Sacroiliac Joint Dysfunction (SIJD)Examination and Treatment Flashcards
What is Sacroiliac Joint Dysfunction (SIJD)?
- SIJD refers to pain in the sacroiliac joint region caused by dysfunction in the joint itself, often presenting as low back pain.
What are common causes of SIJD?
Common causes include pregnancy, trauma (e.g., falls, motor vehicle accidents), and certain repetitive activities like running or lunges.
What is the incidence and prevalence of SIJD?
SIJD is more common in females and may affect 10% to 25% of patients with persistent mechanical low back pain below L5.
What are the symptoms associated with SIJD?
Symptoms include pain with transitional movements, running, lying on the affected side, and trauma-related pain.
What activities exacerbate SIJD pain?
Activities that exacerbate pain include sit to stand, getting out of a car, running, lunges, and pelvic end range movements.
What are the gender differences in SIJD?
SIJD is relatively equal in mobility between men and women from ages 19-45, but after 60, ankylosis occurs in 82% of males and 30% of females.
What is the biopsychosocial model of pelvic girdle pain?
It emphasizes the interaction between biological, psychological, and social factors in the development and management of pelvic girdle pain.
What are common differential diagnoses for low back pain vs. SIJD?
Common differential diagnoses include mechanical low back pain, discogenic pain, facet joint pain, and muscular dysfunction.
What is the role of pain provocation tests in diagnosing SIJD?
Pain provocation tests help identify SIJ pain, with clusters of these tests increasing the probability of accurate diagnosis.
What is the role of imaging in diagnosing SIJD?
Imaging has limited evidence for diagnosing SIJD, with more reliance on clinical tests and patient history.
What is the Thigh Thrust Test?
The Thigh Thrust Test involves flexing the hip to 90°, applying axial force through the femur to reproduce SIJ pain.
What is the Distraction/Gapping Test?
The Distraction Test involves applying pressure to the ASIS to reproduce SIJ pain.
What is the SI Joint Compression Test?
The Compression Test involves applying pressure over the iliac crest to reproduce SIJ pain.
What is the Sacral Thrust Test?
The Sacral Thrust Test involves delivering an anteriorly directed thrust over the sacrum to reproduce SIJ pain.
What is Gaenslen’s Test?
Gaenslen’s Test involves flexing one hip while extending the opposite hip to apply torque to the pelvis and reproduce SIJ pain.
What is the Hip Test for SIJ involvement?
The Hip Test involves placing the leg in a figure-four position and applying pressure to assess SIJ-related pain.
What are motor control/stabilization exercises for SIJD?
- gluteus maximus strengthening
- supine clamshells
- resisted hip hinge exercises
What are mobilization techniques for SIJD?
Mobilization techniques include manual therapy techniques like muscle energy techniques and joint mobilizations.
What is the use of SI joint belts and kinesiotaping?
SI joint belts and kinesiotaping provide external support to the SIJ, helping stabilize and reduce pain.
What are muscle energy techniques for anterior innominate rotation?
These techniques involve the patient resisting against the therapist’s force to correct the anterior rotation of the innominate.
What is the upslip correction technique?
Upslip correction involves applying traction to the leg to pull the pelvis down, often combined with muscle energy contractions.
What is the treatment for innominate outflare?
Treatment includes placing the leg in adduction and internal rotation, and resisting against abduction to correct the outflare.
What is the treatment for innominate inflare?
Treatment includes abducting the thigh and resisting against adduction to correct the inflare.
What are manual correction techniques for pubic symphysis?
Techniques include resisted abduction and adduction exercises to realign the pubic symphysis.
What are specific exercises for SIJ stability?
Exercises include bridges, clamshells, resisted hip movements, and pelvic floor strengthening exercises.
How effective are physiotherapy interventions for SIJD?
Physiotherapy interventions like manipulation, exercise, and kinesiotape are effective in reducing pain and disability associated with SIJD.
What is the role of specific stabilizing exercises in reducing pain and disability?
Specific stabilizing exercises target deep and superficial muscles to improve stability and reduce pain.
What are non-mechanical sources of SIJ pain?
Non-mechanical sources include ankylosing spondylitis, reactive arthritis, and psoriatic arthritis.
How does ankylosing spondylitis relate to SIJ pain?
Ankylosing spondylitis can cause inflammation and pain in the SIJ, often affecting younger males.
What is reactive arthritis (Reiter’s Syndrome)?
Reactive arthritis is an inflammatory condition that affects the joints, including the SIJ, and is characterized by conjunctivitis, urethritis, and arthritis.
How does psoriatic arthritis affect the SIJ?
Psoriatic arthritis can cause pain and inflammation in the SIJ, contributing to lower back pain.
How should SIJD be managed during pregnancy?
Management includes exercises for pelvic stability, use of SI belts, and gentle manual therapy techniques.
What is the impact of age on SIJ mobility?
Mobility decreases with age, with higher rates of ankylosis in older males compared to females.
What is the evidence against the ‘bone out of place’ model?
Current literature does not support the ‘bone out of place’ model, favoring pain provocation tests over asymmetry evaluations.
Why are pain provocation tests preferred over asymmetry evaluations?
Pain provocation tests have higher reliability and diagnostic accuracy for SIJD compared to asymmetry evaluations.
What are the guidelines for selecting therapeutic exercises for SIJD?
Therapeutic exercises should be selected based on whether the joint is too tight or too loose, aiming to diversify the patient’s movement patterns.
What is the Sacroiliac Joint Exercise Algorithm?
The algorithm involves using SI belts, stability exercises, and specific maneuvers like Gaenslen’s manipulation to address SIJ pain.
What is the role of pelvic floor exercises in SIJ pain management?
Pelvic floor exercises help stabilize the SIJ, reducing pain and improving function.
