can only perform just a few motions without pain. To address this issue, it is generally accepted that movements for therapeutic purposes should never make your pain worse. The only acceptable outcomes are either your pain stays exactly the same, or makes you feel better. If you feel better after performing the motion, then reduce either the intensity of the movement, shorten the range of motion, or reduce the total time the activity is performed.

3. What are very specific exercises I can be doing?: Research strongly suggests that there are essentially 4 key muscles to address in the pelvis that must be balanced in order to stabilize the lower back and promote freedom from pain.

Iliopsoas: This muscle flexes the hip and also contributes to extension in your lower back. When one psoas muscle is tight or weak in comparison to the other, torque in the sacro-iliac joints can be a result.

Lumbar Extensors: These are the muscles that run from your head to your sacrum, and function to extend the back. The lumbar portion of this muscle is prone to overworking, partly due to weak abdominal muscles and a tight iliopsoas.

Abdominals: There are 4 muscles in this group, each having important qualities in stabilizing your sacroiliac joint. These muscles are extremely prone to weakness, and need to be strengthened in most cases of chronic pain.

Glutes: Your butt muscles are instrumental in stabilizing the sacroiliac joints, particularly when they are activated together. Many times in sacro-iliac joint dysfunction, squeezing your glutes will bring about immediate stability in the joint, and decrease pain levels. This can be a signal that the glutes are not working as well as they should, and may require strengthening.

If you do a google search on "strengthening" and "stretching" for each of the muscles mentioned above, you will find the appropriate movements to address these essential areas. Remember to only perform movements within a range that you feel both comfortable with, and do not produce more pain.

Sam Visnic NMT

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