M4: Reading Guide 3: PGP Flashcards
When should the diagnosis of PGP take place relative to lumbar spine examination?
after exclusion of symptomatic lumbar spine
Contraction of what four superficial muscles increase SIJ stiffness?
- ES
- lats
- biceps femoris
- glute max
Contraction of what deep muscle increases SIJ stiffness?
TrA
How is the 4-item test cluster used to rule in SIJ dysfunction?
only 2 of the 4 tests need to be positive for a dx of SIJ related pain
How is the 6-item cluster used to rule out SIJ dysfunction?
If all 6 tests don’t produce familiar pain, SIJ can be ruled out
What are the test of the 4-item cluster for SIJ?
- thigh thrust
- distraction
- sacral thrust
- compression
general characteristics of nonspecific inflammatory PGP
constant, unremitting pain
- increased with WB, compression, and provocation tests
- relieved by NSAIDs or local steroid injection
- does not have specific inflammatory disorder or known etiology
general characteristics of centrally mediated PGP
- widespread severe and constant nonmechanical pain
- peripheral cause of pathology not identified
secondary to central sensitization:
- widespread allodynia
- generalized hyperalgesia
- physical impairment
- inconsistent motor control deficits
What are the basic characteristics of Peripherally Mediated PGP?
- well defined, localized SIJ pain
- no c/o PS pain
- usu unilateral, intermittent, and agg/ease with specific postures
- not usually provoked or associated with spinal movement
- mech or timing of onset is clear
- consistent local motor control changes
What are the mechanisms of injury associated with PGP?
- falls or lifting with torsional stresses
- trauma
- sudden heavy lifting
- prolonged lifting and bending
- rising from a stooped position
- MVA with same side on the brake
- repeated torsional stresses (golf, bowling, etc)
How useful is the history for distinguishing between LBP and PGP?
little to no statistically significant dx value for PGP
What is form closure?
stability from anatomy (sacrum and ilium articulating)
How is form closure targeted with tx?
- joint mobs
- manipulation
- soft tissue techniques
What is force closure?
- stability from structures surrounding joints
How is force closure targeted with tx?
- addressing motor control deficits
- most important during mvt/activity such as walking/weight shifting
