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Sacroilliac Problems

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Sacroilliac problems

by: Phil Parle

Q: I am a world class pole vaulter in the states trying to make a comeback. I have a problem with constant pain and tightness in my SI joints. This causes hamstring problems that have plagued me for years. My back is tremendously strong, but my abdominal muscles are relatively weak. Also, my hamstrings are much weaker than my quads. Could this be my problem? Would correcting these strength imbalances help? My other question is: do I need to stop actually pole vaulting until this problem is resolved? It is jumping that causes this condition to be most acute. I don't want to lay off of actually doing the event as this is devastating to preparations.

A: Thank you for your note concerning your SIJ and recurrent hamstring pain.

Firstly there are many reasons for recurrent hamstring strains however they are often related to a pelvic instability and low back pain. Given that you experience constant pain and stress in the SIJ would suggest a likelihood that your problems are related. It would be useful however to exclude pathology inthe Lumbar spine such as stress fractures if this hasn't already been done. Your doctor would organise a bone scan or CT scan pending your full history. Muscle Imbalance

To resolve your problem the instability in the pelvis which is resulting in excessive stress across the SIJ has to be corrected. Strengthening your abdominals would certainly assist in controlling the forward/backward motion of the pelvis. A combination of Isometric and slow controlled sit up excercises are the best. Equally important is to check the function of the Gluteals, and the muscle length of the Anterolateral Thigh muscles such as the Hip Flexors and Iliotibial Band which, if tight, inhibit the Gluteals from performing their function in stabilising the pelvis especially when perched on one leg (extremely important for a Pole Vaulter).

The hamstring weakness is probably more a consequence of the problems at the pelvis and lower back. It may still need to be addressed in the context of full rehab however your base (Pelvic stability) has to be optimised first and would in itself provide for better hamstring function. Do you have to cease Pole Vaulting?

Only if it is severely interfering with your preparation and getting worse. My advice would be to seek some rehab, talk to your coach regarding technique and spacing your jump sessions to ensure good recovery. Finally have realistic goals in your comeback season. Good luck - hope to see you in the year 2000!

Phillip Parle M.A.P.A. M.M.P.A.A.

City Physiotherapy Centre Shop 3 Simpson House 135-137 Crown Street Wollongong

Telephone (042) 261015 Fax (042) 252260

Phillip Parle, Cool Running Australia, 20.08.97

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