Taking it to the next level

Hey everyone,

A question people pretty frequently ask me is “how are you doing now?”.

I haven’t tended to emphasize my daily life on this site, simply because I only have so much I feel comfortable putting about myself on the internet at one time!

But I wanted to answer some of the commonly asked questions, and also give you some encouragement, because I know the real reason people are asking is because they need hope.

What is your current exercise routine?

I actually have not done any aquatic workouts since the summer. I know that, at one point, I wrote on my blog that I did not think it was possible to recover without aquatic therapy.

I think maybe that was true for me at the time, when I didn’t know everything that I do know now.

However, I have been continuing to learn and evolve– you can take a little piece of the puzzle from every new practitioner you meet– and I actually think I now have a much more holistic view of exercise, and how people can recover overall.

My exercise routine now:

On my “hard” days I like to hike in the woods for about an hour to an hour and a half. Usually, on those days I will also come home and do my strengthening routine as well. (I definitely need to put more specifics about this up on my blog!).

With the SI joints, everything is about the cost-benefit ratio.

All of my exercises are designed to give me the maximum benefits of working out, while actually having as little impact on the joints as possible.

So I can hike in the woods with no pain at all… but I don’t push myself to do things that actively aggravate the joint, such clamshells.

At first, it seems counterintuitive… I can be up on my feet, walking up hills, down hills, etc. for an hour and a half… but doing 10 reps of one movement lying on my bed can be painful?

I think that many of us struggle with these beliefs, and “shoulds.”

I could really get into a whole post on this, probably.

But for the sake of this post, I’ll just tell you that the biomechanics of the SI joint are so complex, researchers are still working on figuring them out.

If researchers don’t even fully understand them… how can those friends and family members who sometimes question us really say that we’re wrong? (I try to keep it positive on here, but I do know that’s a thing).

So, a lot of what’s helped me is getting stronger. But it’s equally important to find things that work for you.

I will sometimes still choose to use a grabber if I’m really doing a lot of manual labor or cleaning (I just moved recently, so there’s been a lot of that!).

Especially know that I know what it means to be genetically hypermobile, I give myself permission to do things in a way that lets my joints behave in as neutral a way as possible.

Using a grabber doesn’t mean that I’m weak. It means that I know my body, and I’m choosing to use it in the ways that make the most sense for me, biomechanically.

I want to be able to tidy up my apartment for a few hours– and then be going up and down hills in the woods.

A lot of my exercises now focus on overall movement patterns, and getting the right muscles to work together as a group.

In the beginning, I think it’s really important to start with the fundamentals. Learning about the transverse abdominis muscle, and how to contract it.

Isometric glute squeezes, which let you start to build up strength without really altering the position of your SI joints.

From talking with many of my coaching clients, I’ve gotten the sense that a lot of PT’s seem to skip this level and go right for the more advanced exercises. I think this is why so many of you struggle to get better– when your SI joint biomechanics are off, sometimes you really need to start small and focus on doing a few exercises well, versus doing a lot of exercises.

However, once you build up enough of a foundation, then you can start progressing.

There was a point in time when I could’t do a full glute bridge. I had to start with isometric glute squeezes and build up my glutes, before I could go into the full bridge.

Now, I’m focusing in on muscle groups. I don’t do the isometric transverse abdominis contractions anymore– I’ve progressed to more advanced exercises.

However, the difference is that I’ve spent time focusing in on the TA and I know that I’m contracting it while doing my core exercises, which makes them a million times more beneficial than when you start them without building that foundation first.

I have a new doctor now who really pushes me..

She’s one of the people I sought out after learning I was genetically hypermobile last year– a physiatrist who’s worked with a lot of hypermobile people.

Sometimes, to be honest, I get a little frustrated and wonder if she fully understands my concerns. I think it’s possible I may come back here someday and write a post explaining why I sometimes have mixed feelings…

Yet this person also has a view of hypermobility where it doesn’t have to be so much of a disability… if you do all the right things to manage it.

I actually have really benefited from her perspective a lot of times. She’s the one who really pushed me to realize I could do fascia work on my own (more on that in a later post).

She’s also taught me some really neat things, such as the concept of the foot having its own “foot core” muscles to stabilize it– similar to the core in our abdomen!

And you guys, I actually ran recently.

This part is a little embarrassing because I wasn’t so much running for fun, as much as fleeing for my life.

I made a not-so-great decision to ignore a thunderstorm warning because I still wanted to go for my hike. (I definitely don’t recommend this to anyone– I think I’ve focused for so long on avoiding Covid, I forgot about the other things to be afraid of!).

I may give this its own post too, but– I ran. I ran really freaking fast. Like I haven’t run since high school cross-country.

And I was shocked that I actually did okay.

Yes… this is definitely going to get its own post. I was so surprised why I didn’t have any SI joint pain after this happened. I talked it over with one of my PT mentors and we talked about the fact that, paradoxically, running like this may have actually really forced my muscles to engage.

I had thought I’d be walking around really timidly and limping after this happened, but instead, weirdly, I felt strong. I felt like I was striding everywhere.

Which brings me to what I’ve been learning about how the nervous system actually plays a role in SI joint dysfunction.

My PT told me that, especially for hypermobile people, sometimes the nervous system can develop issues communicating with and turning on the muscles following an injury. It’s a paradox, but I’m starting to think that in running in this sort of life or death scenario actually jolted my body into really turning my muscles on.

There is so much more to say about this but I’m going to have to leave it here for now–

But I am so excited to explain more about the core, activating muscle groups, fascia work, and the “foot core” in future posts… stay tuned!

8 thoughts on “Taking it to the next level

  1. Georgette Callihan says:

    I am seeing my fourth or fifth neurologist. I wish I would have had him at the beginning. He listened to every word and didn’t dismiss any of my other complaints. Immediately, he told me my S1 had an issue. I was totally resistant to anymore shots or ablation because of the side effects and not a good experience. He convinced me to try once more. He is a GENIUS! I can now lift my left foot to walk. I still need the walker to assist me, but I finally have a doctor that allows me to understand what my body is going through.
    Thank you for sharing your knowledge. You have helped me considerably. Please keep posting the nuggets of gold. I, for one, am grateful for all the info.

    Like

    • Christy Collins says:

      Hi Georgette, I’m so glad that my blog has been helpful, and that you figured out this very key piece in your healing! That’s absolutely fantastic! Thank you for letting me know.

      Wishing you the best as you continue your healing!

      Like

  2. Sarah says:

    Hello!
    Do you have trouble with clamshells in general? I do five (on only one side) as first part of a met exercise. I have EDS and saw the connective tissue PT recommended as best in the state by both my geneticist and rheumatologist, at the state university —up until the pandemic. She prescribed this. It used to work well but no longer works.

    Like

    • Christy Collins says:

      Yes… I don’t love clamshells. I can do a lot of other things (hiking for 1-2 hours, bridges, even hip abduction while lying down)… but I really find the rotation of clamshells to be difficult. I still do them *sometimes* but I probably don’t do more than 5, and I always stop when it hurts.

      Sorry to hear you’re struggling– it does sound as though you have a good treatment team.

      I actually used to not be able to do a single clamshell, but the more I built my muscles up doing muscles in a more symmetrical plane (such as isometric glute squeezes and core work) the better I was able to tolerate them.

      I hope this helps!

      Like

      • Sarah says:

        Yes, thank you. Also thank you for your mattress recommendation a while back. I finally replaced my bed and I bought the mattress from room and Board as you suggested. They changed their mattress naming system since your post, but I bought the equivalent mattress and I love it. Now I just have to get the stretching table (which I have meant to buy for two years now.)

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  3. Nia says:

    Hi Christy, I’m so glad I’ve stumbled across your blog I feel like SI joint pain has taken over my life but your blog posts are so informative, I feel hopeful. I have been suffering with SI joint pain for nearly a year now but alongside other issues such as gluteal tendinopathy and hip bursitis. I have been seeing a physio for a couple of months and he had advised that to address the gluteal Tendinopathy and bursitis I need to be building up glute strength with bridges and squats etc and said I should be doing quite high reps. However, he is not taking into account my SI joint issue and doing these exercises causes pain. Its a catch 22, what fixes one is hurting the other and it’s really getting me down recently. Clearly bridges and squats are too much for my back but I still need to build strength to help my hip and glute tendon pain so I just wondering for how long approximately you did isometric glute contractions to build strength without hurting your SI joint for before moving on to harder exercises that move the joints etc like bridges?

    Like

    • Christy Collins says:

      Hi Nia, so glad my blog has been helpful! For me, truthfully, it took about 8 months of isometric glute exercises before I could do a bridge. I’ve been told that’s a bit on the extreme end of things, to be honest, and that some people are able to progress much more quickly. (I think this is one of the ramifications of my genetic hypermobility/connective tissue disorder). So for you, I would honestly go by your pain level. I don’t believe that a “no pain, no gain” mindset works for the SI joints– for me, any exercise that caused pain never turned out to be worth it. So I would really just go by how you feel.

      I hope this helps!

      Like

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