Overall Instability and SI joint Flashcards
Excessive movements of the spine that are within the active subsystem (muscular) control. For example, a gymnast has increased mobility but also has the strength and coordination to control the mobility. There are no aberrant movements present
hypermobility
sxs or components that provide stability to the spine
- Passive subsystem – the spinal column and its ligamentous support
- Active subsystem – the muscles and the fascial systems
- Control subsystem – neural system of balance, coordination, timing, firing
diff btwn hypermobile and instable
hypermobile they can still control
instable, there is uncontrolable laxity or abberant mvmt
The zone where there is minimal resistance to motion of a given vertebra
neutral zone
function of ligg
provide the most support to the spine at the end ranges of motion where they check excessive mobility
if there are deficits to the subsxs then what occurs
increased mobility
the spondys that cause lumbar instability
spondylolysis and spondylolythesis
a displaced spondylolysis
spondylolysthesis
post oblique connection
glut max and lat contraction compresses SI
b) The biceps femoris can control the degree of sacral nutation through the ___
STL
the inner unit muscles consist of
Pelvic floor
Transversus abdominis
Multifidus
Diaphragm
the deep longitudinal group consists of
erector spinae
thoracodorsal fascia
sacrotuberous ligament
biceps femoris
the ant oblique muscles consist of
EO
IO
abd fascia
(these are quiet in sitting with legs crossed)
what are inhibitied when SIJ is unstable
glut min and med (the laterals)
purpose of inner unit muscles
stiffen spine to prepare body for mvmt
largest and most medial lumbar muscle
multifidus
L1 multifidi attachments
L4, L5, S1 & I.C.
L2 multifidi attachments
L5, S1, PSIS
L3 multifidi attachments
S1 SAP, lat. S1 & S2
L4 multifidi attachments
Lat. sacral crest to dorsal sacral foramen
L5 multifidi attachments
Inter. sacral crest inf. to S3
what is the principal action of the multifidus
principal action of the multifidus is segmental control
also prevents forward bending force as abs rotate trunk
other jobs of multifidus
cessation of Er. Sp. firing during LS FB
increases the stiffness of spinal segments
fine tuner of spine (always on)
Agg factors: Prolonged postures (sitting, standing, bending, semi-flexed postures).
Forward bending, sudden unexpected movements
instability
SI is caudal to the
psis
where is px often times with SIJ
at psis
is px uni or B with SIJ
uni
explain SIJ px
dull ache all the way to sharp px with catching
c/o heaviness or out of place feeling
AGG factors for SI
SL stance
walking
crossing legs
plant leg
ease factors of SIJ
tight pants or wearing a back support
what are some disorders related to hypomobility
rotations
up/down slips
in/out flare
nutation or coutnernutation
does SIJ issues have neuro sx
no
what lumbar segments are included with pelvic girdle
L4-L5
what ligg blends with the QL as it attaches at IC and prevents/limits all motions
iliolumbar
which lig is weakest
Ant/ventral
ratio of movement F to M (preggers)
5:1
ratio of F to M non preggers
1:1
the SIJ is a mobilie ___
stabalizer
sacral nutation is
sacral flexion
sacral counternutation is
sacral ext
with nutation, the base of the pelvis does what
spreads out to make room
ant tilt muscles
tight hip flexors tight RF
post tilt muscles
tight hams, gluts
with nutation, the innominate goes
post tilt
with counternutation the innominate goes
ant tilt
if sacrum is right rotated, the left sulcus is ___ and the right sulcus is ___
left is deep right is shallow
in an inflare, the ASIS is ___ and the psis is ____
asis medial psis lateral
with inflare, what muscles do this
hip IR
outflare muscles
hip ER
miss step off a curb could lead to
upslip
downslips are caused by
trauma
the girdle squeeze was ____ closure
form
the oblique crunch was ___closure
force
during lumbar flexion the sacrum flexes, pulling the pelvis__
post
sacral ext (or counternutation) happens in what motions/positions
supoine
at end range lumbar flexion
inhalaion
during left axial rotation, the left innominate does what
left innominate post while right goes ant
tilt is named by
ileum, not sacrum
what are some specific predisposing conditions for si/pelvis issues
preggers
gait abnormalities
leg length issues
vigourous exercise
what is the gold standard to dx si
fluroscopic block
if ___ or more px provocative tests are pos then there is a ___ chance it is SIJ
3 or more
59%
