4 months of pain around SI joint. WTD next?

Back in mid-June I was deadlifting about 90% of my 1rm and I believe I hyperextended backwards on the lock-out. Since then I have had constant, persistent pain to varying degrees in the area around my sacrum. The pain will kind of “radiate”, if that’s the correct word, down through my glutes and hamstrings when I am sitting.

I have not stopped training since the injury, attempting to put to use the method of reducing load, reducing ROM, or changing exercise selection in order to keep moving while it heals. Getting down into the deadlift position was incredibly painful for the first two months, but trap-bar deadlifts did not feel so bad. Initially, I was feeling pain both around my sacrum and my lower back. After several months of very light trap-bar deadlift work and some mobility exercises suggested to me by a coach, the low back pain has gone but the pain around the sacrum has gotten worse.

Once the low back pain was gone, I began working with some rack pulls from just below the knee. On the second week of doing this at light weight (I believe I was doing sets of 135x5x3 with minimal effort) I felt a pop around my sacrum following by a ton of pain and the inability to bend over. Putting socks on has been a real pain in the ass. That was about 6 weeks ago. Since then, I have dialed back the load, reduced the ROM when I’ve had to and made some progress, but always with worse setbacks. I have not been pain-free since before June, but that’s okay. The problem is that nothing I do is helping with my ROM and about every other week there is a new “pop” followed by pain and inability to bend over. Two days ago I was warming up for barbell row with just the bar from upper-shin high pins. As I went to set the bar back down on the fifth rep I felt a pop in the area of my sacrum, this time more on the right side whereas previously the left had been more problematic.

It’s been 4 months since the initial occurrence that started all this. At this point, with how I am feeling today, it’s just as bad as the day after back in mid-june. Cannot bend over, sitting is painful, lying down in bed isn’t much better. Is it time to visit a doctor and see about an MRI or do I stick it out and keep trying to figure out ways to train around it by experimenting with more variations to load, ROM, and exercise selection?

Also, because this may be relevant, my low bar squat has not been terribly affected by this in the last two months or so. Overall the load has gone down but I can hit full ROM up to about 225 pounds with no pain. This is way down from where I was back in the spring, but at least I can still squat something. The only days I cannot squat are days like today where the pain and inability to bend forward from the most recent setback cause me to put squats on hold as well.

Thanks,
Blake

Hi Blake,

Sorry to hear about your complaint. You are doing the right thing to continue to train.

Your report is helpful as it shows that you are correlating hearing a “pop” and then experiencing pain in the SI joint as a causative sequence of events. While this has been your experience, it is noteworthy that the sacroiliac joint is held together by some of the strongest ligaments in the body and it would require immense force (think high speed car accident causing pelvic fractures) to consider damage to the SI joint. So rest assured that there is likely no mechanical correlation here and an MRI will likely not provide much insight in this regard. We don’t know the exact reason why our joints pop or crack. Chalk it up to you having a noisy SI joint.

Given that you have been experiencing this discomfort for some time, despite your best efforts to remedy this on your own by manipulating training variables, it sounds like you would benefit greatly from a consult with Michael or Derek to help guide your path to resolution.