Question
Hello,

I'm male, 21 years old, 6 feet, 250 pounds with a body fat percentage greater than 30%.

I was at my college gym not long ago and got onto a rowing machine. I strapped my feet in position and then noticed the handlebar wasn抰 returned to position and was further out of reach. I made a statement about this and the person rowing next to me heard, and as I was reaching forward trying to grab the handlebar, the person rowing to my left gave me a sudden hard push forward on the left side of the middle of my back without warning. I felt about two simple crackles (like the feeling of joints crackling) to the left of my lower back but no pain at the time. When I got home that day and laid flat facedown on my bed I may have noticed a stretch on my lower back.

It is a few days later now, this happened on a Saturday afternoon and I feel lower back/pelvic pain noticeably getting out of bed today on Wednesday morning. I抦 not sure if this could possibly be from bad stretches the day before, or the gym incident, so I wanted to know your opinion on if this could be related and the possibilities of what happened concerning the description of the physical actions and the crackles that took place. I抦 including a link to a small simple photo where I have marked the approximate area I felt them:  http://img87.imageshack.us/img87/6327/75456040ay1.png

Thank you

Answer
Dear John,

Everything you have described points to a strain of the sacroilliac  (SI) joint in the pelvis.  The joint itself is probably the strongest in the body, and has the strongest ligamentous attachments and fascial coverings.  However, if you strain the area it can become very painful and inflammed, and can send pain over the entire low back and leg and easy effect normal walking.  This is often mistaken for disk and nerve root generated pain patterns.

These injuries are usually easy to recover form though.  It will take some time, but as long as the joint can move freely and you take the necessary steps to keep the joint functional, the pain should alleviate, and a return to normal activity can be accomplished.

The first thing I would recommend for you to do is to ice the area and do not use heat.  The second thing is to find a good local chiropractic physician to examine the area and determine if the SI joint is truely the problem with a functional examination fo the low back and pelvis.  Adjusting the SI joint often significantly reduces pain in the first few vists, and will normalize the function of the joint.  At that point it is appropriate to stretch the low back and hips to decrease any tightness surrounding the joint space and to help pull inflammation out of the tissue.

Good Luck John!

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net