4- Sacrum ME

Question 1

Need 3 things to diagnose the sacrum

Answer 1

1. Deep Sulcus
2. Posterior ILA
3. spring OR sphinx OR seated flexion OR oblique axis test

Question 2

what does a standing flexion test tell you

Answer 2

Tell you it is an iliosacral or sacroiliac dysfunction.

Question 3

what does a seated flexion test tell you

Answer 3

Tells you it is a sacroiliac problem- Positive side is side of dysfunction.

Question 4

3 tests done while supine

Answer 4

hip flop, ASIS, medial malleoli/pebic tubercles

Question 5

4 tests while prone

Answer 5

Iliac crest, PSIS, sacral sulci, ILA

Question 6

What does a positive seated flexion tell you and what would you evaluate after

Answer 6

sacroiliac dysfunction, diagnose the sacrum

Question 7

What does a negative seated flexion tell you, and what would you evaluate after

Answer 7

iliosacral dysfunction, evaluate innominate

Question 8

What does a spring test tell you

Answer 8

Nice Normal Negative– formward sacral torsion

Painful Posterior Positive– backward sacral torsion

Question 9

Sphinx, assymetries decrease, diagnosis and why

Answer 9

Forward Torsion, extension of the lumbar spine so the sacrum goes into flexion

Question 10

Sphinx, assymetries increase, diagnosis and why

Answer 10

Backward torsion, sacrum is stuck in extension

Question 11

what does an oblique test tell you

Answer 11

if the deep sulcus persists, this means that the sacrum is rotated forward and the sacral base at the sulcus is restricted

Question 12

How do you set up muscle energy for a forward sacral torsion

Answer 12

Sim’s axis side down, pt pushes up

Question 13

How do you set up muscle energy for a backward sacral torsion

Answer 13

Lateral recumbent, axis side down, pt pushes up

Question 14

How to treat a bilaterally flexed sacrum

Answer 14

applying anterior pressure to the ILAs bilaterally

Question 15

How to treat a biltaerally extended sacrum

Answer 15

index and middle fingers in the sulci bilaterally with the other hand reinforcing, and continuously applying an anterior pressure

Question 16

when we inhale the sacrum ______

Answer 16

moves backwars/extends (lumbar in flexion)

Question 17

when we exhale the sacrum ______

Answer 17

moves forward/flexion (lumbar in extension)

Question 18

how to treat general sacral torsion

Answer 18

prone with knees bent, exert a lateral force on the legs and have the pt push medially OR spread them tubes like a mofo

Question 19

how to treat unilateral flexion and extension

Answer 19

place one hand on salcral sulci (for extended) or ILA (for flexion) and with the ipsilateral leg perform abduction and internal rotation

Question 20

Three rules of sacral torsion

Answer 20

oL5 sidebending will engage oblique axis on that same side
oL5 rotation and sacral rotation is opposite
o Seated flexion test is opposite the side of the oblique axis

Question 21

How does sacral torsion differ between neutral and non-neutral mechanics

Answer 21

Neutral- superior pole moves forward relative to L5

Non-Neutral: Superior pole moves backward relative to L5

Question 22

Diagnosis: L5NSlRl, _____ mechanics, ___ oblique axis is engaged, (+) seated flexion on the _____, sacrum rotates____, Right superior pole moves____, and the sacral diagnosis is______

Answer 22

Neutral, Left, Right, Right, Forward, Left on Left

Question 23

What is the difference in lordotic curve between forward and backward sacral torsion (same applies for bilateral sacral flexion and extension)

Answer 23

Forward torsion– increases lordosis

Backward torsion– decreases lordosis

Question 24

Symptoms for forward and backward sacral torsion

Answer 24

Forward– SI, inguinal, and groin discomfort

Backward– low back pain when bending backwards

Question 25

in short leg syndrome the deep sulcus is on which side, and how do you know which axis is engaged

Answer 25

the side of the short leg, engaged axis will be the side of the long leg,