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I switched to the 1 kg discus this year and have developed a serious case of SI joint pain. I do back exercises religiously. My back feels good until I throw. I took two weeks off from throwing but it began hurting again after about 10 throws. I am working on technique modifications but am not having much success getting rid of the pain. I am throwing far (>190 ft) and my strength is good.

Has anyone had any experience with cortisone injections into the joint?

Brian McKinley mentioned prolotherapy; I did a lit search but didn't find any evidence that it worked. Has anyone had any experience with this?

I am also considering trying an SI brace, but I doubt it will do much good supporting the joint during a full effort throw.

I watched Jay Sylvester's interview at the throw coach meeting. He talked about using a fast, light approach to the discus. That approach might be superior to my "plop and pull" method..

I also started a vigorous walking program. Stuart McGill (back guy from Canada) said that fast walking with a vigorous arm swing is one of the best exercises for people with bad backs. It might also help me lose some winter fat (from the winter of '84).

Any suggestions would be appreciated.

That is a bummer. I hope you can find some treatment that works. Even if I had a great suggestion I would hesitate to offer it because of how tricky back injuries can be.

I would be equally interested in learning what throwing the 1kg did to cause it. Did you change your posture with the lighter implement? Is the increased speed producing forces you're not able to handle after the release? It seems to me that if you can't get to the bottom of it you're likely to do it again.

Hi, Tom,

I hope you find relief!

Since you mentioned the prolotherapy, I'll report my results, so far.

My physical therapist was treating damaged and chronically tight muscles around and below my left hip (lead hurdling leg) and told me that the source of the problem was a combination of weak core and hypermobile SI joint. His treatments relieved the muscle pain, and one-on-one sessions with the pilates instructor he recommended helped start the core strengthening process. By the time I was able to get an appointment with the doctor that he recommended for prolotherapy, I was pain-free and felt fairly strong, but my PT assured me that the hypermobile SI would lead to continued problems, if I continue hurdling.

Because the PT's treatment and his recommended pilates work were so successful, I trust his judgment and started the prolo in late August. The treatments have involved injections of dextrose in the region of the ligaments that support the SI joint. The theory is that the irritated tissue will shorten and thicken slightly in response, thus reducing the hypermobility. I had 4 treatments at two week intervals, another after a month interval, and the final treatment is scheduled for next week.

I have trained a fairly typical off-season regimen (weights and some track work) throughout the treatments, with the exception that I haven't gone over a hurdle since the Charlotte meet in 2006. When my PT examined the joint a month ago, he said that it has definitely improved. Since I was pain-free before the prolo started, I have a hard time judging actual success of the treatment. I'll let you know when the doctor releases me to start hurdling again.

A couple of interesting notes:
* From the beginning, my physical therapist, an active triathlete, was more optimistic than the non-athlete doctor about the possible success of the prolotherapy.
* As you pointed out, the literature suggests that this treatment is not mainstream. My insurance company does not cover any of the costs.

My PT also recommended wearing an SI stabilization belt full-time for about 6 months. I've been doing that as well, but can't offer any objective assessment of its success either, since I'm not hurdling yet.

Tom, from my experience, the pilates mat work has produced the most obvious improvements. My instructor had excellent techniques for helping me understand how to activate specific muscles to make the effective overall strength of the core system much better. Perhaps in your line of work, you already understand this.

Good luck,

Brian McKinley
M55 hurdler

I found an osteopath who did some interesting counter strain therapy on my left side to get rid of a very long standing SI joint pain that shut me down for three years. I have been pain free for over 2 years since.

I took a kettlebell training course last month. After doing 1000s of kettlebell swings and snatches, my SI joint pain went away. It no longer hurts when I throw.

Tom Fahey M60