pelvis and sacrum Flashcards
SIJ Region Subjective Screening
often identified pain below belt line
radiate into back, groin and thigh
aching quality
no N/T/B
pain often with transitional changes/movement
exacerbated by bending laterally or backwards
SIJ irritation movement
Prolonged sitting, bending forward, transfers in and out of bed, stair climbing, lowering to toilet, vacuuming, sweeping, pulling weeds, loading dishwasher
differential diagnosis of lumbar spine S/S
Low back pain
Symptoms can radiate in buttock, groin, leg, below knee
+/- neurological deficits reported
Pain with prolonged sitting or standing
+/- pain with sneezing
Relieved with rest
differential diagnosis of SIJ pathology
Precise SIJ pain
Symptoms radiate into thigh, buttocks and groin
No neurological deficits reported
Pain with transitional movements
Pregnancy related S/S
differential diagnosis with hip pathology
Groin or thigh pain
Symptoms radiate into buttocks or knee
No neurological deficits reported
Increased pain with loading activities or night pain
Complaints of hip stiffness or catching sensations
if someone have pain with prolonged sitting or standing which one btw L/S, sIJ or hip pathology does he have
L/S
if someone have pain with transionnal movement which one btw L/S, sIJ or hip pathology does he have
SIJ
if someone have pain with loading activity or night pain which one btw L/S, sIJ or hip pathology does he have
hip
Why assess for dysfunction?
Is someone complaining of restrictions in hip movement?
Sciatic nerve symptoms?
Pain at the SI joint?
Pain on the lateral aspect of the lumbar spine (around facet joint)?
Do you see postural imbalances during observation?
Do they do repetitive flexion extension, kicking, twisting motions for ADL and sport?
what is dyspareunia
pain with penetration (frequently in context of sexual intercourse)
Contributing factors: tissue trauma (vaginal birth, pelvic surgery, post infection), pelvic floor muscle spasm, central sensitization, underlying conditions (endometriosis, genito-urinary syndrome of menopause)
pain girdle pain other condition and contributing factor
Other names/conditions: SIJ pain/dysfunction, sacral/gluteal pain, pubic symphysis pain/dysfunction
Contributing factors: central/local sensitization, history of trauma, history pf LBP/pelvic pain, previous pregnancies, increased BMI, smoking, work dissatisfaction, muscle tension/hip or L/S dysfunction
what is endometriosis
When tissue similar to the lining of the uterus implants abnormally outside of the uterus to form lesions, cysts, nodules and other growths. Can be found on any pelvic organ
if a girl have pain with sexual activity, bowel movement, back or leg pain with menstruation, constipation what can she have
endometriosis
what is diastases rectus abdomens
What: inc distance between RA muscle bellies due to a stretch of linea alba
More than 2cm at one or more points of the linea alba including:
At level of umbilicus or
4.5 cm above or below it or
A visible midline bulge with exertion (Thabette, 2019
classification of diastases rectus abdomens
Classification:
Mild: <3cm
Mod: 3-5cm
Severe: >5cm
Tests to diagnose SIJ Pain
Patrick’s (FABERs)
Posterior shear
Sacral compression
Active SLR
Sacral thrust tests
+ve posterior shear test
: pain provoked in posterior aspect of SIJ below L5
what is active SLR
Supine on table
Complete active SLR
If painful, examiner applies a pressure to create force closure of the SIJ
Does pain decrease or is it easier to do?
NORMAL PHYSIOLOGICAL MOVEMENT sacral torsion
Sacrum will
Rotate about its vertical axis
SB about its central axis
we get sacral torsion with which movement
SB and rotation to the opposite side
finding with forward torsion of sacrum
Forward torsions become ASYMMETRICAL in FORWARD BENDING and become SYMMETRIC in BACKWARD BENDING
finding with backward torsion of sacrum
Backward torsions are more ASYMMETRIC in BACKWARD BENDING and SYMMETRIC in FORWARD BENDING
what is unilateral nutated sacrums
, either anterior or posterior, the ILA is NEVER symmetric in either forward flexion or extension
May see some movement toward symmetric but they never become symmetric
