Posterior lumbar and pelvic skeletal and surface muscle anatomy with SI joint pain

SI Joint Pain – Help at Home

Do you have one small, painful spot on your back? Right where the blue arrow is pointing?

ICK.

Pain in this area is one of the main indicators of sacroiliac joint (SI joint, or SIJ) pain. This pain can occur when the joint between your sacrum (your tailbone) and your ilium (the big curved bone of your pelvis) gets pulled out of alignment, usually because of tight muscles around the hip.

Wait, I have a joint there?

You do! The pelvis isn’t one solid block of bone. It’s actually made up of five bones that fit together like puzzle pieces to form a more-or-less solid girdle. I say more or less because there can be some slight give in the joints between the bones. The three bones of the hip (the ilium, the ischium, and the pubis) are fused, and your SI joint is the connection between your sacrum and your ilium.

This joint functions a little like a zipper, with strong layers of ligaments holding the two pieces together while still allowing some small amount of movement. But it’s built for stability, and too much movement or pull in any one direction and you’ll know about it, often with a pain at the back of the hip, towards the top of the SI joint.

Posterior pelvis skeletal anatomy with SI joint pain

The Snowball Effect: The SIJ version

When we have pain or trauma (like slipping and falling, or jarring a joint) to joints, muscles, or other tissues, the body quickly tightens muscles around the area to help protect it from further damage or irritation. Great! Except that the protective tension can also lead to additional irritation via the misalignment discussed above.. And the ball rolls on until you put a stop to it.

Ok, so what should I do if my SI joint hurts?

Joint misalignment is often due to tight muscles, fascia, and other soft tissues; Your SI joint has a lot of muscles and fascia surrounding it. (If you want to dive deep into the muscles, ligaments, and bone related to the SIJ, go here. So loosen them up!

Trigger point self-therapy in the glute region, the adductor region (inner thigh), the outside of the hip, and even through the lower back can provide relief from SIJ pain. All you need is a tennis ball! Here’s how: sit or lay on the tennis ball, or lean into it by pinning it against a wall in the areas shown below.

 

Trigger Point for Glute (Bum) Muscles

SIJ Line Glute Trigger Point for SI joint pain

Sit with the tennis ball pressing into the soft tissue to the side of the sacrum (tailbone). Roll it or move it up and down to find tight spots and hold it until the tension or soreness disappears. Use a moderate amount of pressure – it should feel like “good hurt”.

 

Trigger Point for Adductor (Inner Thigh) Muscles

Foam roller adductor trigger point for SI joint pain

Lay face down with one knee out to the side, hooked over the roller so the roller is pressing on the inner thigh, foot to the outside of the roller. Roll it or move it up and down to find tight spots and hold it until the tension or soreness disappears (it’s safe to apply pressure this way anywhere between just above the knee and the crease of the hip). Use a moderate amount of pressure – it should feel like “good hurt”.

 

Trigger Point for TFL and Glute Min (Outside Of Hip) Muscles

TFL and Glute min Trigger Point for SI joint pain

Lay on your side with a tennis ball in the fleshy part of the outside of your hip, or pin the ball against the wall in the same area. Hold pressure until the tension or soreness disappears, then move to find a new spot (move towards the front or back of the hip). Use a moderate amount of pressure – it should feel like “good hurt”.

Secondary causes can be tight muscles farther from the joint. Give them a stretch with one of the following stretches:

Kneeling Hip Flexor Stretch

Kneeling Hip Flexor Stretch

Kneel on one knee and take a BIG step forward with the other side. Squeeze the glute on the back leg, and drop the hips forward to stretch the front of the hip on the back leg. Not feeling the kneeling? Here are other ways to stretch your hip flexors.

 

Pretzel Glute Stretch

Pretzel Glute Stretch for SI joint pain

Lay on your back and cross one ankle over the opposite knee. Draw the knee back towards your chest, bringing the ankle with it, and hold in place by wrapping your hands around your shin or the back of your thigh (between your thigh and calf).

 

Knee Hook Stretch for TFL and Glute Min

Knee Hook TFL and Glute stretch for SIJ pain

Lay on your back with both knees bent, then drop both knees to one side. Hook the ankle of the bottom leg over the knee of the top leg to pull the knee slightly towards the floor.

Important Safety Reminder!

The trigger points and stretches above are great for SI joint pain, but that doesn’t mean they are right for every single person. If you feel pain with any of these, please stop immediately and seek treatment with a remedial massage therapist, an osteopath, or a physiotherapist (or physical therapist). They’ll be able to give you a better idea of what’s going on, and to treat you appropriately.

 


two medicine balls for at home strength training exercise and fitness

Cardio Workouts For Apartment Complex Gyms

Live in an apartment that has a gym in the building? It’s so convenient… for you and everyone else! 

Most apartment complexes with gym facilities have a treadmill, a stationary bike, and sometimes an elliptical or crosstrainer machine. There’s usually one of everything and that one is frequently in use, especially if you’re working out before work or after hours. But why tie yourself to the same old gym equipment? Here are some fresh workouts that you can use for cardio or aerobic exercise, without slaving away on the treadmill… In fact, you can stay away from the cardio machines entirely. 

These workouts are travel friendly as well, allowing you to keep on top of training even when you’re away from home. Perfect for hotel gyms or even your hotel room if you’re happy to travel with an exercise band (the superband referred to below). And of course, great for home workouts too!

 

Body Weight Circuit 

  • Jumping jacks/Star jumps
  • Shadow boxing
  • Side to side hops
  • Clap pushups
  • Jump squats
  • Plank shoulder taps or Plank shift

Complete 2-5 rounds of 10-15 reps per exercises. See it in action here!

 

 

Super Band Workout

  • Superband front squats
  • Superband shoulder press
  • Superband bent over row
  • Superband monster walk (side-to-side and front-to-back)

Complete 2-5 rounds of 8-12 reps per exercise. See it in action here!

 

Dumbbell Circuit

  • Front squats
  • Shoulder press
  • Split squat
  • Bent over row
  • Lateral squat

Complete 2-5 rounds of 8-12 reps per exercise. See it in action here!

With any and all of these exercises, remember that:

Only perform exercises that you can do safely and pain-free. If you aren’t used to moderate or high intensity exercise, chat with your doctor before starting an exercise program. You can test your Exercise Readiness with this quick questionnaire.

All of these workouts are flexible. If you like or dislike certain exercises, you can swap them out, or just add others in to create more variety. Choose your own adventure!

 

If you’re keen to workout on your own? Keep yourself going with this additional recommended reading: 

Three Top Tips for Injury Prevention

What Gym Equipment Will Give Me The Best Cardio Workout

How Do I Become Stronger Without Going To The Gym


two medicine balls for at home strength training exercise and fitness

Client Question: What is functional exercise?

This is a great question!!

“Functional” has been a buzzword in the fitness industry for years now. It likely conjures up images of someone exercising while standing on one foot, doing much of their workout sitting (or standing – though please don’t!) on a big rubber fit ball to switch on their core. Spoiler: This isn’t actually what it means!**

In reality, most exercise can be functional exercises: Functional exercises are those that have a direct benefit to the movements you make in real life, whether that’s going about your day to day activities, going to the gym to get stronger, starting a beginners running program, or even training to compete in a big race. There is no particular group of exercises that are “functional”.

** As people (personal trainers, coaches, clients, and athletes) have seen how little the above types of exercise help in daily life and performance, the industry has moved away from the balance and instability elements that are the hallmark of the early “functional” trend. In fact, these exercises can lead to poor exercise technique, increased compensation patterns, and minimal additional benefit. They aren’t terrible across the board, but you can make better choices with your time!

Writing A Functional Exercise Program

When I see a client who’s interested in getting into functional movement or exercise, I get really excited, since it lets me stretch my creative juices a bit (and also because these clients have the highest chance of long term success – winning!). The process starts with a good chat about what real life looks like for you, what kind of movements you might struggle with, what kind of movements you get pain with, and what you would like to be able to do more easily. We’ll do a brief movement screen to let your body tell it’s side of the story, since most of us have movement compensations we are not aware of, and then we’ll get started on creating a balanced exercise program to match your needs and goals.

Here’s where the art comes in. When I think about what exercises should go in this program, I think about the movements you make in daily life and/or training. I’ll pick exercises that are similar to those movements to help strengthen the muscles that keep you going day to day. I’ll also pick exercises that will turn on any muscles that aren’t quite pulling their weight in your normal movements (under-active muscles play a key role in injury rates) and exercises that provide a balance to your main working muscle groups, which will further decrease injury risk. You should be able to recognize your in your workout exercises that mimic the movements of your job, or that help you improve strength or cardiovascular fitness levels so that the activities of everyday life become easier.

Common Examples of Functional Exercises

Functional Exercise

Similar Real Life Movement

Squats Sitting down and standing up, as from a chair
Step Ups Walking up stairs
Bicep Curls Picking up a small child
Farmers Carry Carrying the grocery bags

Is Your Program Functional For You?

Whether it’s called functional or not, the best program will evaluate your daily movements, energy needs, and lifestyle goals, and focus on exercises that will improve or maintain your abilities in these areas. Not every exercise will seem like something a movement you make every day, since creating strength for movement can require different muscles and joint angles than you might expect. Your body is a complex machine, and it’s rare that you’ll ever sit down, stand up, walk, carry, or lift things in the same perfectly straight line every time! Overall though, you should be able to see the similarities to your daily life, and within a few weeks should be able to feel the benefits.

If you’re not sure that your program is ticking these boxes, HealthFit can help. Your exercise physiology program is designed to be done in-home, at your gym, or anywhere else you feel the most comfortable and likely to do it, and if that’s not functional, I don’t know what is!

HealthFit looks after residents of inner city Brisbane and the western suburbs, including Spring Hill, Paddington, Bardon, Rosalie, Milton, Auchenflower, Toowong, Taringa, St Lucia, Indooroopilly, Chapel Hill, Kenmore, Graceville, and Chelmer. 

Want more info about how HealthFit can help you? Get In Touch

 


Hypermobile woman doing the splits

Improving Hypermobility

Joint hypermobility is a condition where the ligaments surrounding a joint aren’t as tight as they would normally be, which gives that joint greater movement ability than someone without hypermobility would have. Many people call this condition being “double jointed” or having “loose joints”; clinically we talk about having various degrees of joint laxity.

Joint hypermobility isn’t a black-and-white diagnosis. It actually occurs on a spectrum – everyone has more or less laxity in every joint. Hypermobility is seen more commonly in younger people, since your joints will naturally stiffen as you age. And interestingly, your level of hypermobility can greatly vary between your joints. You may be hypermobile in your elbows and shoulders, and much more stiff in yours wrists and knuckles. You’ll generally be diagnosed as hypermobile when you have extreme ranges of motion in several joints. The most common test for hypermobility is the Beighton Score. You can read more about that test at this link.

There’s a small percentage of the population that stays hypermobile throughout their lives. This can be a positive for some sports and activities, like gymnastics, dance, and martial arts, but for many people, hypermobility can lead to moderate to significant muscle and joint problems: When we look at normal physical structure and function (anatomy and physiology), we see that the role of ligaments are to hold the bones in a joint together in a way that allows smooth, pain-free function. When these ligaments are loose (increased joint laxity), the bones won’t be held together as securely. This can lead to increased wear and tear on the bones and cartilage in the joint. Muscle tension around the joint will also increase as the nervous system tries to create substitute support for the joint.

As such, hypermobility can lead to several annoying or painful symptoms:

  • Pain and tension in muscles and joints
  • Joints that click or pop
  • Joints that dislocate or sublux (come out of correct position) easily
  • Tiredness or fatigue, thanks to your muscles working hard
  • Increased joint injury risk for things like twisted and sprained ankles, or for joint overuse injuries

The most common complaints that my hypermobile clients have are muscular tension, sometimes leading to muscular aches, referred pain, or headaches (when the joints of the neck are affected). Many people don’t actually realise that hypermobility is the fundamental cause of this, instead thinking that it’s stress, or something they are doing in their daily lives that’s creating these aches and pains.

Now, the important part: What do to about hypermobility

There’s no “cure” for hypermobility (short of having surgery to shorten your ligaments, and you’d be hard pressed to find a surgeon who would do that!). It’s also not something that you should think is “wrong” with you. It’s just how your own body works. There are lots of ways that you can help manage hypermobility symptoms though, if you’re finding it to be unpleasant.

DON’T StretchFor Hypermobility

This might seem counter-intuitive, since tight muscles often feel like they need a good stretch. However, if you’re hypermobile, your joint laxity means you’re already “stretched” longer than your body wants you to be. Since stretching may further decrease your joint stability, it can actually backfire and increase muscular tension.

What to do instead?

Get A Remedial Massage

Remedial or deep tissue massage can decrease muscular tension without increasing muscle and connective tissue length. This tension often occurs in both the small stabilizer muscles and the larger muscles that power movement. It’s important to note that the body is using this tension to create joint stability and protect the joints, so by decreasing tension, you’ll have a small drop in joint stability. A good remedial massage therapist will be able to gauge how much tension to relieve. (Great remedial massage choices in Brisbane are Just Knead It and No More Knots.) This is still the number one way to decrease the feelings of tension though, so don’t skip out on it. Instead, think of it as one half of managing the symptoms.

What’s the other half?

Build Strength In The Muscles Surrounding Hypermobile Joints

Strength training builds muscle tension. This might sound bad (and too much of it can make you feel uncomfortably tight), but with hypermobility, this tension is actually a good thing. Stronger muscles hold a slight contraction at all times, even at rest, which can provide the joint stability that your body is looking for. As such, your nervous system won’t be pushing your body so hard to protect your joints, so you end up feeling less fatigued, feeling less muscular aches and pains, and may see a decrease in joint popping, clicking, or otherwise doing weird things. Plus you get all the other benefits of strength training too!

A strength training program for hypermobility should have a large focus on building activation ability and strength in your stabilizer muscles, since these are what the joint rely on for support and integrity. You can follow a program that address that alone, or that incorporates stabilizer training into a well-rounded fitness program.

Hypermobility is one of the more common complaints that HealthFit Coaching provides sessions for. If you’re in Brisbane and are interested in finding out how exercise physiology can help you manage your hypermobility, get in touch today!

 

Want more info? Check out these links:
Gazit, Y., Jacob, G., & Grahame, R. (2016). Ehlers–Danlos Syndrome—Hypermobility Type: A Much Neglected Multisystemic Disorder. Rambam Maimonides Medical Journal7(4), e0034. doi: 10.5041/rmmj.10261 Read it here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101008/
Joint hypermobility symptoms and treatments. (2019). Read it here: https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/joint-hypermobility 
Featured Image Sourced From: https://commons.wikimedia.org/wiki/File:Yoga_Split_2.jpg?fbclid=IwAR1mgs9wappmEXULt8ZfSYoD9zCuduyozzEwukYqWI_qFrETlyeGYOAjpHU

Outdoor gym and walking path at Moorlands Park Toowong

Great Outdoor Gyms in Brisbane

In-home exercise physiology sessions are really popular thanks to their convenience and flexible scheduling, allowing clients to fit sessions in with the other things in life that matter. But that doesn’t mean people necessarily want to be stuck at home. And one of the great things about living in Brisbane is that we can take our in-home sessions outside, taking advantage of the parks, walking trails, bikeways, and outdoor gyms that the Brisbane City Council has installed throughout the city – plus the (almost always) beautiful weather. Some of our favourite spots for in-home sessions are actually outside!

Here are some of the outdoor exercise spots we love to put to use:

Moorlands Park, Toowong

A playground for kids is complemented by a playground for adults. This little park is tucked right off of Coronation Drive in Toowong and is complete with an outdoor gym including parallel bars, chin up bars, suspension training rings, and plyometric boxes, among other choices – definitely enough to give yourself a well-balanced full body workout. It’s also an easy spot to jump onto the Bicentennial Bikeway through a tunnel running underneath Coronation Drive.

Bicentennial Bikeway and Walking Path, Coronation Drive – Toowong/Auchenflower/Milton/Brisbane City

Ok, this one is not a gym, but it is great. The Bicentennial Bikeway (the Coronation Drive Bikeway to locals) was upgraded a few years ago into a pretty flash cycle and walking path. The upgrade saw the Bikeway split into dedicated cycle and pedestrian lanes, keeping the faster and slower moving objects separate so that you don’t have to worry about getting run over! The bikeway runs from Toowong to underneath the William Jolly Bridge, about 2.7km. This is an immensely popular stretch with well maintained paths and minimal hills. The biggest drawbacks: There’s not a lot of shade, and if you hit peak foot and cycle traffic, you’ll find it’s quite busy. There are plenty of water stops along the way, and some covered seated areas where you could do dips, step ups, and squats, if you wanted to do a combined bodyweight strength and cardio workout.

Robertson Park, Indooroopilly/Taringa

A nice little walking loop tucked between the St Lucia Golf Links on one side and Indooroopilly State High School on the other. There are several exercise stations interspersed along the path, including a climbing rope, chin up bars, step up steps, and others. You could get a great workout here by running or briskly walking a loop, and stopping at a different exercise station for each lap you do. You can also duck across the road and take a walk or run down the wide walking path that runs along Hillside Terrace in St Lucia.

Frew Park, Milton

New in 2014, Frew Park has an amazing playground complete with climbing and bouldering areas that are good enough for adults to play on when the kids aren’t around. If you’re looking for more traditional exercise equipment, there is also an outdoor gym area featuring cycle and elliptical type equipment, chin up and dip bars, and others. The gym area is edged with a concrete edge that is perfect for high squats or step ups. And there is a concrete walking path that rings the gym, allowing you to walk or run some laps if that’s your thing. An added bonus: As home to the Roy Emerson Tennis Centre, Frew Park also hosts their own coffee shop, open 7 days per week.


Can I Claim Exercise Physiology On Private Health Insurance?

Lots of clients ask this question!

Exercise physiology is included in extras cover through many private health insurance providers, so if you’ve got extras, you may be in luck. Here’s a quick guide to getting the most out of your exercise physiology cover.

Make sure your exercise physiologist has the right qualifications

Private health insurance companies only provide rebates for sessions provided by ESSA Accredited Exercise Physiologists (AEPs). ESSA is the governing body for exercise physiologists in Australia, and work with Medicare and private health insurance companies to make sure AEPs maintain high standards. You can verify ESSA accreditation on the ESSA website.

Find out what your coverage is

Call your insurance provider and find out if your cover includes exercise physiology, how much money you have allocated to that category, and what your expected rebates are. You may also want to find out when your annual coverage renews, as some insurance companies work on the calendar year, and some on the financial year. All of this information can help you plan out how to best make use of your coverage. Click though to Private Health Insurance – Exercise Physiology Cover to find a list of private health insurers that include exercise physiology in their extras cover. If you don’t see your private health provider on the list, definitely give them a call and tell them you’d like to see it added!

Don’t worry about a referral

They aren’t required for exercise physiology sessions covered by private health insurance. (You will need a referral from your GP if you wish to claim for Medicare rebates though, and you can’t use Medicare and private health to cover the same session.) Exercise physiology sessions can be held in-home so that you can exercise when it’s easy and convenient for you, or can be held in your local park, in a gym, or in another location you choose. We’re experts at coming up with creative and effective in-home sessions, no home gym required, which means that you can save on a gym membership as well.

Do make sure you have a valid reason for seeking treatment

Exercise physiology sessions that are clearly intended to prevent, delay, or improve a chronic disease or injury are generally covered, but general fitness programs are not. The Medicare definition of a chronic disease or condition includes things like diabetes and heart disease (among others), but also ongoing muscle and joint pain from traumatic or overuse injuries. This includes lower back pain, knee pain, neck and shoulder pain (including from or causing headaches and poor posture), and general musculoskeletal soreness that you’ve been experiencing for at least six months.

Talk to your exercise physiologist about making the most of your rebates

At HealthFit, we’re all about maximising your benefits, which means having a plan for making the best use of them. After discussing your ultimate, long-term goals, together we’ll work to figure out how many sessions you might need to reach them. This always varies based on how much support and accountability you need to stay on track, how much work you’re willing to do on your own, and how quickly your body adapts to exercise, among other things. But we’ll always aim to get you moving easily and feeling great as soon as possible.

 

Have questions about exercise physiology? Interested in signing up for in-home sessions? Get in touch! 

HealthFit Coaching looks after inner city Brisbane and the western suburbs, including Spring Hill, Paddington, Bardon, Rosalie, Milton, Auchenflower, Toowong, Taringa, St Lucia, Indooroopilly, Chapel Hill, Kenmore, Graceville, and Chelmer.