Massage and Sacroiliac Joint Dysfunction

Okay, so here’s a somewhat tricky subject (like everything related to the SI joint, of course!).

Once in a while, I really need help breaking up some of the knots and tightness that build up in my muscles.

I try to stay ahead of it by stretching regularly, but sometimes, I get to a point where my muscles are just plain tight, and it doesn’t seem to be something I can stretch my way out of.

This is especially true in the winter.  When you’re cold, your body tightens up your muscles as a way to conserve heat energy.

This is a huge factor for me because of all the swimming I do.  I try to stay as warm as possible afterwards and come home and do my stretches right away, but every six weeks or so I find my muscles– my leg muscles in particular– have become so tight it’s actually limiting my workouts.

The right massage therapist can really help with this.  I’m not talking about a relaxation massage… I’m talking about someone who knows more precise techniques to help calm muscle spasms.

However, a big issue for me, since developing SI joint dysfunction, is that my SI joints are extremely hypermobile.

And so, they’re also sensitive to even the slightest touch or pressure from a massage.  Even having a therapist work on my upper back can actually cause my SI joints to lock up, if she ends up using too much pressure.  (It was true for me then, and it’s probably still true now, which is why I use caution.  I’m doing better, but I’m not in a rush to find out where my limits are).

It was not uncommon for me during the five year period when I really struggled to go in for a massage and come out with my legs and upper body feeling amazing… and my SI joints totally locked up.

Scheduling

For a while, I tried to schedule things so that I could go directly from my massage to my the chiropractor’s office, so that he could unlock my joints if they’d gotten stuck during the massage.  (This was, of course, before I realized the chiropractic adjustments themselves were actually not a good idea).

At the time, it was a really difficult decision to make– whether to get a massage or not.  I felt like I needed to loosen up my muscles so that I could go on working out and getting better.  I just also knew that, each time I actually went for a massage, I’d come out feeling so much better throughout the rest of my body, but worse in my SI joints themselves.

How did I find my way around this?

I ultimately found one massage therapist that I had a really good feeling about– Lynn.   My first massage session with her was still hard on my joints, but I had a really good feeling about her as a person.  I felt as though she was a careful listener, and wasn’t judging me for having this weird problem no one else was having.  She had also had some training to be a physical therapy aide, which might have helped in why she was so understanding.

And over time, we worked out a process.  It was trial and error, really– I would let her know when a certain technique or approach was too much pressure for me, and she wouldn’t use it again.

I wouldn’t say we ever got to a point where massages were perfect for me, but that wasn’t her fault.  Gradually, we perfected a routine that allowed me to get the maximum benefits for my muscles, with the least amount of harm to my joints.  It was such a relief to be able to go for a massage without wondering if I was risking a major setback.

However, I decided that it wasn’t worth it to have Lynn work on the muscles around my SI joints themselves.

I wouldn’t even really let her do much on my low back.  It was just never worth it.  With every single massage therapists I had seen over the course of this problem, having someone apply any pressure directly around the SI joints was bound to make them rotate.  Once my ligaments there were sprained, the joints just couldn’t stand up to even the lightest direct pressure.

Luckily, the muscles in those areas never seemed to lock up to the point where I needed help.  As long I stretched them regularly, (for example, the knee to chest stretch is really important for the muscles in the back of the hip) they seemed to be okay.

It was really everywhere else– my legs (particularly the calf muscles, and the muscles in the front and the back of my thighs) and also my upper back.  My biceps were also often tight as a result of the things I did in the pool.  So luckily, not having her work on my worst areas didn’t seem to have any significant drawbacks.

You don’t want to increase mobility in the joints themselves.

Since I’ve been blogging about SI joint dysfunction (you can see my early posts over on Sunlight in Winter), I’ve occasionally received well-meaning comments from people suggesting I use massage to increase the mobility and range of motion of the SIJ’s.

While I really appreciate it anytime someone takes time out of their day to offer help and advice, this is probably not the best way to look at it.

The purpose of massage is to increase mobility in your muscles… not the joint itself.

SI joint dysfunction tends to occur when the ligaments of the joint have been sprained.  This means the joint is moving too much.  Any form of vigorous massage or pressure ends up putting more force on the ligaments, moving the joint out of place and potentially re-spraining the ligaments themselves.

I discussed the importance of allowing ligaments to heal in my previous post on SI belts and taping techniques.  As I explained there, you really want to avoid doing anything that’s going to push your ligaments outside of their normal range of motion– and, if you’re like me, having someone apply any kind of pressure to the area is probably one of those things.

My advice:

Don’t go for a massage just because you’re experiencing SI joint dysfunction and want to see if it will help.  A massage therapist might even offer to use specific techniques on the SI joints to see if they can help– I would strongly suggest you decline.   In my opinion, many physical therapists aren’t qualified to treat the SI joint– I wouldn’t move down the chain of training.

Instead, I would recommend that you get evaluated by a knowledgeable PT (hopefully you can find one) and see what they find.

Muscle imbalance can be a potential cause of SI joint dysfunction.  When some muscles are pulling too hard and others not enough, it can create uneven tension on the joint and pull it out of position.  So see if the PT thinks massage is something you might need.  If you aren’t sure you need it, I wouldn’t suggest just trying it just to see what happens, since there are potential drawbacks.

Meanwhile, if you’re like me and you have specific areas of tightness you need to loosen up, I’d suggest looking for a massage therapist who’s comfortable focusing specifically on those areas, and won’t get offended when you them not to give you the same massage they give everyone else.  (I’ve encountered that).

Sometimes it seems like the less training someone’s had, the less aware they are of complexity, and the more convinced they are that there’s only one way of doing things.  So be careful of who you trust with your body, and try to find someone as open-minded and accommodating as Lynn!

For further reading:

Hope this was helpful!

 

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