Reader email: Kerry (“Why am I not getting better, even though I exercise?”)

Hi everyone,

Here’s an email from the first person to give me permission to publish our communication since I put out my request a few weeks ago: Kerry.  She’s been suffering from SI joint dysfunction since she slipped on ice and fell last winter.  (She also fractured her sacrum when she landed).

Kerry and I have a lot in common, as you’ll see below.  I think many of you will be able to relate to her questions– especially about why she’s been spending so much time pool running but not getting better.

So here’s Kerry’s email, with my response below:



My name is Kerry and I stumbled upon your website yesterday and seriously almost got chills because your story is so similar to mine.  I haven’t been suffering from SIJD as long as you have, but we’re so similar in terms of backgrounds (I am a runner too!), careers in medicine (I’m a physician assistant, and I know you’re studying to be a PT), and daily discomfort, things that aggravate the SI (bending, sitting for a long time, seriously ANYTHING in the 24 hours after going to the chiropractor), even where we live (I live in Boston!).

I was writing to hopefully get some advice—I fell and injured my SI joint, as well as suffered a sacral fracture, when I slipped on ice leaving work on February 8th.  I’ve been in and out of my physiatrist’s office, three PT offices, as well as two chiropractors.  I am still in daily, aching, pain.  I’ve tried aquajogging in the pool, as well as land-based PT/strengthening exercises, and I’m still at such a standstill in recovery. 

I’m mostly reaching out just to thank you for your incredibly helpful website, and seeing if you have any words of wisdom/recommendations for any further opinions in the Boston area. 

Thanks so much for your wisdom, support, and just being a light in the seemingly ever-growing dark skies.   Please feel free to use my email on your website, or let me know anything I can do to help continue the awesomeness that is your webpage.  

Have a great Friday,



My response:

Hi Kerry,

Thanks so much for letting me know my blog has been helpful– I really appreciate hearing it!   Sure, I have a few suggestions which you might want to consider.

One thing to make sure you’re really being conscious of is whether your pool exercises are building strength or endurance.  When I first started my pool workouts, I was also doing pool running, like you.  I noticed a dramatic improvement at first, but then I plateaued and felt like I was stuck.

It’s actually when I first started seeing my physical therapist Paula that she pointed out that my long 30-40 pool running sessions were really more for cardio/endurance.  She reminded me of what I had already known from my running days, but had been too overwhelmed to really think about in the pool: that to build STRENGTH, you need to be performing a very small number of repetitions (like 6-12) and then be exhausted at the end.

She gave me a few exercises to do in the pool (mostly things to strengthen the muscles in the back of the hips,like hip extension, hip abduction, and hip external rotation) that I did 1-2 sets of about 12 repetitions of.  (Note: I don’t expect the average reader to follow this part: I used these terms since I was emailing someone with a medical background.  I do have more info on my exercises coming up!).  

So if you haven’t tried this already, you could try using some sort of a floatation device (like a pool noodle under your arms) so that your legs are hanging beneath you, and see how many of these motions you can do.  If it’s too easy, there are ways to add resistance (but I’d consult the PT on that). This is also good because it gives you the benefits of traction 


As you may have seen from my blog, I’ve sort of come to feel that chiropractic adjustments are a necessary evil that should only be used very sparingly.  

But I did learn a lot about my problem from the chiropractors I saw, so if you’re trying to gather information, I recommend the two I saw in the Boston area.


One last thing: I have seen many people say now that building core strength is really the key to stabilizing the SI joint.  So above all else, make sure you know how to activate the transverse abdominis.  I would hope your PT would have already gone over this with you, but if not– make SURE you know how to activate it.  It acts as a corset and stabilizes you during all your other movements.  It can really be your biggest ally, once you know how to activate it.

Here is the post I wrote about it: 

What I think you need, if you haven’t already had it, is for someone to teach you when you are just lying down on your back, and aren’t at risk of further irritating your joints (like in the second video I included in the post).

Okay– wow! That was a lot of information.  But I totally get where you’re coming from and how complex this problem can be.  Feel free to let me know if you have any other questions!  (And thank you for giving me permission to use your message on my blog!!!!).



Kerry’s response (excerpted):


I cannot thank you enough for this well-researched and thoughtful reply.  I totally never thought of my pool workouts that way (oh the curse of the long-distance runner–I was going more for stamina/insurance rather than strength!) and can’t wait to get in the pool this week.

I will keep you posted on how everything is going, and I’ll be following along the blog as well.  Thank you again for being so supportive, and acting as an advocate for SIJD and offering your time and expertise.  I am so grateful.


Thank you again, Kerry, for giving me permission to publish this here!  I know it will help a lot of people!!!

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