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Question: I have SI hypermobility that keeps recurring, despite my being active at age 54, ( I like to walk, bike, do basic yoga, and weight training). I had prolotherapy in 2002 and 2007, with good results, but my symptoms are back, and more severe than ever. Do I need an Xray or MRI?
My local PT had me doing lunges on the affected side to stretch the hip flexors, but with no improvement. I'm thinking of getting another series of prolotherapy injections, but would like to follow it up with specific and customized PT to get better. What do you recommend? I cannot stand or walk without pain and "clunking".
Thanks Melissa

Answer:
Melissa thanks for your question. You should consult with your physician to determine the cause of your new or worsening symptoms, as well as, if further diagnostic testing is indicated. The SI Joint hypermobility can be caused by many factors including ligament laxity, muscular weakness/inhibition, and sensorimotor impairments. We would recommend consulting a physical therapist with advanced training in manual therapy diagnosis and treatment to address your specific lumbar spine, pelvic, and hip impairments. After this diagnosis and treatment, the physical therapist would place you on a speficic exercise program for your individual condition including self corrections, stretching, and strengthening. To answer your question, lunges may be too advanced given the inhibition of the gluteus maximus and medius associated with an SI dysfunction. Lunges can be included as part of a functional training program if the gluteus maximus and medius are able to dynamically stabilize and move the pelvis.
Please visit our website www.sidysfunction.com or contact our office to schedule your phone consultation for additional information.