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Twisted Pelvis/ Lower Back Pain

post #1 of 7
Thread Starter 

Hi

I have a posterior twisted pelvis- the right side of my pelvis is rotated backwards most likely due to and/or caused by all of the muscles on the right side of my body to be super tight. (I am also left handed and most of the muscles on the left side of my body are stronger).It started after I hurt my back telemark skiing about 6 months ago after a sweet powder day at Whitewater with lots of pillows.  I’ve tried chiropractic and it didn't seem to help, and my physio has got me stretching for 30-40 minutes every day s for the past 4 months focusing on muscle imbalances with no improvement. Most of the pain is in the lower back around the SI joint but also radiates into my left glute occasionally- and my left glute is super tender. I've also tried IMS and acupuncture and am thinking about trying massage (ART?). I have also been focusing on activating and strengthening my transverse abdominus and multifidus muscles in my core and back. I am a competitive Nordic ski racer and even though the pain isn't that bad it has limited my training and I need to get it better a.s.a.p.

 

What do you think is the best treatment? And do you think I should completely stop training to let it heal?

 

Thanks

Shawn

post #2 of 7

G'day Shawn. It sounds like the sort of thing a well-educated Pilates instructor could address. You'd want someone that does rehab work and that's a specialized sub-set of certified Pilates teachers. The type of person I'm thinking would have a physiotherapy or kinesiology background in addition to certification as a Pilates instructor. Feel free to PM me your location and I can try and get a recommend for someone that's qualified in rehab work to have a look. FWIW, 2 years ago there were days I could barely walk due to osteoarthritis in my left hip, now it hardly bothers me at all. 

 

IMHO, the danger of continued training is that you will overwork the muscles, joints and tendons you're using to compensate. I don't have anatomy background so won't try to diagnose you! But I do think Pilates will help to loosen the tight muscles and re-align your pelvic girdle properly. At the very least it'll train optimal movement patterns and help get you balanced again.

I'd continue with the core strengthening regimen (multrifidus and transverse abdominus) but pay attention to

1) not activate your glutes 

2) keep your pelvis even

What type of exercises are you doing for this? I'm tempted to recommend a supine posture - if you have a twisted pelvis working in standing postures may exacerbate the imbalance. It'd also be useful to know if it was "just" muscle strain or if there's also some soft tissue damage going on as well. I'm tempted to recommend some oblique work as well but I'd rather have someone that's hands on with you do that or know a bit more about your back injury.

 

I'll try to run this by our studio owner tonight and see iof she can offer any advice. It's a tough one because the back is involved. In our instructor training we were cautioned to not take rehab clients or people with chronic injuries unless we have the appropriate education.

 

Hope this helps.

post #3 of 7
Thread Starter 

Thanks for your help

 

-I was thinking about trying Pilates, there are a couple of supposedly good athletic therapists in Nelson BC (where I live)- who also do Pilates.

-When I went to the Physio she could temporarily re-align my pelvis just by light manual manipulation, but it would quickly go back into its rotated position.

-I've only been training once a week as of late, although we've been rock climbing in school- but rock climbing doesn't seem to aggravate my back too much.

As for exercises, I have been stretching pretty much all the major muscles in my body ( Lats, glutes, hip flexors, quads, hams, calfs)  except for the muscles specific to my back. I have also been putting a raquetball under me while I do some of the exercises to try and loosen tender spots.

 

I haven't heard of supine posture, but I'll take a look at it. And my Physio said not to work my obliques because they are already strong enough and are taking too much of the load that the transverse abdominus and multifidus should be taking. And she also said that there may be a disc involved in the injury, but who knows?

 

That would be great if you could run it by your studio owner, what type of studio do you work in?

 

Thanks again

post #4 of 7

G'day Shawn, thanks for the feedback.

 

That tidbit about your obliques shows why it's important to have a hands on diagnosis. Given that and the fact that your physio is able to re-align you temporarily, it sounds (more) like a muscle imbalance. My guess is it's been there for some time, most of us have them. I remember when I used to squat 400-500 lbs. and I would see myself twisting both on the way down and back up (great use of the mirror to check form eh?). My gut feel is that has something to do with my left hip

 

A well-educated Pilates instructor should be able to assess you and prescribe exercises/movements to correct that imbalance as well as making you aware of your posture. Even if it's congenital, they should be able to "re-train" your movement patterns to an optimal alignment. What you're looking for is someone with a good education in neuro-muscular issues, anatomy and movement re-education. Again, a degree in kinesiology or physiotherapy is a good start since they will have the necessary anatomical awareness

 

I'm training as an instructor at Body harmonics in Toronto - it's a Pilates-only studio but the senior instructors are also certified in several complimentary disciplines - primarily focused on movement like yoga, gyrotonics, bobath etc. I'll be finished at the end of this month (June) - I went skiing at the end of March instead of finishing my final certification course! No regrets, they got 65cm of fresh the Wed/Thurs before, I arrived on Saturday and we got another 70cm or so between Sunday night and Tuesday! Definitely worth the sacrifice...

 

I'll see if there's anyone in or near Nelson that Margot knows or can recommend. I haven't had a chance to speak with her about this yet but I will see her at a class on Friday and will bring it up.

 

Also curious if you've done a functional movement screen (FMS)? There was a thread a few months ago about the benefits of FMS training for skiing and the screen seems to have promise identifying issues that could lead to injuries. Check out their web site and if you think it'd be of value use the map to find an FMS 'expert' close to you.

 

Have a good one, talk soon.

post #5 of 7

G'day. She doesn't know anyone personally in Nelson but there are people in Prince George she could recommend - but that's a 13 hour drive from you? Let me know if you want their names. Else I reckon one of the therapists in Nelson should be able to diagnose and re-train your movement to address the imbalance. 

 

Keep us posted on your progress and best of luck.

 

Greg

post #6 of 7
Thread Starter 

I haven't done a functional movement screen, but I'll check it out. And I went to see an orthopedic surgeon the other day and he ordered me an MRI, not sure how long I will have to wait for though...

Ya Prince George is a 13 hour drive, although my ski coach grew up there, so maybe I could ask him about the people in Prince George. 

 

Thanks

Shawn

post #7 of 7
I have a similar issue but mine is due to a back defect. ART is the only treatment that has been successful, and that's with periodic "tune ups". I am an avid skier and biker, so I know that it can be addressed. My left side is always tight, and pelvis twisting can occur.

Find a good deep tissue massage therapist in your area who deals with athletes. This can help alot (will likely hurt a bit too). I would also recommend contacting Elna Munoz in Vancouver, her clinic is called Optimal Performance. See if there is someone she can recommend in your area for ART. I use her ART services personally. This assumes you don't have someone lined up. Again a focus on athletes in the practice is a must.

My back has been an issue all my life, but ART (active release therapy) along with deep tissue massage have been the only long term successful treatments I have tried.

tw
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