Aerobics with SI Joint problems

D

dsimmons

New Member
Hi Cathe,

I am a 48 year old female and I work out to your "basic to intermediate" step aerobics program six days a week. My problem is with my sacroiliac joint. Three injections over the past 1 1/2 years has afforded great pain relief. However, I still need a couple injections to my right joint. I do not want to stop working out and love the step aerobics. I do modify the jumping and lunges but then feel like my work out does not give me the aerobic benefit. Also, the squats, which I actually love, over time cause increased pain to the SI Joint.

Do you have any programs or suggestions for a good aerobic workout that would not utilize the SI Joints as much as the current basic step + body fusion program? Or any suggestions as to what I could modify and how to modify some of the lunges, squats and jumps so that the SI Joint is not overworked?

I would very much appreciate a reply.

Thank you so much,
Dorothy A. Simmons
 
Hi Cathe and Dorothy,
I can't believe this post because two seconds ago I was just lamenting that I have to give up step aerobics due to a bulging disk between L4 and L5. If there are any modifications, I would sure love them!

Rosemary
 
Hi Rosemary,
I was just diagnosed about 3 weeks ago with a lumbar herniated disc. Just curious what treatment your doctor put you on? Injections, physical therapy, surgery, medication (and if so, what kind?) My next appointment isn't for another couple of weeks and I'm very curious what they told you.
Thanks much.
Lisa
 
Dear Dorothy,

I'm an exercise physiologist and have had a lot of trouble with this area myself - I'm extremely hypermobile (usually the case with SIJ problems) due to pregnancy/childbirth.

Step aerobics isn't usually recommended for somebody with SIJ problems (Don't smack me for saying this :) ) However there is light at the end of the tunnel. Usually people with SIJ issues have disturbed core stability issues - ie you don't recruit the core properly due to your back injury. Also, often in SIJ problems pelvic upslips/anterior rotations occur - that is the sacrum is improperly aligned relative to the spine - this should be assessed by a physical therapist.

Over the past two years I hsve been working on recruiting my core properly using a technique called real time ultrasound and also on my glutes. I teach step and I run, but I have to be extremely careful about how I move ie recruit transversus first then glutes and so on (the easiest way is to draw up your pelvic floor).

You could try some of Cathe's very good strength tapes and alternate your video with a lesser impact type of cardio such as swimming. Don't give up, but accept that there is no quick fix for this problem (I wish :) )

Cheers
LizN
 
Hi LizN, Good Morning,

Thank you so much for the informative reply. I have been researching treatment alternatives to the injections and the ultrasound is one that I am going to ask my doctor about. What is your opinion on Iontophoresis treatment?

Would you explain to me in laymen's terms what you mean by "recruit transversus first" ;and is the only way to "recruit the core" properly done with specific medical or pt treatment?

I do intend on trying some of Cathe's strength tapes and am not about to give up. I also understand this is a life long challenge but am blessed to have good health and wonderful resources, you included, to help me understand this health issue.

Thank you again!!!!!
Dorothy
 
Hi Lisa,
My doctor has me taking anti-inflammatory meds right now. We're hoping that might take care of the problem. I'm also doing some back exercises and stretches. She mentioned a steroid block as a possible treatment, but first she wanted to try the anti-inflammatory meds. I'm hoping to avoid surgery at all costs.

Right now I'm finding that spinning is the only aerobics that doesn't bother my back. I'm going to try the elliptical trainer while I watch a Cathe step tape!

Good luck and let me know what your doctor tells you!

Rosemary
 
Hi Dorothy,

What we refer to as the "core" includes the 4 layers of abdominal muscle - from outside in they are rectus abdominus (what gives you that six pack), external obliques (aid in twisting motions), internal obliques (provide stability) and transversus abdominus (provides stability and stiffness to the spine). In the back area we are looking at spinal extensors (externally - which allow your back to extend) and multifudus (which stablizes and gives stiffness to the spine).

The transversus and multifudus muscles work to give the spine stiffness and provide stability which is a key issue with SIJ problems - we don't consciously contract them as such in normal life, as they should be switched on at about 30% of max contraction. For example if somebody threw a really heavy ball towards you, you would brace to lessen the impact (this is the spine stiffening).

With SIJ problems you need to learn how to get transversus/multifudus working again properly which is what I'm alluding to when I mention "recruiting the core". As I mentioned before, the glutes also tend to be weak and strengthening them, especially gluteus medius (this runs close to your hip) helps tremendously.

I don't know about iontophoresis (though I intend to google it after I post here) - real time ultrasound is where you place an ultrasound wand on the abdominals (you can see all four layers on the screen - exactly like a pregnancy one) - you can learn to recruit/use transversus properly.

Most medical doctors here (I'm Australian) have little knowledge of SIJ problems, but a physiotherapist (or physical therapist in the US) should know about realtime ultrasound.

You may like to google the following resources - Caroline Corning Creager (US physical therapist), Barbara Hungerford - she is Australian and has an excellent pelvic stabilization floor program (which I could send you a copy) and Jeffrey Rhodes (pioneering this research here in Australia).

Good luck and don't give up.

From one pelvic princess to another,,,,

Liz n
 
My experience with epidurals.

First, there's a good chance it will work for a bulging disc.

Second, I found out the hard way that it doesn't work for a herniated disc.
 
Can anybody explain to me the difference in herniated and bulging? I thought they were the same thing. I know that ruptured disc is entirely different but I thought herniated and bulging were the same thing. Thanks to anyone that can help.
Lisa
 
Hi Lisa. It was easier for me to just copy and paste the differences. I hope this helps.

What is the difference between a ruptured disc and a herniated disc?

A. Nothing. "Ruptured disc" and "herniated disc" are two names for the same thing.

What is the difference between a herniated disc and bulging disc?


A normal healthy disc has a usual height and shape. As a disc begins to degenerate and lose its normal water content, it begins to lose some of its ligamentous strength. With this loss of water content, there is usually a loss of height, which causes the edge of the disc to protrude beyond the edges of the bone. This is comparable to letting air out of a car tire. As a car tire loses air, the tire broadens out as it loses height. The same is true for a disc. When the disc extends beyond the normal edge of the bone by greater than 50% of the circumference, it is termed a bulging disc.
A herniated disc occurs when a portion of the disc extends beyond the edge of the normal adjacent bony edges and measures less than 50% of the circumference of the disc. A disc herniation usually occurs when the outer lining of the disc becomes torn, allowing a portion of the disc material to be expressed out of the normal confines of the disc itself. If this disc material extends out and pinches one of the nerves passing by as it goes to an extremity, it often produces radicular pain into that extremity. Specifically, if a part of the disc extends out of the disc in the low back and pinches one of the nerves to the leg, then pain will extend down into the leg in a pattern of the nerve being pinched. If the disc material that is herniated does not pinch or irritate a nerve going to an extremity, often there will be no leg symptoms. In fact, there may be no symptoms or just back pain. A bulging disc may pinch a nerve, again causing extremity pain. More often than not, a bulging disc is associated with back pain.
 
Hi Liz n,

Once again, thank you for the great information. I have been busy as of late but have also researched the sources you listed.

Yes, I would very much appreciate a copy of the pelvic stabilization floor program by Barbara Hungerford. Just let me know what I need to do to help facilitate receiving this information.

Thank you again,

Dorothy
 
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