I realized yesterday that everything I’ve written about my own road to healing really comes down to two factors:
- Letting sprained ligaments heal
- Building muscle strength
These two factors make up two equally important sides of the same coin. You need both for healing. Unfortunately, you’ll also have to balance one against the other.
Why? Let’s look in more detail.
1) Letting sprained ligaments heal
When a ligament is sprained, it means there has been “a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints” (check out this article from the Mayo Clinic).
The unfortunate reality is that when a ligament has been sprained/stretched out, it may never completely heal and shorten back up to its original length.
However, it can still heal and tighten back up to an extent, so that at least the acute injury phase/inflammation is over, and it becomes a little more stable.
So part of recovering from an SI joint injury requires allowing the ligaments to heal, and not continuing to perform motions or activities that continue to re-injure them, or possibly cause them to become even more stretched out.
For me, this corresponds to the parts of my story where I talked about learning to adjust my motion patterns and habits, so as not to put more strain on the joint:
- Key Point #3: Adjusting my own movement patterns
- The SI joint is like a puzzle
- Positions where the SI joint is more or less stable
It also meant eventually coming to the conclusion that receiving chiropractic adjustments to the area were more trouble than they were worth, because of how they stressed the ligaments:
- The end of my SI joint issues is officially in sight
- Key Point #7 Learning to adjust my own SI joints (using the Muscle Energy Technique instead of chiropractic adjustments)
Essentially, you need to cut way back on anything that stresses the joint, so that your ligaments have a chance to calm things down. If you keep stressing them and continually pushing them outside of their normal range of motion, you’ll prolong your healing process (or possibly never heal).
(Side note: This is why people use prolotherapy: its purpose is to try to help ligaments tighten back up).
2) Building muscle strength
The other equally important thing you need to do is build your muscle strength back up to where it was before the injury– and then some.
Because the truth is, you’ll probably never be able to count on your ligaments to the way you were able to before your injury (not that it’s something you ever had to think about consciously! They were just quietly doing their job).
However, when your muscles are strong enough, they can “take over” for ligaments that have been stretched out.
You have all sorts of major muscle groups that contribute to the stability of the SI joint, and when they are strong enough, they can support the joint to the extent that you may no longer notice your ligaments being sprained.
This is essentially what happened for me. I know my ligaments will never quite tighten back up to the way they used to be. But once I stopped constantly re-spraining them with chiropractic adjustments and got physically stronger, my joints stopped moving out of place. I stopped having to think about my movement patterns as much, because my muscles were holding my joints stable.
- See my corresponding post When muscle strength takes over for weak ligaments
3) Uniting the two factors
Unfortunately, when your ligaments are already sprained, building muscle strength will probably be easier said than done.
Your muscles and joints were designed to move with your ligaments holding things in place. Without them doing their job, things get a little bit tricky. Normal movements that wouldn’t have hurt before can end up putting way too much stress on your joint.
This is why I truly consider aquatic therapy and pool exercise to be the key to my recovery.
In the water, you weigh so much less; your body is protected from the force of sudden impact. For me, it was the best way to give my muscles a workout without further irritating my ligaments.
For the first few weeks following my injury, I only seemed to get worse (despite the fact that I was in land-based physical therapy, and my PT said she was giving me exercises that would help my SI joint).
My chiropractor is the one who insisted, over and over, that I join a gym with a pool, and I have to admit he turned out to be right. The moment I finally started doing aquatic exercises is the moment I truly started to get stronger.
That’s why I’m such a huge advocate of aquatic therapy now. People email me asking for exercise recommendations all the time, and although I know the idea of pool exercise can be a bit daunting (and potentially expensive) it is really the best thing I can suggest.
I do have a few land-based exercises which I think some people ought to be able to do without making things worse (I’m planning to put these up at some point). However, I still really think the pool is the best.
For me, it was the only way to build up enough strength while simultaneously allowing my ligaments to heal.
For more, I’ve written a few posts on Strengthening, including:
- Three major muscle groups to strengthen for SI joint dysfunction
- The most important place to start strengthening: the core & transverse abdominis
I’ve also written a few posts on Aquatic Therapy specifically, including:
- The importance of pool exercise to my recovery
- One of the best things you can do for yourself in a pool: traction (letting your legs hang beneath you in the deep end).
Gosh. Okay, that was a lot of information. Hopefully you were able to follow what I was trying to say.
The SI joint is a super complex subject– which is what can make it kind of fun to write about. But it’s also why I personally struggled with it for over five years before finding the answers I needed. That’s why I’m so determined to share what I’ve learned.
I have a lot of ideas for upcoming content, including some more visual explanations and even (potentially) videos! Please stay tuned!
If you have any comments or questions, please don’t hesitate to contact me or leave a comment below.
And just a note–
There are many people who decide to proceed with SI joint stabilization surgery, or require other forms of treatment such as prolotherapy. The purpose of this post is not to make a value judgement on anyone else’s path to healing, or imply that you should be able to heal without surgery.
I am simply sharing what worked for me, and I’m grateful that the extent of my injury wasn’t worse, so that I could recover in the way I did. What worked for me may not work for everyone, which is why I make an effort to address other potential avenues for healing on my blog.