You probably have a pretty good idea how things are going in PT based on the title of this post, along with some other things I have mentioned this week. I figured it was time for an update since I have been trying to do them weekly. I was hoping to be able to have some positive updates to share by the time I wrote this but that’s just not the case this week. I would never want to sugar-coat all of this because there is really no point to all of that. Besides, I know some of you who are reading this are also frustrated with injuries and sometimes it’s just nice to know that other’s are going through something similar.
If nothing else, the past week has made me realize that I MUST deal with my hip/pelvis issues once and for all or they will always come back to haunt me. It is so frustrating to hear some of the same things I was told about my SI joint almost 5 years ago when I went to PT for the first time. But when you go months or years feeling good, you could imagine how I would think those problems were gone. It’s a complicated area to understand, and something I could never explain very well, but I’ll just share what I have learned about it all lately.
You can read about my gait analysis and first few weeks of therapy in these posts:
So that picture is a diagram of the pelvis area and the muscles connected to it. As you can see, there are alot of muscles that can pull on the sacrum or interfere with alignment. I started PT with the initial complaints of lingering piriformis pain on the right side that would come and go, and occasional tightness in the left adductor and front of hip.
My PT noticed that my right SI joint was anteriorly rotated (so the bony point at the front of the hip was lower on the right, and the bump in the back was higher on the right). At my first few sessions he was able to adjust me and I was general feeling ok and doing well.
On Saturday when I tried to run everything on my left side felt OFF. I have noticed this before, but since it wasn’t really painful I didn’t think too much of it. But now I am paying attention to every little thing. I go back and forth between feeling tightness in the back right area and front left area. As I have said before, I couldn’t figure out any reason for this pattern!
When I went back to PT this week I tried to explain these patterns and my PT said that when I am “out” (so have that right anterior rotation) my right glute muscles aren’t going to work properly and my left hip flexors are going to have to work extra hard to pull my leg through when I am running. So what do I do? The goal is to keep everything where it’s supposed to be! (Easier said that done).
My PT showed me two ways to correct myself because now I can recognize when I’m “out”. (I don’t think I am going to share these because you really shouldn’t do them unless you know what’s going on with your pelvis and should consult a medical professional first). It all sort of make sense because over the past few months I’ll have a few days where I feel good followed by a few days where I don’t- which were probably dependent on what my SI was doing on those days.
So whenever I go out of alignment (and sometimes I have Rob check me just to confirm) I do the corrections. However, it is CRAZY how my body does not want to stay in the proper position! I know some of you have talked about how you know when your hip is out and you get it fixed and its better for awhile- well not for me! Sometimes I just stand up and hear a pop and know I am out again. I must have been living this way for a long, long time for it to be this messed up. All of this makes sense with my injuries history, and is probably connected to my labral tear 5 years ago.
The other night in PT I did my self-correction and then ran on the Alter-G, and stayed straight! It seems like running actually doesn’t (usually) mess up my alignment, but other activities involving twisting are more likely to mess it up. The key is, I need to be in proper alignment before doing any exercises (running or strength).
So my routine for now is: stretch/foam roll hips, check for proper alignment and correct if necessary, then do PT exercises, then check again and self-correct if necessary.
As the title of this post says, progress is not always linear. Just like my hips. (Ha.) I know some of you have commented about how I am so positive and overall I guess I am but I definitely have meltdowns as well, they just don’t usually make it to the blog. I know that I won’t give up and I will continue to do what I need to do to be able to exercise and go about my day to day life without pain. I just hope it doesn’t take too long:)
Have you ever dealt with SI joint/alignment issues?
What was the most frustrating injury that you ever dealt with?
I’m linking up with Jill for Fitness Friday!
I have the exact same issue as you. EXACTLY. Which is why I’ve been doing those hip strengthening exercises! I don’t think my hip goes “out” as much as yours does, for some reason but it’s definitely often enough to drive me nuts.
Gah it’s so annoying! If you figure out any secret cures please let me know, and of course I will do the same:)
This must be so frustrating for you. I’m happy PT is at least helping you to piece things together little by little. Hang in there!
Thanks! It’s definitely good to be working with someone who is knowledgable and has helped me to slowly figure out what’s going on.
I can only try to imagine how frustrating this is for you! I hope it can be worked out as fast as possible and that you feel back to normal (whatever normal is, right? lol) and running pain free soon.
Thank you! I hope so too!
Hang in there my friend, I KNOW it is frustrating, and you wonder if you will ever run healthy again, but you will get there, and posts like this show your maturity about it, and that will pay off. You are right, progress is not linear, but all these little steps back will make you appreciate it even more when you do get back to full health. You can do it! Here for you if you need me 🙂
Thanks Tina! It’s never easy to be dealing with an injury but I think when you have no idea how long it will go on for it makes it that much harder. But I am staying positive and I keep telling myself that it will get better!
As someone who has been in PT and has dealt with particular issues and also as a fitness professional THANK YOU for not sharing the exercises!!! Especially when dealing with the hip/back/pelvis, you can’t be playing around. No, progress is not always linear, but we both know that it can be parabolic–a few down days can lead to a giant upswing!
That is what I keep hoping! I’m wondering if its going to get worse before it gets better as my muscles adjust to being in the correct places.
This is really interesting. I know it is frustrating, but all of this work will make you stronger and healthier when you get back to running. As I’ve said before, I’m impressed with your commitment to fixing what is wrong and your patience – regardless of the off-blog meltdowns 🙂
Thank you! It’s not always easy to be patient but I feel like I don’t really have another choice:)
This is one I know well, too! It’s really frustrating. I think it’s actually good progress that you can recognize and self correct, so focus on that positive.
Thanks and I will keep that in mind! If you have any suggestions for next steps if PT doesn’t work I would love to hear them!
This is definitely like unlocking pieces of a mystery, really slowly. Even though it feels ridiculously frustrating, it’s necessary to know these things as you go forward toward running goals. I do think every injury “pattern” has complexities that are deeply ingrained and tough to fix, but you really are on the right track to moving through this and correcting some of it. Great explanations, I’m learning a lot from this!
Thanks, and what you said is spot on. Sometimes thinking about it all makes my head spin!
Yes, that sounds really frustrating! I have some lingering issues that have been going on for years and I really need to get it checked out to see what I should be doing to fix the issues. I think it’s great that you can adjust when you are “out” since you now know how- that seems like that will help a ton!
Yes, I hope so! If only I could stay that way it would be great, but its better than having to wait until the next time I see my PT!
I started with a chiro before going to PT, and my right leg muscles were so tight, they were pulling my hip up. We worked on getting those loose and getting my hips back into alignment. Then PT to help strengthen the muscles and keep them from overcompensating.
That sounds like a good plan and similar to what I did. My PT is continuing with some deep tissue work since my right external rotators still get really tight!
Good on you for perservering with this, I can imagine how incredibly frustrating it is! I really hope it starts looking up for you! I haven’t dealt with hip/pelvis issues but I recently re-sprained my ankle which has not been the same since the first time and I am definitely feeling frustrated with it. Why does running not love us as much as we love it?!
I feel like after getting injured once then its just a downward spiral! I hope that your ankle is feeling better!
Oh man this has to be frustrating. I hope things get better. It sounds like your doing what you need to get stronger. Patience is sometimes the hardest thing to remember and stay strong through. Sometimes we just have to work while we wait. You’ll be back soon! 🙂
Thanks so much!
I’m so sorry you are going through all of this, its so incredibly frustrating when your body doesn’t just do what you want it to! I have to go to to PT whenever I run long distances because of my calves, the only way to attempt to fix my main issue is surgery which I’m not willing to do because it’s not guaranteed to work and the recovery is long, but they can usually get me to a place where I can run with less issues. I also have a laundry list of other issues like my glutes/hamstrings don’t activate when I run so I try and work on that too…it would be so much easier if my body just cooperated! Hugs my friend and have a great weekend!
Ugh that sounds like an annoying issue too! Not sure why our bodies don’t like to cooperate!
Ughhhh this is so frustrating and I totally get it. I’ve made the mistake with my calf several times of running through it once the pain wasn’t “that bad” and then ended up out of running for months (as you well know). If it comes back again, I’m going to wait to run again until I know exactly what the problem is. You’re being so smart about your injury and it will make you a better and stronger runner because of it!
Thanks, and that sounds a good plan for your calves. I feel like once we deal with the same issue a few times it really means we need to take a step back and figure out whats going on!
I can’t even begin to imagine how frustrating this is for you. Hopefully now that you have a better sense of what is going on and how to correct it you’ll be able to start making some lasting improvements.
Thanks! Yes, I hope so too!
This sound really hard, but you will be so happy that you dealt with it now in a few years!
I just got a referral for physical therapy for my right hip/glutes, and I’m pretty curious to find out if I have a similar issue.
Good luck, and stick with it!
Keep me posted- hopefully your issue isn’t as annoying, but maybe if you caught it early enough it will be easier to correct.
Honestly I think progress is rarely linear. This is easy to become overwhelmed with, but I’m glad you’re breaking it all down to bare bones and addressing each issue. SO many running issues stem from those darn hips. Wishing you a permanent solution!
Thank you! And yes, I know that there are often setbacks in recovery. Hopefully by taking it slowly I will avoiding having these problems again!
I hear you on your frustrations! Have you been continuing with the running or trying to limit it? I’m curious if that helps or not.
I wish I could run but ever since my labrum surgery I avoid it because it’s the one thing that always causes flare ups!!! My hamstring has been bothering me for a few weeks now so I’m going Monday to PT to get itt checked out, fingers crossed!!
Somedays when I don’t run I feel worse and it makes me even more confused. If I run when I’m “out” then my left hip feels tight. That’s crazy that you haven’t been able to run since your surgery! Is it the same pain you had before the surgery? Good luck with the hamstring stuff!
Oh and to answer your question I have been limiting running alot lately…I only run on the the alter-g after my PT has made sure I’m aligned and then I have been trying to run on my own one other day a week, but if it doesn’t feel good then I stop.
I had a knee injury this time last year and it had a bruise for MONTHS. It was frustrating because I could not run like I wanted to and felt hopeless. Fortunately I healed by lifting weights and getting the muscles around it stronger and I am back to normal now.
That sounds like a frustrating injury you dealt with. Its good that you were able to do exercises while it healed that ultimately helped you to become stronger!
That sounds so frustrating, but good for you for persevering through it! PT is rough both mentally and physically. When I was in PT for weak calf muscles/underpronation, it felt like I was just stuck at being injured for months. Then all of a sudden things got exponentially better, I was able to run again, and haven’t had the problem since! You’re so right that it’s not linear, there are not many ups and lots of downs before things heal.
It can really feel like its taking so much longer than its supposed to! And I think the worse feeling is when my PT gets confused as to why this is still such an issue for me. I think alot of people start PT without any knowledge about what is going on or what to do, but I was already doing alot of the strengthening exercises and foam rolling ever day!
I’m so sorry you’re dealing with all this pain and frustration! It would drive me mad. I’m so scared that now that I’m running a lot more something like this is going to happen. It sounds like you have so much good support from your PT though which is good! Neither one of you is giving up. Good luck!!
You shouldn’t be worried about this happening! As long as you deal with any issues if and when they creep up I think you will be fine. I’m pretty sure my imbalances stem from years of running, and all the dancing I did when I was growing up.
The most frustrating aches/pains I’ve dealt with were my foot and the one thing I haven’t been to the doctor for yet…my hamstring. I haven’t really talked about it, but it is a huge pain in my ass (literally) and slows me down a lot. I’m learning so much about PT and what I SHOULD be doing by reading your blog and you’re right…these things need to be corrected or they will come back to haunt you. I need to make an appointment.
Ugh sorry your hamstring is still annoying you! But definitely get it taken care of! You are better off dealing with it now than having ongoing problems down the road like me.
After reading your posts recently. I think my little IT band issues are nothing compared to what you have been dealing with. I can not imagine how frustrating it is. US runners never want to deal with injuries that are going to make us stop running.
I don’t think you should minimize your injury- its things like that which can lead to imbalances and bigger problems later on! So even though it doesn’t feel like a big deal right now you should definitely get it taken care of!
This is really frustrating! I can’t imagine needing to re-correct myself: it seems SO frustrating and also time consuming to keep needing to check and re check-it would drive me nuts! I think you’re really good about it though and that’s awesome!
It is annoying, but at least I am able to make sure I am aligned and fix myself if necessary, rather than having to wait until my next appointment. Hopefully my body will start cooperating soon!
What I am going through now is definitely the most frustrating! I am writing a knee update post and I was going to say the same thing- progress is not linear! I have days where I am like, wow this is working! And then I have a random day when I’m like… hold on a second, why does my leg hurt so bad today!? No rhyme or reason sometimes. I remain positive because I feel like if I am committed to figuring it out I HAVE to figure it out eventually. And no matter what, each day that goes by is one day closer. But it is still extremely frustrating to not be able to run at my full potential right now.
Ugh I know exactly what you mean. I feel like I am learning so much about anatomy from dealing with this and I probably should have gotten another degree in PT or something! But yes, each day we are one day closer to being healthy as long as we keep being smart about things!
Don’t worry. We got this.
I have pain in my left SI joint at times, which is my weaker side…Becky and I continue to address my hip strength. I keep doing my homework…
I think my pain might be a little arthritis, tho…when I use my Voltaren gel, the pain just disappears.
Interesting…I think my left side is weaker (that’s the side where I had surgery 4 years ago) but I mostly have issues in my right SI area. All that stuff is so complicated! But I plan to continue with the strength stuff and hope that it pays off!
Ahhh, good ole patience… I know it all too well these days! I will not bore you with all the details on my knee situation – but I just keep looking toward the near future and how this will all be a distant memory.
I am so sorry about this injury, but you are being really smart about!!
I love to think about injuries testing us and making us smarter. I hope you’ll be back on the road very soon!!! 🙂
Sorry that you are having knee issues, but that is a good point that going through this stuff makes us smarter and stronger! Hopefully we will both be feeling better very soon!
I’ve been dealing with the same exact problems for several years now. Every time I go to the chiro, my pelvis is always rotated and we need to correct it. I’ve learned some techniques to fix it on my own now too, but I have a heck of a lot of work to do as well.
It sounds like this is a pretty common issue, so its frustrating that there isn’t an easier way to deal with it! And from working with some different chiros and PTs it seems like this issue can be slightly different for everyone making it harder to figure out. If we can get strong enough to overcome these issues it will make us a million times stronger as runners!
If we can keep in mind that progress is not always linear some things would be so less frustrating for us. I focused on correcting imbalances and alignment all last year and then something else comes up now. Sure I’ve improved my alignment but now is where the nonlinear part comes in.
Ugh, that is so frustrating! I have sort of always felt that way with injuries, like I would overcome one thing and then something else would pop up a few months later. For the first time I am feeling like this is the missing piece of the puzzle because when my alignment is off so many other issues came up so easily, despite all my efforts to do the “right” things with my training and recovery. Its so frustrating- but these lows help up to become smarter and ultimately stronger.
I’m almost sure we are dealing with the same issue, Lisa. My trainer in college would check my alignment on a daily basis and I was almost always out as well, which probably explains why my hip problems started when I graduated- there was no one to fix them anymore other than an occasional visit the chiropractor, which I stopped going to because it would just get out and I can’t afford to pay someone to put me back in line on a daily basis haha. Some of the things my trainer had my do in college before she adjusted me also make sense now because if I do some similar movements on my own, I can tell that it’s in line again. I just so happened to be doing a stretch I normally do, but I must have done it different the time I realized it helped to put things back into place. The PT I work for now was telling me that one of the things she has people work on is developing the left adductor, because it’s weak on a lot of people due to the tendency for a lot of us to stand still with our weight on our right side a lot of the time. She told me that I’m most likely using my right leg to run on more, which was kind of mind blowing to me…why would I run more on the side that hurts was my initial thought! But then she explained the tendency for a lot of us to hang on the right side of our body when standing so these muscles are more developed and it’s just the natural tendency of the body to use the side that’s obviously used more. Which explains why we need to pay attention to which side is weaker so that we can use both sides more evenly. She also stressed again how important pelvic alignment is and just how much it can contribute to so many injuries from the pelvis down to the feet. It’s crazy, but it makes so much sense! Sorry for the novel long comment, but I’m so glad you’re focusing on getting your pelvis in line. Although I was anxious to get into harder training, I’ve really had to focus on the root of the problem and I know it will benefit me in the long run.
That makes so much sense! And very interesting because I think part of my current issue is a left adductor strain (well, that was what the ortho I initially saw said), my PT found some nasty tight spots on my left adductors and psoas that he is doing deep tissue work on and ART. I actually said to my PT the other night that after a good run on the alter G that I felt like my left hip was working…not in a bad way, but just like it probably wasn’t working at all before! I know I still have alot of work to do but its really helpful to hear about your experience. That sounds so great to be able to work for a PT and learn even more about this stuff!
I have the exact same issues! I have started doing yoga and think it maybe helps, did you notice that yoga made any difference? Hang in there!
Before I knew exactly what was going on I felt like sometimes it helped, but not always. I think I need to work on learning the proper way to do certain poses and make sure I don’t make things worse by doing too much twisting or deep stretches that could aggravate things. I want to try to go back soon and just take it really easy and see how it goes!
I am so sorry things are tough right now. It sounds like you are doing everything you possibly can, though. I am sure all your work will pay off!
Thanks! That’s what I am hoping:)
This sucks Lisa! On the plus side – you know what the issue is and how to fix your alignment. I have issues with my glute medius and other gait problems. Like you, I know what the problem is but my physiotherapist has told me that it’s something that I’ll need to work on for the rest of my running life. It’s a pain but if it keeps me healthy it’s a sacrifice I’m willing to make,
I’m at the point where I keep saying how careful I will be from now on once I am back to running healthily! I just hope I can keep that promise! I always did my best with the strength stuff but I think I will need to be even more aware of any signs that things are off.