Innominate Mechanics

Question 1

Iliolumbar Ligament

Answer 1

Attaches from anterior iliac crest to transverse processes of L4,and anterior sacral base
Referred pain to groin, low back, and lateral hip
Via sclerotomes and ilio-inguinal nerve

Question 2

Rotate anteriorly and posteriorly about the inferior transverse axis of the sacrum, at level of S3 TP
Induced by hip motion such as during gait

Answer 2

innominate Motion

Question 3

Heel Strike

Answer 3

Weight bearing increases anterior rotation about the inferior transverse sacral axis (S3)
Sacrum rotates about alternate oblique axes
Shear forces are taking place at pubes

Question 4

Non physiologic dysfunction

Answer 4

innominate and pubic shears

Question 5

Motion restriction and asymmetry of the sacroiliac joint and pubic symphysis can manifest…

Answer 5

SI joint
Innominates anteriorly
Pubic symphysis
Internal/external rotation asymmetry of the lower extremities

Question 6

tissue texture changes are clues to

Answer 6

Iliolumbar ligament
Sacral sulcus
Anterior lumbar tenderpoints (AL1-5)

Question 7

Patient supine, Positive on side of restriction
Optional: Can assess/listen for respiratory motion at each side

Answer 7

ASIS compression test

Question 8

Identifies side of dysfunction of the sacroiliac joint,
PSIS rising ipsilaterally is a positive test
Caused by SIJ locking and tissue tension on that side
This pulls the locked innominate forward prematurely with flexion of the spine

Answer 8

Standing Flexion test

Question 9

How to do prone testing for innominate dysfunction?

Answer 9

Involves patient prone, with One finger over PSIS and other on sacral sulcus. Lift lower extremity and move in different directions to test anterior-posterior rotation, medial/lateral motion, and internal/external rotatory motion. The dysfunctional side will be restricted

Question 10

posterior innominate presentations

Answer 10

Inguinal groin pain due rectus femoris stretch/dysfunction, Medial knee pain due to sartorius stretch/dysfunction. A cause can be tight hamstrings

Question 11

presentations of anterior innominate rotation

Answer 11

Iliolumbar ligament tenderness same side
Tissue texture changes at the ipsilateral ILA of the sacrum
Hip extensor muscles can be stretched and irritated Especially hamstrings
A cause of anterior innominate rotation can be: Tight rectus femoris

Question 12

dysfunctions are non-physiological
They occur in directions not normally associated with sacroiliac motion
Should be treated before physiologic dysfunction

Answer 12

shears