I first want to say that I wish I could see the physios in this forum. Some of you have been insanely kind to answer my posts in the past and you all seem very knowledgable. So thanks for that.

But now I have a pretty important decision: I wanted to get some feedback on whether I should fire my physiotherapist.

I have been seeing him for two weeks now for SIJ dysfunction. Right now it's in anterior tilt and my right leg (painful side) appears 3/4ths and inch shorter than my left -- X-ray showed this is not anatomical, no true leg length inequality. In the two weeks since I started seeing him I've been to him six times - every Monday, Wednesday, and Friday.

All he has me doing is 1 exercise and 3 stretches: glute med exercises, hamstring stretches, psaos stretches, and IT band stretches.

Now, I have progressed from clams to lateral leg raises to lateral leg raises with a resistance band, but other than that he won't give me ANY other exercises (like glute max or ab exercises -- which I understand are essential to fixing SIJ) until he sees "more improvement in my hamstrings."

Every single time I see him all he does is put heat on my back and does some light myofacial release on my glutes (I do my glute med exercises at home). Then he tests my hamstrings, frowns, and says "Okay, see you in a few days."

When I started seeing him he said my right and left hamstring were both at 80°. He wants them both at 50°. In the two weeks since I first saw him - stretching every two hours - I've gotten the left one down (up?) to 55°, but the right one only has improved to 70°. The right side is where I have my problem and I feel that maybe - just maybe - the right hamstring won't get any looser until I start strengthening my glute max so the SIJ can be held in the correct position.

When I confront him about this, his reasoning is that until the right hamstring is as loose as he wants it any glute or ab exercises would be pointless because I would be training my muscles with my SIJ out of position and that won't get it any better.

Is that true? Can that be true? Ideally, totally loose hamstrings would be great, I admit, but wouldn't training the glutes and abs maybe help take some pressure off my psoas and hamstrings - which might make my hamstrings easier to lengthen, not to mention giving my SIJ some support when I walk and sit?
I just don't see how getting that right hamstring a little looser is going to magically move my SIJ into position where it's safe to do glute and ab exercises.

I keep telling him that all I have is 20 PT appointments a year - and I've already used 6 on him. If I use another 6 and he doesn't like my hamstring length, I'll be wasting a lot of my visits. I also want to point out that he does not want me doing any walking, bike riding, or any other exercises besides the glute meds and the three stretches. I actually feel like because I've been so sedentary for the last two weeks (besides the stretches and glute med exercises) that I've lost MORE function in my glute max and abs.

I fully admit that my physio knows more about rehab than I do, but I'm just really frustrated and any advice would be very appreciated. I also want to make sure I'm not being milked by him to stretch my therapy out so he can make more off the insurance.

(BTW - I'm in the US right now, so I have private insurance - which is why I have limited PT appointments. -- US health care is....lacking....)

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