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SI Joint and Meralgia Paresthetica

samedifference
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SI Joint and Meralgia Paresthetica

I have an unstable right SI joint that causes my muscles on that side to overwork in attempts to stabalize the hip. My Psoas tightens and sweels pushing my Lateral Femoral Cutaneous Nerve against in Inguinal Ligament causing numbness, tingling, and soarness on the outer right thigh. My glutial muscles are usualy soar and feel underused compared to the opposite side (left). This right leg is inwardly rotated and shorter than the left due to a tilted pelvis.  

I have been experiencing this problem for the past five years. Some days its ok but if I overwork my hips everything gets thrown out of order and the soarness and numbess get farely painful. I have used Sacral Belts in the past in attempts to properly heal the ligaments that hold the SI Joint in place with minimal success. Admittedly, this was due to my lack of patience in the gradual introduction of intensity in my activities.

After reading some of the posts about SI Joint problems I am inspired to give the Sacral Belt another chance with honest discipline and patience. I have been following the 8 Steps Program, have had an Initial Consultation, and plan on taking the Foundation Course very soon.

My questions are:

Do my Sacral Ligaments still have a chance to heal properly after so many years with this problem?

Also, How careful do I have to be with my activities during the day? I have been using the Sacral Belt and basically only walking and hip hinging during the day. The feeling of relief is definitely noticable while wearing the Sacral Belt and when I take it off I can feel how tender it is around the SI joint.   

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What you describe is very similar to what I have experienced in my body. A sacral belt can be very helpful reducing excessive loads on the ligaments, but is only part of the solution. The ligaments that support the SI joints are amongst the strongest in the body, and can suffer inflammation. When the excessive loads are reduced or removed the ligament can return to a healthy, non inflamed state. What does remain is excessive length in the ligaments that means less intrinsic stability in the area. 

The Gokhale Method Foundations course contains techniques that are very helpful. Stretchsitting and stretch lying on the back especially give a stressed psoas a chance to relax. The Inner Corset helps stabilise the SI joints, especially important if the ligaments are over stretched. Hip hinging can be very helpful, though moderation is advisable if the SI joint is having a bad day.

As you are probably aware pelvic anterversion is a key part of restoring our natural architecture. With SI issues its best not to rush on this front. When the SI joints are painful a mild tuck may even be helpful, (not a strong tuck, that can be very aggravating).

The action of the feet is a significant factor. In nearly every person with SI issues I have seen, including myself, one foot was much more vigorous in its kidney bean shaping action. Paradoxically better on the painful SI side. What needs to happen is to very consciously bring the other foot up to the same level of strength & vigour of kidney bean shaping. This, and how the effects of this propagate through the body, is something that can best be worked with once you have got the foundations under your belt.

The concept of counter nutation and nutation of the sacrum within the pelvis are important, but my experience both personally and as a teacher is that this is best treated a secondary layer of understanding once you have grasped the idea, but not necessarily the full expression, of pelvic anteversion. 

It might be that stack sitting, possibly glide walking may need to done in moderation at first - how you feel will let you know - but short of writing a book on this subject my advice would be take the foundations course, being aware you might have a couple more boulders in the way on your path back to health that may need further navigation.

samedifference
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Thank yo for your in-depth reply, John. It was extremely informative.

Can you elaborate on what "back to health" entales?

     With the Sacral Ligaments permanently stretched what will my limits be when I am back to health? walking, rock climbing, hiking, running, weight lifting...I assume there has to be a limit in life activities with a compromised SI Joint.

     I Walk many hours at work and would like to start Rock Climbing when i am feeling more secure with my body. Is this too much to ask of from my body (SI Joint)?

     Would it be safest to wear the Sacral Belt for the rest of my life or will the restructuring of my body, strengthening in the proper areas, and proper movement be enough to keep my SI Joint stable?

Thank you again for your help. Whatever the future prognosis of this dysfunction, I plan on participating in the Gokhale Method Program as extensively as possible. I know how crucial it is to the future of my body's health. 

 

 

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Lengthened ligaments are mostly caused by chronic loads due to postural problems. Even though they dont simply spring back the good news is that natural posture, with improved muscle tone is usually a practical solution. 

The other factor is that other structures, muscles, connective tissue and often heavy duty structures such as the IT band shorten, sometimes asymmetrically. Gently lengthening out this tightness is certainly part of my personal journey back to healthy SI joints.  Healthy functional bodies tend not to investigated as much as those undergoing surgery for example - my SI joints functiuon perfectly heathily, with the judicious use of an SI belt, some yoga moves that reinforce stability, avoiding yoga moves that might be OK for others but which place too heavy a load on my SI joints - triangle pose is a prime example, as would be any pose that required extreme leg articluation such as wrapping my legs behind my head - I can do it but my SI joints object afterwards.  

This leads into the question about everyday activities, and fun ones like rock climbing. Initially as the pelvis returns to a healthy archictecture its good to be very conservative - and always let comfort be the measure. Initially, much as I loved the feel of stack sitting, my right SI joint objected. No problem stretch sitting worked a treat. Now with much greater stability in my pelvis I mostly stack sit, including now as I type this, one of Esther's head cushion on my head encouraging an almost spontaneous alignment in my axial skeleton.

I dont rock climb so tricky to comment in detail, but I do clamber on and off of boats - and am more agile than most despite a remaining looseness in my SI ligaments - healthy function is what I focus on - even though probably quite invasive procedure would probably be needed to determine the exact state of my ligaments.  Without applying the Gokhale Method in my life I doubt I would be doing 1/2 of what I do now.

samedifference
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Im sorry for the late reply. I was in mourning of the loss of function in my SI Joint Ligaments. Pretty sad to hear that they will never work properly again. Its hard to accept considering all the competitive athletics I have been a part of all my life. It became who I was, and I now have to raccess it all and learn to accept my physical limitations. At 31 years of age, it seems sudden, but I know how small of a limitation it actually is. I'm not paralyzed. When my primal posture and movements are restored I am happy to know that I will be able to live a pretty full life.

Thank you so much for your help. I have a much better understanding of what to expect in my upcoming journey back to health. As for exercise I feel that I should stick to the Optional Exercises in 8 Steps book and pick other exercises that can be adapted to use Primal Posture. I wonder if there are any of the Optional Exercise should be avoided with SI Joint Dysfunction...

I hope to reach a healthy and happy level of movment in my life soon. Thank you, again. 

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31 is a better age than 47, which is when my primal posture journey began. An expression Gokhale Method teachers are very fond of is "let comfort be the measure", that will help weed out moves that are not appropriate at the moment. Cross legged sitting is very natural, depending on your hips. It doesn't work for me, I stack sit on a meditation bench. The hamstring lengthening exercise in the appendix is a nice gentle stretch for most people, for me it creeps into the ligaments destabilising my SI joints and needs to adapted accordingly. Hip hinging or an adapted yoga table pose work better in my case.  It sounds like you have figured the big picture really well.

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