By Silvia on Thursday, January 31, 2002 - 12:22 pm:

I've been reading through some messages on this site regarding SIJ dysfunction and prolotherapy.

I've read that only the short posterior and the long posterior SI ligaments should be treated. Does this apply to those who suffer from hypermobility syndrome? Or is this just for those who have injured their SIJ but don't have a connective tissue disorder?

The reason I ask is that with HMS we tend to have looser ligaments than a normal person.

Any input would be appreciated, and Park if you read this one I would like your opinion on it. You really seem to know a lot about this.

Thanks,
Silvia

By Park Griffin on Thursday, January 31, 2002 - 01:26 pm:

Silvia, there is always a possibility that some ligamentous injections may need done in other ligaments, too; beyond the normal long and short posterior SI ligaments. The long posterior SI ligament helps limit the anterior rotation of the pelvic bone (innominate). The short posterior SI ligaments help limit the lateral sacral cant. Also, tightening the short posterior SI ligaments can help take the "slop" out of a hypermobile SI Joint. The problem with the other ligaments is that they have a much more detailed role to play regarding normal lumbosacral function, and indiscriment injections into these ligaments can bring on permanent dysfunction. The nice thing about the ligaments is that when everything is in balance and alignment, the only thing affecting the proper neutral tension of the ligaments is the superincumbent weight of the spine directed into the sacral wedge. Again, in the standing position there is a very delicate balance of tension that should be on the sacrotuberous, sacrospinous, posterior interosseous, and iliolumbar ligaments. If any of these ligaments is tightened too much with prolotherapy, the result could be a permanent lumbosacral dysfunction. The important factors when deciding to inject other than the short and/or long posterior SI ligaments are this: Are the SI Joints in the self-bracing position? If the SIJ's are properly aligned and one of the ligaments still feels sloppy, prolo may be warranted, and the other factor: Your prolotherapist needs to know when to stop.

Park

By Silvia on Friday, February 01, 2002 - 05:30 am:

Park,

Thank you very much for your response. I'm going to bring this up with my prolo doctor. I should have also mentioned that I have a leg length discrepancy. My right leg is slightly longer than the left, and my hip is slightly higher as well. I wonder if this has something to do with the problems I'm having. Plus, I was born with my right leg dislocated and had to wear a brace for over a year. I also wonder if this has something to do with all of these problems I'm having.

Anyhow, thank you very much for taking the time to respond and for all the information you have provided.

Silvia

By Silvia on Friday, February 01, 2002 - 05:33 am:

Park,

I forgot to ask, how do I know if the SI's are in the self bracing position?

Thanks,
Silvia