My Summer of Discontent Part 2: Anatomy of an Injury

Unsurprisingly, asymmetries are that get too extreme are bad. Most asymmetries aren’t as obvious as Sloth’s, but they are common among both the general population and athletes. No one is immune from asymmetry.

SI Joint Pain

In Part 1 of My summer of discontent I described how I had been experiencing back pain–SI joint pain more specifically–and how it has made my life miserable. At the time of writing that post, I thought I had solved the problem. Now I’m not so sure. It’s very hard to know because I’m not sure if the terrible back spasm I experienced caused my asymmetry or the spasms were the result of having pre-existing asymmetries.

Looking at in another way, I could say that I did fix the obvious asymmetry and the resulting pain (my pelvis was higher on the left than the right) but I had only addressed a symptom and not the cause.

Let me explain.

The muscle that was causing my lateral pelvic tilt is the quadratus lumborum. It is one of the thirty-three muscles that attaches to the pelvis. It originates on your pelvis (next to the SI joint) and attaches to your lowest rib and four of the upper lumbar vertebrae. Its main actions are to laterally flex your spine (side to side bending) and also extend the spine (pulling you up from a bent position). The picture below is from the rear and only shows one of the QLs because it is demonstrating that the QLs are found underneath the visible lower back muscles, the spinal erectors. So the QL is located deep to the superficial spinal erectors.

It should be easy to see how a tight QL could cause the pelvis to tilt. If one side is tight while the other side is normal, a tilt will occur. That is what happened to me. The left side QL was pulling my pelvis up on the left side, so that it tilted down to the right.

lateral pelvic tilt

My lateral tilt: left side higher than the right

Once I stretched the left side QL, the pelvis returned to a more neutral position.

neutral pelvis

A more neutral pelvis

In the bottom picture there is actually a slight tilt up on the right side. It is hardly noticeable. However, above the waistband of my shorts you can notice that the right side of my body has more of a curve than the left side. The left side above my waistband is straighter and it looks like my torso is slightly shifted to the left.

My posture in the second picture reflects the situation which I find myself in now (accompanied by an angry right side QL), and I believe it was caused by the way that I stand. I’ll explain it in the next “My Summer of Discontent” post.

It must be understood that the pain I was feeling wasn’t necessarily coming from the QL itself. My left side QL was overactive, but it didn’t hurt. It was my whole lower back that was achy and my right side SI joint was feeling sharp pain. The QL was the culprit while my lower back and SI joint were the victims. This type of scenario occurs constantly with the human body: the victim screams while the culprit remains silent. This is why finding the source of pain can be so frustrating.

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