Sarah (Singapore): Sorry to report that I have had a nasty accident today here in Borneo, after being thrown from a banana boat ride and my son landing full force on my lower back. I can move everything but am in totally agony - had pethadine injections (more pain relief than I had giving birth!). Pelvis not broken according to X-rays but I am not convinced as the pain is unbelievable and cannot walk.

I have been trying but cannot lift my butt at all without severe pain.  So doing it just with the actions (I can lift it maybe a mm) and the tail scoop. I was wheel chaired into the pool yesterday which was awesome and I stood up and did some thigh stretches and tail scoops and even got to draw my butt cheek down. It felt good but not much change.

I am certain myself that my sacrum is out on the left side and my psoas

Psoas Major

is massively spasming. I can feel my psoas by my spine and just pressing it lightly I know it's spasming!! The worst pain is the occasions the sacrum catches. I am on drugs which don't seem to be helping ....

I'm on steroids for swelling - but I am worried about taking these prednisolene dhasolone. I'm on painkillers which only take the edge off: Ultracetm muscle relaxants alprazolam which are amazing but run out today.

I am also a bit scared as when I sit I just cannot lift my legs/feet to get them on the wheelchair foot rests. I have to lift my own thighs otherwise the pain in my back is a killer. I have a high pain threshold normally doctors always tell me. When lying in bed moving my legs is painful too. Is that the psoas?? I can walk a bit with a stick.

I am certain my sacrum is out as my 17 year old son landed with his knee in my back. If I touch to the left of my spine which i think is the top of my psoas it is very painful.

I am most worried about not being able to lift my own legs without pain as described when sitting in wheel chair. I promise I have a high pain threshold normally - gave birth 3 times with only pethadine so I am not being a wimp!

As I sit here my pain level is a 2 out of 10 as I can feel tight tight back and spine. It's when I stand up into a position similar the utkatasana I get a catching shooting pain and certainly cannot twist. Walking is getting better but again if I catch the pain level is 11 out of 10!

Iliacus

Martin: I'm so sorry to hear you are in pain, Sarah. Is your pain directly on the surface on your spine (or beside it)? Your psoas inserts on all lumbar vertebrae, L1-L5 as well as T12.

Sarah: Pain is on left of spine all the way from L1-L5.

Martin: When you get the catch, where do you feel that the most?  Is it back? front? both? Do you get pain in your low abdomen and groin with the catch?

Sarah: No severe grasping pain in groin or abdomen with catch (but I have tried side stretching and can 'feel' my groin then but not pain. Catch is in back of left pelvis in the SI joint - definitely not spinal. Really feels like the join between sacrum and pelvis. Being weightless in pool really helps and I have tried doing standing thigh stretch with tailbone scoop - in fact I was tailbone scooping all the way to hospital in the ambulance thinking of you!!! Thank goodness for your therapy training!

Martin: Is the pain around your sacrum primarily on one side? Is it worse when you get the catch?

Sarah: All on left where I got the impact. As I sit here in wheelchair I am pain free - excruciating as it catches but my husband just held a warm shower hose to my back and that has really helped ease the tightness. I am feeling much more confident that I know what it is now but it is a real lesson in just how much pain people can be in.

I imagine you have several things going on.  You may have bruising on your back, spasm in your psoas and lumbar muscles, and a subluxed SI joint.  The psoas and SI compound each other. 

Sarah: I have been trying to keep moving do you think I should stop?

 

Martin: First thing is to get your psoas quiet and that may just require some serious down time until inflammation subsides and your nervous system calms down.  Your best bet is to be on your back with some weight on the tops of your low abdomen.  Sandbags work nicely. Here is what I recommend:

Get down on the floor and use your hands to help you lie on your side. Gently roll from there to your back and lie still with your knees bent. Be in a quiet comfortable place with low light no interruptions. Place some comforting weight on your low abdomen. This can be your hands or a sandbag or small bag of pet food. Let your energy settle. Eye pillows can help too. Let gravity have your body and just be there for at least 30 minutes. Your nervous system needs to calm.

When you feel very settled and pain free, you come up by rolling to your side. From there use both hands to come up as slowly as needed to stay calm and pain free. This technique is a way for you to calm your system and let your muscles release from the trauma. You may need to do this

several times a day for a few days until you are feeling better. Once you get to a more stable place, contact me again and I can give you some more active healing tips

to can take care of your SI and your psoas more. You may need someone to help. One of your fellow teachers there would be good choices. I can guide them via skype for some more healing work. I certainly hope you are feeling better very soon.

With Love,  

Martin