SACRUM

Question 1

Sacral posterior landmars

Answer 1

ILAs inferior lateral angles, Sacral sulcus is medial to PSIS. Start at illiac crests, work down to PSIS, then go medial to find sacral sulcus (the divots). For ILA use base of hand to poke around till you find base of sacrum, then use thumbs to hook up under ILAs.

Question 2

Respiratory effects of sacrum

Answer 2

With inhalation, sacrum rocks backwards (extension) (base back, apex anterior). With exhalation sacrum rocks forwards (flection) (base forward, apex posterior.

Question 3

Bilateral flexion

Answer 3

Sulci anteiror, ILAs posterior

Question 4

Unilateral flexion

Answer 4

1 Sulci anterior, that ILA posteiror

Question 5

Bilateral extension

Answer 5

Sulci posterior, ILAS anterior

Question 6

Unilateral extension

Answer 6

1 sulci posterior, that ILA anteiror

Question 7

Torsion

Answer 7

Name it for base part of axis, then name rotated left or right. First letter is what is looking at, second letter is axis.

Question 8

Seated flexion test

Answer 8

They seated on table WITH FEET ON FLOOR, fingers right below PSIS, they bend forward to touch toes, see which finger goes forward more. That is side of problem(For it to be a torsion, the left axis must be locked so it could only be a left axis torsion) If one didnt move farther forward, its one of those bilaterals

Question 9

Lumbosacral spring test

Answer 9

They supine, hands on top of each other perpendicular to lumbosacral junction. Press down. If stiff, that’s a positive test, says that sacrum is extended (base is posterior). If ease of springing, that’s a negative test that tells you the sacrum is flexed (prefers anterior)

Question 10

Backward bending spring test

Answer 10

They prone, put thumbs in sacral sulci, see if more deep or shallow, then have them bend backwards. If inequity gets worse, that’s a positive test and tells you the sacrum is posterior. If the sulci depths get better, that’s a negative test and means the sacrum is anterior.

Question 11

Sacral mobility during respiration

Answer 11

they prone, palm hand on sacral base facing downards, other hand on that hand facing upwards, have them take deep breaths and exagerate motion. See if likes inhalation (moving backwards) or exhalation (moving forwards). If doesn’t like inhalation, that is an anterior sacrum. If doesnt like exhalation, that is a posterior sacrum.

Question 12

4 point stati sacral eval

Answer 12

Put thumbs on ilas, and fingers in saral sulcis. Compare sulci to one another and ilas to one another. See what is superficial or deep. IF ILA is opposite the sulcus on same side, that’s a unilateral flexion or extension. If its on the other side, that’s a torsion.

Question 13

Sacroiliac rocking oblique test

Answer 13

Put thumbs one on ILA one diagonal sacral sulcus, and rock it. Then do for other diretion. The axis will be the stable one, and the one that rocks the most is the opposite of the axis (this is hard to explain with words but I think you get the gist)

Question 14

Gapping SI joint

Answer 14

If sacrum is flexed, internally rotate leg to open back of joint. If sacrum is extended, externally rotate leg to open front of joint

Question 15

Unilaterally extended sacrum (left)

Answer 15

Left sulcus is posterior, left ILA is anterior, right side feels opposite

Question 16

Unilaterally extended sacrum MET/ART

Answer 16

They prone, sacrum is extended so abduct and externally rotate that leg, put heel on left saral base and spring downward (prolly use both hands. For muscle energy use respirations, breathe in resist, exhale push it more forward.

Question 17

Unilaterally flexed sacrum (left)

Answer 17

Left sacral suclus is anterior, left ILA is posterior.

Question 18

Unilaterally flexed sacrum MET/ART

Answer 18

They prone, abduct and internally rotate leg to open back up, hand on left ILA, when they inhale press down, when they exhale resist it. (She used both hands on ILA)

Question 19

Bilaterally extended sacrum

Answer 19

Both sacral sulci posterior, both ILAs anterior.

Question 20

Bilaterally extended treatment

Answer 20

Prone, abduct and externally rotate both legs, palm of hand in center of sacral base, press down for art or for met when they inhale resist, upon exhalation push more forward.

Question 21

Bilaterally flexed sacrum

Answer 21

Both sacral sulci anterior, both ILAs posterior.

Question 22

Bilaterally flexed sacrum treatment

Answer 22

Prone, abduct and internally rotate the legs, hands on ilas, when they breathe in push down, when they exhale resist.

Question 23

Forward sacral torsion

Answer 23

Treat both flexed torsions the same. For a left on left, both the right Sulcus and ILA feel anterior, and both the left sulcus and ila feel posterior.

Question 24

Forward sacral torsion Treatment

Answer 24

Any torsion treatment axis side goes down (lateral recumbent on table). Then, if forward torsion want them to rotate torso down torwards table. Since both letters same use both legs down. One hand monitor SI joint, push their legs down off of a table, do muscle energy, then you return them to neutral.

Question 25

Backward sacral torsion (L on R)

Answer 25

L on R axis, so gonna have right side down, but since its backwards torsion twist back side down (can pull their arm out if needed). Monitor at L1-L5 junction, move hip and knee of 1 LEG into flexion, then push down. Make sure they close enough to table so its actually going down, then YOU push your patient back towards neutral