Rider SI problems

[peedin]

Long story short: I’ve had lower back/butt pain on the left for years. It would flare up, settle down, flare up. You get the idea. I did chiro treatments which helped, PT which helped, massage which helped. The last few months have been bad. Massage person said he can feel the knots in the fascia. I’ve done e-stim, foam roller, lacrosse ball on trigger points. Finally saw my primary when I could barely lift my leg to go up the stairs. He diagnosed SI problem and sent me again to PT. I’ve had ultrasound and exercises and was finally feeling better until dismounting on Sunday. ZING went my left hip.

Saw PT today and he said yep, soft tissue injury. Did lots of ultrasound and release and feeling better this afternoon.

I want to know what soft tissue is injured. I have a feeling it is not easy to isolate. Has anyone perfected a way to dismount that does not torque the torso? I’m a rerider so not quite flexible as I used to be. I used to dismount on the mounting block and need to experiment with that.

Guess it is a long story…

[atr]

I have issues with arthritis around my SI, and my piriformis muscles can go into spasm quite regularly. I cannot dismount unless my horse drops his head… This can get a bit problematic if he’s feeling a bit high and I’m at the farm on my own. I have discovered that if I stand him facing up hill on the slope up to the back door of the arena, I stand a better chance.

Getting older is not for sissies.

[Laurierace]

Not to be Debbie Downer but you may want to check out this thread.
http://www.chronofhorse.com/forum/showthread.php?470801-Joining-the-hip-pain-club

[peedin]

Had X-rays and my hips are clean. No arthritis. It’s not the trochanter that’s sore, it’s the tissue around the SI joint. Riding isn’t the problem , it’s the body torqueing of dismounting.

[Laurierace]

That’s good. My pain was 100% in my SI which is why it took 4 1/2 years to figure out it was coming from my hip. Simkie is the one who clued me in to the possibility otherwise we may have never figured it out. Can you get off onto a three or four step mounting block?

[Magicboy]

Yes, use the mounting block! I spent some time sort of sliding down whilst holding onto the back of the saddle and ended up hurting my arm and shoulder…

[mvp]

OP, a Rolfer might help you. Rolfing really helped me. The idea is to stretch out the fascia that’s too short in places and, thus, holding joints out of alignment. Once you do sort out that tissue, you must restrengthen the other stuff that should be doing it’s job-- collateral ligaments (as in the SI joint, especially) and also muscle.

[IPEsq]

Add dry needling to your chiro/massage/ultrasound. In particular, focus on the glute minimis, glute medius, quadratus lumborum, and psoas. All of these muscles are tight in riders and IME contribute to keeping the SI out of whack to the extent the ligaments hurt. FWIW, I’ve had extensive hip, low back and thigh xrays and MRIs and nothing of the bone, disc or cartilage nature is wrong with me but my right SI joint has tons of problems and I also get some nerve stuff on the left side. Because the most of my pain is on the right, I don’t seem to have the same issue as you with dismounting.

[Simkie]

Radiographs won’t show a hip labrum problem, so do keep that in the back of your mind as you work through this stuff. Like Laurie, my hip pain presented 100% like SI.

Very much agree in dry needling, and trigger point injections may also be useful.

[Lady_Eboshi]

[QUOTE=peedin;8742547]
Long story short: I’ve had lower back/butt pain on the left for years. It would flare up, settle down, flare up. You get the idea. I did chiro treatments which helped, PT which helped, massage which helped. The last few months have been bad. Massage person said he can feel the knots in the fascia. I’ve done e-stim, foam roller, lacrosse ball on trigger points. Finally saw my primary when I could barely lift my leg to go up the stairs. He diagnosed SI problem and sent me again to PT. I’ve had ultrasound and exercises and was finally feeling better until dismounting on Sunday. ZING went my left hip.

Saw PT today and he said yep, soft tissue injury. Did lots of ultrasound and release and feeling better this afternoon.

I want to know what soft tissue is injured. I have a feeling it is not easy to isolate. Has anyone perfected a way to dismount that does not torque the torso? I’m a rerider so not quite flexible as I used to be. I used to dismount on the mounting block and need to experiment with that.

Guess it is a long story…[/QUOTE]

http://dralisongrimaldi.com/resources/lateral-hip-pain-mechanisms-and-management/

THIS^, chapter and verse. Third time I’ve posted it here now. The glute medius is the usual culprit, but your piriformis and psoas can be involved as well. The glute med. attaches on your SI at one end and your trochanter on the other. This condition can come and go for YEARS (like mine has) and about the only thing anyone can agree on is that you have to stop straining it.
I’ve found what works best is to ALWAYS sit with your knees lower than your hips, and don’t carry heavy loads with all the weight on one leg, like up stairs.
Try the Trendelenberg test for yourself, if it sends you to the moon you’ve just narrowed things down a pile.

Labral tears are the new “fashionable” Dx right now, because we’ve only recently developed the imaging tech to discover them. The bad news is many of them are actually asymptomatic, just like osteoarthritis can be, too. They find tons of both in cadavers who’d never complained of pain. So what may be found on imaging unfortunately isn’t necessarily what’s causing your pain. The even worse part is that labral tear surgery is new, controversial, expensive, painful, and has a success rate of only about 30%.

OTOH, the glute medius tendinopathy tends to be self-limiting if annoying as hell.