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Spinal Hypermobility? Prolotherapy?

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#1 AllyGirl


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Posted 05 November 2011 - 08:39 AM

I've been off running now for about 7 months with a diagnosis from a sports dr of high hamstring tendinopathy on the right side.  I've done the resting thing and the exercises and the stretching and it's ok and slowly getting better.  As it started to recover I got serious tightness and pain in right glute, hip and lower back.  I have had pain in the right SI joint for as long as I can remember and was using chiropractic manipulation to treat it and it held it off (but didn't really fix it).  I've regularly done a lot of weights and core work too.  So I went back to the physio about the tightness and we did lots of trigger point therapy and all of the tightness has settled, except that which is directly affected by my SI joint which is hugely inflamed.  So basically, when I'm all straight, my SI joint is unhappy.  Apparently this makes me 'special'.  I have other words for it ....

Anywhoo .... my physio has referred me to a back specialist who uses prolotherapy (glucose based injections to create additional support structures around the spine) to deal with what appears to be hypermobility of the lower spine.  Once we have this under way we're going to combine it with Pilates to really secure this area.  I've read lots about this, and there are lots of success stories, but they're put forward by clinics that offer the treatment.

I'd love it if someone could share their experiences with either this type of injury or prolotherapy as a solution.

What I'd really love is to go for a run ... one day ??

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#2 FitToRunPhysio


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Posted 09 November 2011 - 01:33 PM

Prolotherapy works for some, but not others.  
I would definitely start more "core stability" exercises.  You need to work on lumbopelvic control (hip and back).  It's also important to check your leg length as this can sometimes influence the SIJ.  
In most circumstances back pain can be treated by physios with manual therapy and exercises.
There is no harm in meeting with a specialist, but make sure you get all the facts.  
Let me know if you need more details about Pilates in Brisbane.
F2R Physio

#3 NeillS


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Posted 09 November 2011 - 02:49 PM

In my experience with these stubborn unstable SIJ issues, here are a few things I've figured out over the years:

1) Most SIJ problems are not SIJ problems, they are either deep glute/piriformis trigger points/tears or referred lumbar spine pain caused by a myriad of different things

2) The very few that I haven't been able to fix by treating the points in (1) (which is probably 10 over 7 years) I have instigated an SIJ stability program (see Brukner and Khan textbook Clinical Sports Medicine) over 12 weeks exactly as they describe. 6 or 7 of the 10 have gotten 90-100% better with this program.

3) The other 3 have gone down the route of radiofrequency denervation/SIJ diagnostic block and have responded temporarily to cortizone to varying degrees.

I would strongly NOT suggest prolotherapy. I've never heard of anyone having a good result around the spine from it. Try finding someone who will dry needle your glute med/min/piriformis and see if that helps. Seek MRI of the lumbar spine and SIJ before doing anything invasive. You may find it's an L5 disc in isolation which can be treated and fixed with cortizone/microdiscectomy if it's stubborn. Do nothing until you've had scans to rule all these things in or out of play!