SI and pelvis Flashcards
what is considered the functional pelvic girdle?
L4/L5, two innominates, sacrum, two SI joints, pubic joint, and two hip joints
How can we think about the pelvis?
it is a force generator as well as a force attenuator. It allows for the absorption of force during running and walking.
what three muscles are most commonly slow to activate in SIJ pain?
multifidis, internal oblique, gluteus maximus
what low back issue commonly presents with SIJ pathology as well?
disk herniation, be aware that folks with a disk herniation usually have some form of SIJ pain as well
what happens to the SIJ as we age?
it changes shape!
what type of joint are the SIJs?
planar
how much motion occurs at the SIJ in degrees and mm?
1.15 to 2.5 degrees, or less than one mm
what two muscles can influence the sacrotuberous ligament and provide stability to the SIJ via tensioning?
glute max, hamstrings
in what motion does the sacrotuberous ligament restrict motion and provide stability? Why is this important?
flexion, if people sit slouched and the SI is in extension this mechanism does not work
what innervates the upper and lower region of the SIJ?
anterior and posterior rami of L5.
Where does the S2 nerve root go upon exiting the foramen?
through the piriformis, need to be aware of.
Does the sacrotuberous ligament control anterior or posterior rotation?
posterior
does the long posterior sacroiliac ligament control anterior or posterior rotation?
anterior
what is the sacroilitis CPR?
thigh thrust, compression, distraction, sacral thrust, gaenslan
how many tests need to be positive in the sacroilitis CPR?
3 of 5
what is the stenosis CPR? (5things)
bilateral symptoms, leg pain more than back pain, pain during walking/standing, pain relief upon standing, age >48
how do you perform gaenslen test?
think like a torsion test, symptomatic knee to chest, thomas test position with other leg and give pressure
what leg goes to chest on the gaenslen test?
symptomatic
what is the gold standard for limb length discrepancies?
radiographs, look at sacral base position to see if tilted one way or another
what two factors affect the sacral base?
idiopathic scoliosis, and limb length discrepancy
if you determine someone has a limb length discrepancy and decide to correct with a heel lift, within how many mm should it be corrected to?
5mm
what is a test to rule out pelvic fx?
active straight leg raise, if they can’t in ER, high probability of a fx, if they can, low probability of fx
what is the most commonly fractured part of the pelvis?
pubic ramus
is it common to see centralization with SIJ dysfunction?
no, this is very rare and usually indicates a lumbar issue
what 3 findings help rule in lumbar stenosis and rule out PGP?
older age, absence of symptoms with coughing, full resolution of symptoms with sitting
what is the hip CPR for OA?
limited in adduction, flexion, ER/IR at 90 degrees of flexion
which two tests of the SIJ cluster should be performed first and why?
thigh thrust and distraction, high sensitivity and specificity
do pelvic belts decrease muscle activity?
no, but they help decrease pain which can actually lower inhibition and increase muscle activity
what is the purpose of prolotherapy in the SIJ?
cause an inflammatory response that facilitates fibroblastic activity to promote collagen synthesis and provide additional stability
