Let’s get normal. Simple steps to better back health.
Heard this one? “I threw my back out while reaching to pick up my keys. The pain dropped me to the floor.”
Many sore back episodes start with a simple low intensity movement. Often it results from normal activity; bending to brush your teeth, putting a dish in the dishwasher, reaching for a familiar object getting in or out of a car. Nothing heavy or strenuous.
What’s going on here? Back pain is very common with up to 80% of adults as members of the club. It is common and the cause can be hard to nail down.
There are also several different things that, in common language, are grouped together under the umbrella of “back pain”. These include lumbar spine pain, pelvic and sacroiliac joint pain, sciatica and hip pain. Trigger point activity in muscles can also create pain that mimics other conditions. All this can be confusing and difficult to sort out.
One of the most common complaints is SI Joint pain or pain in the sacroiliac joint. Some experts suggest that this pain is caused by a “subtle variation from normal”. This may explain why it is so common and hard to pin point the cause.
Here’s the logic: If SI Joint pain was a unique condition, something far from normal, it probably would not affect so many people. And, because of its uniqueness, it would be easier to screen for and to diagnose.
For example, when a car’s wheels are out of alignment there are subtle signs. The steering may pull to one side. Tire wear may develop an uneven pattern. Bad alignment causes problems. Bad alignment can develop slowly over time or it can be the result of a traumatic bump or pot hole. You know what that feels like.
Properly aligned, tires last longer. The tire shop has an alignment test to diagnose the problem. If alignment is an issue they can correct it. Frequently, we don’t even know our car has an alignment problem because it is a “subtle variation from normal”.
Let’s get normal. If SI Joint pain caused by a subtle variation from normal then how do we maintain normal so we don’t develop the subtle variation?
Robert DonTigney, a Physical Therapist and educator, has studied the SI Joint for 35 years and worked with over 8000 cases of SI Joint pain. He offers some easy self care suggestions to maintain normal. In my corrective exercise and soft tissue pain relief practice I introduce clients to his daily exercises. We think of them like a daily vitamin to maintain good SI Joint health.
These self care steps are a great way to maintain normal. No equipment is needed. They are easy to do and pain free. Variations of the exercises can be done lying down, seated or standing. I’ve found some clients like one position better than the others, but all can be effective.
Step 1 Glute Bridge: This exercise activates the posterior muscle chain and wakes up the extensors of the body. Start supine lying on your back. Bend your hips and knees to place your feet flat on the floor. Press your hips up toward the ceiling. Hold for 10 seconds. Repeat five times.
Step 2 Knee to opposite foot: This exercise helps to organize the alignment of the SI Joint and pelvis. Start supine lying on your back. Bend one leg at the hip and knee to place the foot flat on the floor. Press the foot down into the floor. Drive the knee downward and across toward the opposite foot. This will drag the hip off the floor slightly.
Step 3 Shoulder drop: This exercise provides a way to organize the SI Joint structures while standing. Start by standing with one foot up on a chair or bench. Bend at the waist and drop the shoulder (same side as raised knee) inside the raised knee and rotate the torso slightly away from the raised knee.
Step 4 Piston Knees: This seated variation provides an easy way to keep things aligned throughout the day. Start seated with knees at 90 degrees and feet flat on floor. Alternate moving the knees forward and back creating a piston action. Limit torso and shoulder action and focus the movement in the hips and pelvis.
These exercises help maintain proper alignment of the SI Joint structures and encourage things to be normal. They activate the proper muscles to maintain better muscle balance. All should be done pain free.
Correcting faulty movement patterns and cleaning up muscle imbalances produces better function. Sound functional movement patterns provide a good foundation on which to build normal daily activities and to increase performance capacity.
Don Miller teaches corrective exercise
and practices massage in his Scottsdale, AZ office.
Don Miller, MA, CES, LMT