What does my x-ray mean? And why wouldn't these same results show up on an MRI?

[MrPhysio+]

hi Loft33,
Happy New Year to you.
Sorry for the delay, holiday time has been busy here in Oz.

I will comment within your text, below.

I've had two chiropractors tell me it's my SI joint. Agreed, to a point. And about a year ago I went to a physio and she had me do a side-lying leg raise to test my glute med muscles. Even as she was doing it I could tell (and obviously she could) that my right glute med "was about 80% weaker than my left glute med." I remember how astonished I was at the difference in strength between sides. With my left one I could resist against her pushing down. With my right one I couldn't even resister her push for a second. It was like my right glutes were jelly. My right SI joint is the one I have a problem with. If the SIJ is affected the body may inhibit the muscle strength on that side to protect against further injury. Continued inhibition of the muscle leads to disuse atrophy ie further strength loss increasing dysfunction in a downward spiral.

{BTW - I had an MRI of my low spine done July 1st, 2011 for a separate issue (burning pain in toes - turned out to be very tight calf muscles). Everything was normal (except they didn't mention the transitional S1 segment - that's why I freaked out about the x-ray). But there were no disk or nerve issues. So, I am pretty convinced this issue now is muscle imbalances causing SIJ problems on my right side.}

I've made a work out program for myself, which I plan to start next week. I was hoping you might review it. My goal is solely to achieve muscle balance to start.

Monday/Wednesday/Friday
At home:

* Planks 3 reps x 30 seconds
* Clams 3 sets x 20 reps each side
* Bridges 3 set x 20 reps
* Back-lying Pelvic Tilt with extended knee (weight on ankle, stabilizing pelvis when I raise leg) 50 reps each leg
* Dead Bug 50 reps
* Side-lying Straight leg raise (abduction) 3 sets x 20 reps each side
* Side plank 3 reps x 10 seconds each side
* Monster walk with band around ankles 3 sets of 20 feet in each direction
All the above are fine except the Monster walk. I have a problem with this exercise, especially in the initial stages of core stability as lunge type movements will stress the SIJ. Standing / running on uneven ground, swinging the leg in /out of a car, prolonged standing with one knee bent etc can irritate the SIJ. Once core stability is increased and the SI joint ligaments have stopped being inflamed (can take months), more difficult exercises can be introduced.
Then, at gym:

* Stair machine or bike for warm up I do not like stair machines due to the pelvic torsion. I have found a higher proportion of Si joint injury in those using stair machines. the bike is not as bad, however i advise against bike exercise in the earlier stages. Rowing machine is preferred.
* Abductor machine Ad / adduction machines okay if done with perfect form ie only if you have fairly good core stability.
* Adductor machine
* Quad machine
* Hamstring machine

(I add those gym machine exercises because when I used to go to the gym, doing those in that specific order seemed to "reset" my SIJ when it felt out of alignment)

Tuesday/Thursday/Saturday

* 1 hour walk Okay if on flat ground without cambered surface until good core stability.
* Stretching (I say "stretching" but what I used to like to do was compression for about 30 minutes with various-sized balls and foam rollers on my muscles (glutes, QL, hams, quads, etc) followed by about 30 minutes of stretching). It doesn't sound like a lot, but it's actually quite the "workout". Takes about 1 hour total. avoid lunges!

I'm about 40 pounds over weight right now, so I'm looking for slow weight loss (2-3 per week) and stabilization of my body.
Good idea.

So what do you think of the program I lined out to start with? I was thinking of doing it for 2-3 weeks and then slowly adding more/harder exercises. Should be okay given the above comments and cautions.

Also just a couple questions:

If my right glute med/min is so much weaker than my left, should I be doing exercises for the left side? I mean, if I'm doing a total of 60 reps of side-lying abduction on my right (weaker) side, should I do the same amount for my left (stronger) side?
It is generally considered that you should maintain the strength of the unaffected side whilst bringing up the strength of the affected side. To achieve the rebalance you will need to do more exercise on the affected side. Keep progressions (reps, weights, times etc) within 15% of the current level and stay at that level until it is fairly easy then progress another 10 - 15%. This will reduce post exercise induced soreness and avoid reinjury.

I know for most exercises you should give yourself at least a day's worth of rest between them, but for the exercises that are working the smaller stabilizing muscles (like clams and monster walks) should I be doing those every day? And what about planks? Should those be done every day or should there be a rest period? All muscles react the same way for strengthening. If you are trying to bulk them up, give a days rest for rebuild and recovery. You can walk every day if not loading heavily with hills. If so, give days rest for heavy walking, and have one heavy then one light day. Be guided by how your muscles feel. Planks can really load the abdominals, so be careful.

Hopefully the above will help in your recovery. Once again, sorry for the delay in response. Feel free to ask questions if any more arise.
Cheers,
MrPhysio+