sacroiliac joint -pelvis

Question 1

the pelvis is a bowl shape - the force transfers through which structure?

Answer 1

pubic symphysis

• distribute forces around the circle –> keeps going

Question 2

bone - pelvis

in standing where is the ASIS in relation to the ipsilateral PSIS?

Answer 2

should be lower

Question 3

what is a hip hike?

Answer 3

a movement that involves raising the hip on the non-stance (contralateral) leg while keeping the hips pointed forward and the core stable

Question 4

what is a hip drop?

Answer 4

non stance leg (contralateral) is dropping below pelvis

Question 5

what is the force distribution of the pelvis?

Answer 5

forces from gravity coming down into SIJ, forces coming up through femur –> distrubtes forces around the circle and keeps going.
* the SIJ and pubic symphysis will disipate and redistribute forces

Question 6

What are the ligaments of the sacrum and pelvis?

Answer 6

• ilioilumbar ligament
• anterior sacroiliac ligament
• posterior (dorsal) sacroiliac ligament
• sacrotuberous ligament
• sacrospinous ligament

Question 7

what happens if there is ossification of ligaments in sarcum and pelvis? (ligametns in general too)

Answer 7

repeated pressure can cause this and it can then compress nerves, and limit mobility beyond normal limited range

Question 8

what is the significane of the interosseous SI ligament?

Answer 8

fills space between sacrum and ilium. it is the **most important stabilizer **

Question 9

arthrokinematics

during functional tasks what is the rotatory degree of SIJ? what is translation of SIJ?

Answer 9

rotatory: 1-3° (around any axis
translation: 1 mm

Question 10

osteokinematics

what is the closed packed position of SIJ?

Answer 10

nutation
* partially due to strength of ligaments (becoming taut) and joint surfaces

Question 11

osteokinematics

what ligaments become taut in nutation of sacrum?

Answer 11

• sacroiliac interosseous ligament
• sacrotuberous ligament
• sacrospinous ligament

Question 12

osteokinematics

anterior movement of sacrum in relation to ilium
and/or
ilium rotates posterior on sacrum
what motion is occuring?

Answer 12

nutation

Question 13

osteokinematics - sacrum

what ligaments become taut with counter nutation

Answer 13

interosseous ligament
long posterior sacroiliac ligament

Question 14

which ligament is the most important stabilizer for the SIJ?

Answer 14

interosseous sacroiliac ligament

Question 15

what is movement and rotation for pelvic torsion?

Answer 15

2 mm of movement
1° of rotation

Question 16

what movements include torsion of the pelvis?

Answer 16

• walking
• any kind of recipricol activity

Question 17

talk about the SIJ across the lifespan
- what bone growth occurs during adolescence?

Answer 17

auricular bone
- smooth, flat

• past puberty SIJ becomes more incongruent, less smooth and very stable

Question 18

subjective exam/symptoms

SIJ dysfunction
symptoms

Answer 18

• unilateral pain
• acute/gradual
• pain can refer into posterior thigh
• pain with transition movements (sit to stand)
• pain with unilateral lower extremity activities (walking, stairs, running)

Question 19

objective exam/signs

SIJ dysfunction objective exam/signs

Answer 19

• tenderness over SIJ
• positive fortin finger test (points to PSIS)
• pain with single leg squat test or single leg drop jump test
• negative neuro screen (no nerves in joint)
• pain with lumbar lateral flexion AROM
• segmental mobility:
  joint hypermobility if younger age or pregnant
  joint hypomobility if older age

Question 20

why might someone with SIJ dysfunction have pain with lumbar lateral flexion?

Answer 20

• translation occuring, body weight shift this is a shear + weight = pain

-

Question 21

clinical considerations

what is ankylosing spondylitis

Answer 21

• inflammatory disease of subchondral bone

Question 22

what are signs/symptoms of ankylosing spondylitis?

Answer 22

• disc, SIJ, facet joints, costovertebral joint (occurs in multiple regions)
• pain, stiffness, loss of motion
• insidious/no MOI 3+ months
• increase exercise could make it worse (inflammatory response)
• stiffness all over
• trouble with breathing, ribs can’t move = aerobic capacity decrease

Question 23

anlylosing spondylitis is more common in male or female? what age range is most common?

Answer 23

male 2:1
- 20-40 years of age

Question 24

pelvic position (resting alignment) - hamstring strains
what position could increase hamstring strain likely hood? what decreases?

Answer 24

anterior pelvic tilt + leg flexion = increase
posteriorpelvic tilt + leg flexion = decrease

• the hamstrings originate on ischial tuberosity and insert on the head of fibula and tibia

Question 25

SIJ, pelvis

what is form closure?

Answer 25

form (structure, shape)
- wedge shape of SI joint
- interosseous ligaments (gray area, also aides in force closure)
- increases friction

Question 26

what is force closure?

Answer 26

• compressive force
• muscles
• ligaments
• fascia (thoracolumbar fascia for SIJ)
• “self-bracing”
• gravity

Question 27

SIJ, pelvis

what muscles are involved in force closure?

Answer 27

• mutifidus
• Erector spinae
• pelvic floor
• hamstrings
• abdominal group