Many times people perform stretching routines in order to overcome back pain but little do they realize that too much stretching can actually cause back pain. If you stretch too much you can develop what is known as a hypermobility syndrome. This means that a joint develops too much motion and becomes unstable.
I see a good number of these cases every year and many times the patient is completely unaware that their stretching caused the problem. In fact, many patients try to stretch more in order to alleviate the pain. What they are actually doing is making the problem worse. Many times they have trouble accepting that stretching contributes to the pain because they feel that their back muscles are tight.
One joint that frequently develops instability is the sacroiliac joint. At the base of the spine is a triangular bone called the sacrum. The sacrum forms a joint with a part of the pelvic bone called the ilium. You have both and right and left sacroiliac joints. There are a number of ligaments that hold the joint together. When the ligaments become overstretched the joint becomes unstable.
An unstable sacroiliac joint can produce pain and muscle tightness. The muscles work to overcome the unstable joint by becoming tighter. They attempt to stabilize the loose joint. Many people think that these tight muscles must be stretched so they continue stretching or even worse stretch more.
I have seen these syndromes develop in people who are very flexible such as dancers and those who practice yoga. In many cases people who are flexible to begin with take up stretching which creates the instability problem.
Sacroiliac instability presents as low back pain on the right or left side usually below the belt line. Sometimes the pain can radiate to the buttock, groin or back of the thigh. There is a muscle deep in the buttock region called the piriformis muscle that also can be involved. This muscle works to stabilize a loose sacroiliac joint and becomes tight and painful. In some cases the piriformis muscle can affect the sciatic nerve which runs down the back of the leg. It is important to remember that the tight muscles are the body's way to stabilize the joint.
One test for sacroiliac instability is to lie on your back and lift the right and left legs one at a time. A positive test is when the pain is worse with lifting either leg or one leg feels weaker than the other during the lift.
Treatment for sacroiliac instability is to first avoid stretching the ligaments and creating further damage. Physical therapy modalities such as ultrasound, electrical muscle stimulation and ice can help. A licensed health care provider such as a chiropractor or physical therapist can also prescribe stabilization exercises similar to those found in pilates routines. In some cases a sacroiliac support belt also called a trochanteric support can help to support the joint. This belt is worn around the widest part of the hips. In many cases the belt provides some immediate relief from pain.
If you have any of the following you could have sacroiliac instability:
1. Traumatic injury to the low back.
2. Low back pain treatment that is not working.
3. Low back pain after taking up stretching or yoga.
It is best to get a diagnosis from a licensed health care provider who can also provide the appropriate treatment to help you heal. Generally, in most cases stretching is a good thing for the low back but for some very flexible people it could cause damage to the sacroiliac joint. As with any back injury, early intervention by a qualified practitioner will prevent a minor problem from becoming an aggravating, chronic one.
