SIJ issues

[Kriszty]

Thanks to you both.
I suggested the steroid injection to the surgeon but he did not think it was warranted.
Happily she seems to be doing a lot better, jumping better as well, with the rehab etc. I have stopped the DMSO and she is just on previcox and amantadine, will be stopping the amantadine shortly. She has put on a LOT of muscle and is just generally a lot stronger. I do wonder how much the hock arthritis is contributing to it, and whether she is doing better because it is being treated.
Fingers crossed for the nationals in 3 weeks!
Kriszty

[Kriszty]

Hi Laurie, David , anyone else reading.

I have an update for this case (my dog) that I thought would be interesting, and need some advice please.
I found another professional (physio this time) to assess both my dogs as I was not happy about how they were pulling up after competitions/training.
She did a very thorough clinical exam, and assessed the MRI for Rosi.
She thinks the offweighting on the LH is caused by spinal disease, she had spondylosis on the L lateral aspect of L7-S1. Increased exercise causes her to have pain on medial adductor palpation due to nerve pain from the spine. NOT an adductor tear, as you suspected all along Laurie. So she must have nerve pain radiating down the LHS most of the time, with it getting worse with more exercise. MRI report below:

Thoracolumbar spine
There is mild dorsal bulging of the T13-L1 intervertebral disc with the subarachnoid space maintained at
this site. The remainder of the thoracolumbar spine is within normal limits.
Lumbosacral spine
There is mild to moderate spondylosis deformans on the left ventral and lateral aspect of L7-S1. There is mild to moderate dorsal bulging of the L7-S1 intervertebral disc into the mid ventral vertebral canal. The
L7-S1 perineural fat is maintained. The right and left intervertebral foramen at L7-S1 are within normal
limits. The L6, L7 and S1 nerve roots are within normal limits. The pelvis musculature, including the gluteal
muscles and iliopsoas muscles, are within normal limits. There are no abnormal regions of contrast
enhancement.

1. Mild lumbosacral intervertebral disc bulging and mild-moderate left degenerative changes without
evidence of compressive radiculopathy.
2. Mild T13-L1 bulging intervertebral disc without compressive myelopathy.
There is no evidence of a dynamic lesion at the lumbosacral junction.

Unhappily, her daughter Zen has also been offweighting her LH. I radiographed her yesterday and found ?mild spondylosis in the same area (I think). She has just turned 3 and does seem very hypermobile in her pelvis. She also seems to have an area of mineralised opacity on the RHS. She has no pain on palp/extension of psoas (did have an old injury there). She often has pain on epaxial palp and the orthopod who examined her yesterday felt she had lumbo-sacral pain.
Rads attached.

My questions are around treatment. The physio I am seeing likes e-stim so we are doing a lot of that (on painrelief not tetany settings). The exercises she prescribed made Zen worse (started with cookie stretches, then raising 1 front leg, then diagnonal legs then front legs up on box). Zen has been actively avoiding doing them and they were causing the offweighting to look worse afterwards. I was wondering if UWTM would help, to cause an increase in muscle bulk to help stabilise her pelvis. Still dont have a laser. As she is hypermobile I guess mobilising the area is not helpful (apart from low grade for pain relief). Not sure if I will be able to get hold of shock wave again.
TIA!

[Kriszty]

I took Zen to the chiro last night to get some more input. He felt she was sore LSIJ and mild L-S. And that she had a tight/sore ITB (?) and gluteals. He mobilised , used the activator and put some needles in.
I tested her motor control and timing and she has a MARKED drop with L leg standing, corrected by stimulating the abs. Could this be the cause of the SIJ issues, or the other way around (I think you said both Laurie?). She backs up straight. Her hamstrings are very tight. She has been off on LH for months now (has seen many people) but it seems to be getting worse. (poss started post spey?)
My thinking is she needs lots of abdominal and gluteal strengthening. She is weight bearing better post adjustment, but as soon as I tried to do any strengthening exercises at all (eg MCAT, 3 leg standing), she uses a base wide stance and offloads more straight afterwards. The chiro suggested NSAIDs, and a more all over exercise program (eg UWTM) rather than targeting a specific muscle group, but I thought you had to target to get results. Thoughts will be much appreciated. I will keep going with the e stim and pulse mag.

[lehughes]

Hello again!

Wow, this is a long thread... and I'm so sorry you're still having issues!

Yes, the abdominal or gluteal weakness can cause an SIJ issue or SIJ pain could cause inhibition of the abdominals / gluteals.

Interesting it may have come about after the spay.
This makes me think that scar tissue intra-abdominally could be an issue.
So... do you find someone to do osteopathy / visceral manipulation? Or someone that could do myofascial release techniques?
Weird thought: I had one dog that had continual back issues and in the end had a 'stump pyometra' that when they went back in and removed the stump, she was much better!!

I think you are at a point of really thinking outside of the box!!!

In regards to strengthening you may need both general strengthening and targeted strengthening. No, UWT won't specifically strengthen glutes or abs. But it's not useless... it just doesn't deal with the root of the problem.

So... maybe go with the strengthening but also look into osteopathy and myofascial release.

Laurie