You have been told nothing is wrong. You have had imaging. You have seen specialists. The scans came back unremarkable. You were sent to physical therapy and then told you just have to live with it. You do not. The SI joint is the most under-diagnosed source of chronic low back and hip pain — and Dynamic Shockwave+ changes that.
What SI Joint Dysfunction Actually Is
Your sacroiliac joint — where the sacrum meets the ilium on either side of your pelvis — is where every step, every squat, every lifted box transmits load from your torso into your legs. Small range of motion (2 to 4 millimeters), massive ligamentous reinforcement. When those ligaments become lax, inflamed, or injured, the joint moves slightly out of its groove. Pain radiates into the glute, the groin, the back of the thigh, sometimes into the low back.
Here is why it gets missed. MRI usually looks normal. X-rays look normal. There is no disc herniation for the radiologist to flag. Patients get diagnosed with “non-specific low back pain” or “sciatica” and sent off with muscle relaxers. Clinical estimates suggest SI joint dysfunction accounts for 15 to 30 percent of chronic low back pain — and virtually none of them are looked at correctly on first pass.
How We Treat SI Joint Dysfunction
Our protocol starts with diagnosis — not imaging. Dr. Garg runs a battery of provocation tests — FABER, Gaenslen, thigh thrust, and compression — and uses diagnostic ultrasound to visualize the joint and surrounding ligaments under dynamic load. Three or more positive tests combined with ruled-out disc and facet pathology gives us the answer most providers missed.
Treatment is Dynamic Shockwave+. Focused shockwave (Storz devices, the platform I teach on at ASTI, the American Shockwave Training Institute I founded) delivers acoustic pulses deep into the SI ligaments and surrounding fascia. Unlike radial pressure waves — which scatter at the surface and are not true shockwave — focused waves penetrate to the joint capsule itself. We pair this with EMTT, which works on a different mechanism — low-frequency electromagnetic pulsing that accelerates cellular repair in connective tissue.
For refractory cases or tears in the sacroiliac ligament complex, we add Dynamic PRP+ — ultrasound-guided high-dose platelet-rich plasma directly into the ligament. For patients whose pain has chronified and rewired their nervous system, we add Dynamic Mind+ (EXOMIND) to address the central sensitization most providers never consider.
Over 90% of our patients self-report a 75% or greater improvement following treatment.
For patients who came to us after being told nothing was wrong with their back, identifying and treating the SI joint is often the missing piece no one else looked for.
Your Recovery Timeline
SI joint ligaments respond differently than tendons or cartilage. Here is the typical arc — most patients feel the joint “tracking” differently after 3 to 4 sessions.
| Phase | Timeframe | What Happens |
|---|---|---|
| Inflammatory response | Days 1–7 | Treatment triggers repair signaling |
| Ligament stabilization | Weeks 2–6 | Collagen cross-linking begins |
| Functional return | Weeks 6–12 | Sitting, walking, lifting all improve |
| Full remodeling | 3–6 months | Ligament strength reaches new baseline |
Is It Worth It?
Consider what SI joint dysfunction actually costs you. You stop taking long drives. You stop lifting your kids. You stop running. Years of your life get constrained because no one diagnosed the right joint. Meanwhile, you accumulate bills from imaging, specialists, PT, and the occasional cortisone shot that lasted six weeks.
SI joint fusion runs $30,000 to $60,000. Recovery is 6 months minimum. Complication rates are non-trivial, and fusion eliminates joint motion permanently — transferring load to adjacent spinal segments. Dynamic Shockwave+ is self-pay, yes. It is also a fraction of the cost of fusion, and it preserves the joint instead of welding it shut.
Cherry Technologies offers payment plans. The dream outcome is simple — you sit in a car for a road trip. You lift your toddler. You run. Those are not small things when you have not been able to do them in three years.
A Real Patient Story
T.T. came to us after years of being told her back pain was structural. Every provider before us missed the actual source. Here is her experience:
“I had a great experience with Dynamic Athlete doing shockwave and EMTT for lower back pain. For years I have always attributed my pain to the structural issues with my back and it wasn’t until Dr. Garg looked further into my pain and considered other reasons, that we were able to pinpoint the issue as actually coming from my SI joint. Since doing shockwave and EMTT to my SI joint I am able to sit comfortably in a car again and haven’t dealt with the daily pain I was experiencing.” — T.T., Google review
Her daily pain is gone because we looked where no one else did.
Take the Next Step
Dr. Garg will personally evaluate your back and hip, review your imaging, and run the provocation tests most providers skip. If your pain is coming from the SI joint, he will identify it. If it is coming from somewhere else, he will identify that too — and refer you to the right specialist.
Call: (303) 997-1733
Visit: www.dynamicathlete.com
Email: StayActive@DynamicAthlete.com
Location: 1790 30th Street, Suite 270, Boulder, CO 80301
Insurance is accepted for consultations and office visits, including Medicare and Kaiser. Advanced regenerative treatments are self-pay. Payment plans are available through Cherry Technologies.
FAQs on SI Joint Dysfunction
How is SI joint dysfunction diagnosed at Dynamic Athlete?
Through physical exam provocation tests (FABER, Gaenslen, thigh thrust, compression), diagnostic ultrasound to visualize the joint under load, and exclusion of disc or facet pathology via existing imaging. Three or more positive provocation tests combined with corresponding imaging findings confirm the diagnosis. Most providers skip these tests. That is exactly why the joint is underdiagnosed.
What does the Dynamic Shockwave+ protocol involve?
A series of focused shockwave and EMTT sessions targeting the sacroiliac ligament complex and surrounding fascia — typically 4 to 6 treatments over 6 to 8 weeks. Selected patients also receive ultrasound-guided Dynamic PRP+ into the ligament directly. No sedation, no bed rest, no time off work. You come in, get treated, walk out.
How long until I feel results?
Most patients feel the joint moving differently after 3 sessions. Meaningful pain reduction by week 6 to 8. Functional improvement — driving, sitting, lifting — by week 8 to 12. Ligament tissue continues remodeling for up to 6 months. This is not a cortisone shot. It heals — it does not mask.
When is surgery warranted for SI joint dysfunction?
SI joint fusion is considered only after exhaustive non-operative treatment fails — which is rare in our clinic. Fusion eliminates joint motion permanently and transfers load to adjacent spinal segments. If you turn out to be a surgical candidate after regenerative treatment, Dr. Garg will tell you directly and refer to a spine surgeon he trusts.
Does insurance cover SI joint treatment?
Insurance covers the consultation, exam, and imaging. Medicare and Kaiser are accepted. Regenerative treatments (shockwave, EMTT, PRP) are self-pay because insurers still classify them as investigational. Cherry Technologies offers payment plans. Compared to the lifetime cost of fusion surgery, the regenerative protocol is a small fraction. Visit our pricing page for more detail.
We see patients from across the Front Range — Boulder, Longmont, Lafayette, Louisville, Broomfield, Superior, Denver, Golden, Erie, Westminster, and the mountain communities.