Pelvis/SIJ Classification/Diagnoses Flashcards
Location of Symptoms: Ilio-Sacral Disorders & Sacro-Iliac Disorders
SI local or referral pattern
Anterior Innominate
Agg Factors
Gait
Stair Descent
Posterior Innominate
Agg Factors
Gait
Stair Ascent
Inflare Innominate
Agg Factors
Gait
Outflare Innominate
Agg Factors
Gait
Upslip Innominate
Agg Factors
Gait
Downslip Innominate
Agg Factors
Gait
Anterior Innominate
Ease Factors
Hip Flexion
NWB
Posterior Innominate
Ease Factors
Hip Extension
NWB
Inflare Innominate
Ease Factors
Hip IR
NWB
Outflare Innominate
Ease Factors
Hip ER
NWB
Upslip Innominate
Ease Factors
NWB
Downslip Innominate
Ease Factors
NWB
Anterior Innominate
History
Activity Related: kicking soccer ball
Posterior Innominate
History
Activity Related: slipping on ice with one LE forward
Inflare Innominate
History
Activity Related: hip in end range IR
Ex. plant leg when kicking soccer ball while cutting
Outflare Innominate
History
Activity Related: hip in end range ER
Ex. Ballet dancer
Upslip Innominate
History
Activity Related: Step off curb with knee straight
Downslip Innominate
History
Trauma: being pulled by 1 LE
Ex. Foot caught in stirrup when falling off running horse
Ex2. A bad guy jerking your leg back when you try to run away
ROM Testing with all Ilio-Sacral Disorders
Decreased mobility with unilateral Squish
6 Ilio-Sacral Disorders
Anterior/Posterior Innominate
Inflare/Outflare Innominate
Upslip/Downslip Innominate
(Innominates moving on fixed sacrum)
Anterior/Posterior Innominate
Special Tests
+Gillet’s
+SFB Test
+long sitting test (aka supine to sit test)
Inflare/Outflare Innominate
Special Tests
+Inflare/Outflare Test
Upslip/Downslip
Special Tests
+Gillet’s
+SFB Test
Anterior Innominate
Muscle Length
Chronic=Shortened Hip Flexors
Posterior Innominate
Muscle Length
Chronic=Shortened Hams
Outflare
Muscle Length
Chronic=Shortened Gluts
Upslip
Muscle Length
Chronic=Shortened QL
4 Sacro-Iliac Disorders
Sacral Torsion
Instability
Locking
Degeneration
(Sacrum moving on fixed Ilium)
Instability
Profile
Female post-pregnancy
Locking
Profile
Post Trauma
Degeneration
Profile
Chronic SIJ Pain
Sacral Torsion
Agg Factors
Gait
Lumbar Rotation
CKC Rotation activities
Instability
Agg Factors
Turn over in bed
Lumbar Rotation
Getting in/out of cars (transitional movements)
Locking
Agg Factors
Gait
Lumbar Rotation
Degeneration
Agg Factors
WB and movement
Sacral Torsion
Ease Factors
NWB
Instability
Ease Factors
Tight pants/belt
Locking
Ease Factors
Being still without moving
Degeneration
Ease Factors
NWB
Decreased movement
Sacral Torsion
History
Incidious onset (piriformis tightness)
Traumatic
Activity Related
Instability
History
Recent Childbirth
Trauma
c/o frequent “popping”
Locking
History
Trauma
Sudden jarring of pelvis
Degeneration
History
Early onset ankylosing spondylitis RA Post lumbar fusion Hip arthritis Leg length discrepancy Infection
Sacral Torsion
ROM
normal mobility with forward (flexed) sacral torsion
Stiffness with backward (extended) sacral torsion
Instability
ROM
Normal, but guarded due to pain
Locking
ROM
Severely limited on involved side
Degeneration
ROM
Limitation with all AROM
Severely limited if progressed to SIJ fusion
Sacral Torsion
Special Tests
+Seated forward bend test
+prone on elbows test
Instability
Special Tests
Excessive motion of SIJ compared to other side
Locking
Special Tests
+Seated/Standing forward bend test
Decreased motion with unilateral squish test
Degeneration
Special Tests
+Provocation tests
Sacral Torsion
Palpation
prone on elbows:
anterior torsion=deep sacral sulcus
posterior torsion=shallow sacral sulcus
Instability
Palpation
Painful SIJ
Inconsistent landmark palpation
Locking
Palpation
Painful SIJ
Degeneration
Palpation
Painful SIJ
Sacral Torsion
Muscle Length
Tight piriformis with anterior torsion
Instability
Muscle Strength
Decreased TrA and Glut Strength
Locking
Muscles
muscle spasm possible around involved SIJ due to pain
Suspect SIJ disorder if ____of 6 provocation tests are +
3+/6
Gold standard to diagnose SI dysfunction
SIJ Fluoroscopic Block
Function of SIJ
Transfer load
Absorb LE motino
Stability
Nutation
Flexed Sacrum
Sacral base more anterior
Counternutation
Extended Sacrum
Sacral base more posterior
Sacral Torsions
Anterior/Posterior
(Anterior=base forward, posterior=base backward)
Left/Right
Named for direction that front of sacrum is facing