SACRUM Flashcards
Sacral posterior landmars
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.
Respiratory effects of sacrum
With inhalation, sacrum rocks backwards (extension) (base back, apex anterior). With exhalation sacrum rocks forwards (flection) (base forward, apex posterior.
Bilateral flexion
Sulci anteiror, ILAs posterior
Unilateral flexion
1 Sulci anterior, that ILA posteiror
Bilateral extension
Sulci posterior, ILAS anterior
Unilateral extension
1 sulci posterior, that ILA anteiror
Torsion
Name it for base part of axis, then name rotated left or right. First letter is what is looking at, second letter is axis.
Seated flexion test
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
Lumbosacral spring test
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)
Backward bending spring test
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.
Sacral mobility during respiration
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.
4 point stati sacral eval
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.
Sacroiliac rocking oblique test
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)
Gapping SI joint
If sacrum is flexed, internally rotate leg to open back of joint. If sacrum is extended, externally rotate leg to open front of joint
Unilaterally extended sacrum (left)
Left sulcus is posterior, left ILA is anterior, right side feels opposite
Unilaterally extended sacrum MET/ART
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.
Unilaterally flexed sacrum (left)
Left sacral suclus is anterior, left ILA is posterior.
Unilaterally flexed sacrum MET/ART
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)
Bilaterally extended sacrum
Both sacral sulci posterior, both ILAs anterior.
Bilaterally extended treatment
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.
Bilaterally flexed sacrum
Both sacral sulci anterior, both ILAs posterior.
Bilaterally flexed sacrum treatment
Prone, abduct and internally rotate the legs, hands on ilas, when they breathe in push down, when they exhale resist.
Forward sacral torsion
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.
Forward sacral torsion Treatment
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.
Backward sacral torsion (L on R)
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
