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si joint disfunction, otherwise known as a pain in the a$$

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  • si joint disfunction, otherwise known as a pain in the a$$

    Hi everyone,

    I am in desperate need of some success stories from riders who have or are dealing with sacroiliac joint disfuntion or sacroiliitis. I am beginning to wonder if I will ever ride again..

    I am a 58 yo with a wonderful horse that I ride mostly for pleasure, but have done some training level dressage and little hunter stuff. I have a long history of back issues, bulging disk, sciatica, things like that. But have been able to manage these issues in the past. I have seen: an orthpedic dr, a neurologist, chiropractor (who said there was nothing he could do for me), done PT (nothing helped), pain injections (they DO help for awhile), and pain meds (currently on relafen - which keeps the pain tolerable). But if I do ANYTHING physical, like mucking stalls, lifting water buckets, picking feet, I am in horrendous pain, like I can't move type of pain. It does go away and resolve to a tolerable level, but I am getting to the point where I just don't know where to go or what to do. Last spring I bought and started using an inversion table for my disk issues, and it really helped, but now my neuro says that's probably what screwed up my SI joint! Really?

    Am I destined to get epidural injections for the rest of my life? Are my riding days over? Has anyone out there had something similar, pursued a therapy that actually worked?

    Very sorry if I'm sounding like a whiner at this point - I just want my life back.
    "Feed your faith and your fears will starve to death."
  • Original Poster

    Well, now I guess I have a reason to whine if there really are no success stories out there..
    "Feed your faith and your fears will starve to death."


    • #3

      i am 25 and dealing with the same thing. in college i competed on the NCAA equestrian team. when i was 19, they put me on the rearing horse in the barn who proceeded to flip over on top of me in practice. could not move my legs, or body for that matter and was ambulanced to local hospital. after literally a month in a pill coma and laid up in bed, i slowly started walking on crutches. ever since then my back has not been the same.

      i started in intense physical therapy for degenerative disk disease along with bulging L4, L5 and SI degeneration, sciatica, etc. there would be mornings when i could not feel my legs and could not go to class. after a few hours sensation would return. I did PT for nearly 4 years, 2-3 days a week, along with at home exercises and stretches. But always, and to this day (though less so) needing to be careful how i bent over to pick something up, using legs to lift, etc...they suggested fusing my back. i told them to eff off...

      It appears i have mild nerve damage from the 'rubbing' of bulged disks, but is not really noticeable until i do side strength comparisons.

      What my physical therapist said is that most horseback riders have extremely tight and underdeveloped hamstrings and our quads are overdeveloped- have you ever been able to bend down and touch your toes comfortably? i have not, and this tightness throws the lower back alignment off. Also, a weak core puts undue stress on the back. You should be able to get from your therapist or even online a booklet of back, hamstring, and core stretches and strengthening exercises. do them religiously.

      what my PT also told me is that there are tiny joints in your SI area on either side of your spine that, when a trauma is incurred, the lubricant within the joints ceases production and the joint becomes immobile. She did an exercise that was the most painful, but incredible feeling at the same time. standing up, she finds the joint with her thumb and presses in. as i lean forward bending from the waist, then away from the side she is on, she digs her thumb into the joint to release the stickiness. once the joint is moved over and over, the lubricant returns, and your back no long feels like a brick wall. over a period of time doing this, the joint stops losing the lubricant and moves properly. i too got an inversion table but found it to be minimally helpful.

      i wish i could tell you the cure all for the problem. i do have recurring 'flare ups' but they are no where near as bad as they used to be, or as frequent. i do my stretches and strength exercises every day. I do wear a back brace when i ride (most of the time), and have noticed that i do not have the same strength in my back i used to before the fall and subsequent diagnosis. but i do ride, i still win equitation classes, break babies, etc. with minimum pain. i have never been a fan of taking pills and try to avoid them as much as possible.

      the best i can offer is stretch your hamstrings daily and build up your ab and lateral muscles, and find a new physical therapy regimen you can deal with. its not going to be magically fixed in 2 months, but after a year or so of steady treatments and at home exercises you should be able to manage the pain as i do.

      good luck, and feel free to PM me if you have any questions


      • #4
        Stem Cell PRP

        There is my super success story!
        I've posted in depth about it before, so please feel free to search the archives and also p.m. me.

        I was hit by a deer while I was galloping my big dwb. Compression fractured a bunch of vertebrae, re-arranging some in novel places. Since I didn't want to come off, I also hyper-extended all of my pelvic ligaments. Lots of fun with the S.I. Oh, it took 6 months to get diagnosed...

        I was a poor surgical candidate, so I did the P.T. for 2 1/2 years, then my P.T. suggested looking into prolo. It took many rounds of prolo, and then PRP became available. That worked much better. Now there are even better forms, like BMAC.

        It was covered by insurance until there was too much TV coverage on pro athletes, such as super bowl quarterbacks, using it. It is still comparatively inexpensive, and it is done in a little at a time, so there isn't one huge bill.

        This form of stem cell uses your own blood and appropriate tissues to place in the damaged areas. It is wonderfully easy, and I think much less painful than epidurals. I just used tylenol for pain afterwards. I could feel the improvement immediately, too!

        I went from the stage you talk about- I would get "stuck" halfway up mounting a young WB and not be able to get up or down until the adrenaline kicked in.
        Now I am hilltop foxhunting on green mares that I've trained, trail riding on small mountains for hours, and taking lessons with Wofford and Colleen Rutledge in starting the mares in jumping for eventing. It felt amazing to order my schooling set of jumps.

        I'm careful about what horses I ride, although I have to admit, I'm eyeing Brazilian Wedding. She's my kind of personality.

        By the way, my Dr. has a large group of world class/Olympic riders that he has done. The ones that I've talked to about it, have all been happy for years with their results. That includes one who went on to win 2 world championships in 100 mile endurance racing. Her prolo lasted 20 years, until she got kicked by a horse. Then she had it zapped again.

        Here's the site for my guru, Dr. Mayo Friedlis. Look at "regenerative" treatments. (I just saw they added discs to the list. I thinking I'm going to add that to my collection.)

        Intermediate Riding Skills


        • Original Poster

          Thanks Silanac & Whicker!

          Silanac, I've been thinking about PT again, and actually will begin this afternoon. I have done PT in the past, and have continued on my own, but this latest episode seems to have been brought on by exercises and stretches. Sometimes I just push too hard (back in the old days they used to say no pain no gain, not so much anymore). BTW, I've had a therapist do that thing with the SI Joint where they press in on it, but it didn't do anything for me. I think, but I have no doctor to back this up - it's my own intuition - that the ligaments to the R SI joint are damaged, so the SI is hypermobile. I always feel better if I am wearing a back brace, very low, like around my hips, to "hold" everything in place.

          Whicker, I'm glad you mentioned the additional therapies, I have already started to look into it. I doubt my insurance will cover, but everything I've read about my condition seems to point in this direction. I will check out the threads and the website, thanks! (As an aside, I have been drooling over Brazilian Wedding for about 3 weeks now!)

          OOh just checked the website, they have offices not too far from me (about 2 hours). Thanks again!
          "Feed your faith and your fears will starve to death."


          • #6
            I have been through periods of intense SI discomfort, but nothing like you describe. Don't know what set mine off, probably having a very large draft cross which muscle issues which made for very difficult gaits and the occasional big buck. I did find out that wearing Dansko clogs seemed to irritate it (I've *never* worn any kind of heels, or at least not since I was in my 20s, I'm 60 now). Now that I'm older and heavier, I try to wear flat, supportive footwear. I also gave up chiropractic adjustments, not because they didn't help my back a lot, but for totally unrelated reasons, but since I no longer have the SI adjusted, I don't have as much trouble with it.

            Anyhow, you have my sympathy because that kind of pain is very unpleasant--one of the few things that can make me nauseous.
            "One person's cowboy is another person's blooming idiot" -- katarine

            Spay and neuter. Please.


            • #7
              I sent you an email. Enjoy!
              Intermediate Riding Skills


              • #8
                I think a big key to stuff like this is to go to a GOOD Pain Management specialist. They often have tools in their sleeves to help out.
                Says she who is destined to lots of injections for the rest of her life :P


                • #9
                  gram, I feel your pain. I have RA and the SI joint is inflamed when I am not medicated. I agree that a pain management specialist is most useful. For me, I am on 2 different meds but Mobic (meloxicam) is what has improved thepain in my my SI joint. If I run out of my Rx, I feel it creeping up on me after a couple of days. I still can't muck much more than 5 stalls and I've adjusted the way I do most everything (lugging water buckets is OUT and I don't dare weed the garden), but the Mobic has made a major difference for me. I'm not in pain just sitting motionless, like I used to be. Most importantly, I can ride - and I almost gave it up.

                  A specialist will work with you and find a good combination of treatment, PT and help you make positive lifestyle changes. There is also a surgery that will stabilize the joint to keep the joint from flexing, reducing the inflammation which is what makes it painful - I was considering it until I got the right medication that impacted that joint.

                  Good luck to you. I winced reading your post because I know that pain so well!


                  • Original Poster

                    whicker, thanks for the inspiration! I will let you know if I pursue this therapy.

                    Monsrpony, I also ride a draft x, hmm, could that be part of the problem? She is wide, but I am pretty long legged, so never really thought about it being a problem.

                    Update, right after PT yesterday, I felt really good for the first time in awhile. I think it was the ultrasound (deep penetrating heat) that felt the best. But today, I'm back to square one pain-wise. Maybe some more time flat on my back with a heating pad is in order.
                    "Feed your faith and your fears will starve to death."


                    • #11
                      Originally posted by gallopinggram View Post
                      ...Maybe some more time flat on my back with a heating pad is in order.
                      NOOOOOO, Not heat!!! ICE, ICE and more ice. It's the inflammation that's causing the pain, so you want to reduce the inflammation, and that's done by ICE. More time flat on your back (20 minute stints) with an ice pack is what you really need.
                      I have felt your pain, only in L4/L5 and L5/S1, and I did lots of icing, PT, chiro and decompression tables. Going on 3 years now alternating chiro and decompression, with core strengthening and pain is 99.995% gone. If/when it does come back, I use an ice pack and the pain goes away. No pills, no voodoo, and more importantly NO HEAT and I'm good to go.
                      GOOD LUCK!


                      • #12
                        I have a SI dysfunction. A few things. Find a GOOD PT who knows how to put a SI joint back in alignment. It's not super complicated but the person needs to k ow how to to it. Other suggestion is get a Serola Sacroiliac Belt. $40 worth of support that WORKS. I also have 2 giant ice packs and buy magnesium sulfate (Epsom salts) in bulk at the feed store. The PT (or a gentle chiro) is really the key for getting the SI joint together.

                        My PITA happens multiple times a week thanks to my connective tissue disorder. Apparently nobody told my hips to fuse properly either. *eye roll*
                        "You are a child of the universe, no less than the trees and the stars;
                        you have a right to be here." ~ Desiderata by Max Ehrmann


                        • #13
                          i also forgot to add, if your PT has a stim machine, use it religiously. it hurts at first but my god it is heaven once you get used to it. stim and a heating pad...heavenly


                          • #14
                            I've always been told to use moist heat - I never do, but that comes from the chiro who never did much for my SI (he does wonders for the rib that goes out, but not the SI)....


                            • #15
                              I second looking into prolotherapy in your area. The doctor who worked on me was also a pain management specialist, so he could have offered other treatment modalities, but we didn't need them, the prolo worked.

                              My original injury was a running injury while I was on the college track team. Torn adductor muscles on one side that turned into pelvic dysfunction including a hypermobile SI joint. I couldn't run, continued to ride but paid for it with severe pain, had referred pain in my shoulder too. I tried PT for a couple of years, but with no change. Finally, out of desperatation, I tried prolotherapy to ligaments around my hip and pelvis. I had about 10 sessions. I am now pain free for running, riding or anything.

                              If your issue is being caused by hypermobile ligaments or tendons, prolo will likely help by tightening these structures and fixing the underlying issues.

                              A blog featuring the musings of a semi-neurotic adult amateur rider on riding, training, showing, life.


                              • #16
                                Sorry, gram, I have no solutions to offer, just thank for your original post as it helped me suggest some options to my ortho when i went in this morning.

                                I have the whole bulging disk, L4/L5 thing going on. The doc's initial assessment was that most of my issues were muscular and derived from an inflamed piriformis, but she also thought if PT for that didn't work that it might be an SI issue.

                                Got my trigger point injections this morning, am getting steroids in the SI joint next week. She wants me un-sedated for that!/ i get the reason for diagnostic purposes, but I'm not liking the idea of more pain.

                                So tired of trying to work from my couch, which has resulted in neck pain. So tired and worn down from being in pain. My mare is rehabbing from a ligament injury, so riding has been minimal but each time it hurts or I have no strength. Am worried I might hamper her recuperation, and frustrated that I can't ride the way I want to.

                                I try to focus on the fact that I have a job, and that I can ride a bit, but sometimes i can't help but break out that tiny violin, ya know? Thanks again for your post, OP, and to everyone else who offered thoughts and experiences.
                                My Blog: A Work In Progress


                                • #17
                                  Just a note on prolotherapy is to be sure you are in alignment before having it done. I have heard some bad outcomes from folks who had it done, ligaments tightened, but things were not in perfect alignment when it was done. Just a thought.
                                  "You are a child of the universe, no less than the trees and the stars;
                                  you have a right to be here." ~ Desiderata by Max Ehrmann


                                  • Original Poster


                                    There are many more of us out there than you know. Try a search for si joint pain!

                                    I recently had another joint injection, and things have calmed down a bit. The steroid joint injections seem to work well for me.

                                    Since my original post, I had an accident with a very naughty dog, which resulted in my taking a nasty fall, in which I had a hamstring and probable gluteal strain (went to the ER and had to have morphine for a complete set of back, hip & pelvis xrays). Was not able to walk normally for a couple of weeks, which set the si joint on fire. My doc gave me a prednisone pack and suggested PT. Went to PT and did my exercises religiously. Rode my horse 2 times, and was in a lot of pain after each, so decided to get another injection. Things have calmed down alot, but we are moving off the farm in 1 month, and I have a lot of physical work to do. I am trying to delegate any heavy lifting to others, but there is so much to do (including moving my horse and the contents of my barn) that I don't think I'll be able to make any significant progress until we are settled in to our new place. I will be "horseless" for the first time in 25 years! (Actually, my horse will be living at my daughter's farm, about 5 miles away.) I'm thinking of pursuing prolotherapy, but have to get my life together before that happens.

                                    Good luck with your therapy, I wish I could be of more help!
                                    "Feed your faith and your fears will starve to death."


                                    • #19
                                      @PalominoMorgan - did you have any problems with the Serola Sacroiliac Belt sliding around? I've been looking for something to help with my own hypermobile SI, would like to chat with someone that has used a belt/support. You can PM if you want, I don't want to hijack GG's thread. thx.


                                      • #20
                                        I would like to hear about the belt, as well...Have had SI problem since 1994, sometimes it stabilizes and isn't much of a problem, other times it is excruciating. I am currently seeing a chiro that does kinesiology, think it is helping. I had a wonderful osteopath that kept me well aligned, but he is only working in the hospital now, no office patients....sigh....Also have severe neck, shoulder, and mid back problems...all injuries.