SI Joint Flashcards
Nutation
anterior sacral tilt
posterior iliac tilt
clinically: anterior pelvic tilt
Counternutation
Posterior sacral tilt
Anterior iliac tilt
Clincally: posterior pelvic tilt
Diagnosis of Pain
Originating from SIJ
Positive SIJ compression test Positive SIJ distraction test Positive femoral shear test Positive sacral provocation Positive right Gaenslen’s test Positive left Gaenslen’s test
Lumbar Manipulation for Acute LBP
Pain does not travel below the knee Onset ≤ 16 days ago Lumbar hypomobility Either hip has > 35° of internal rotation FABQ - work subscale score < 19
CPR for diagnosis SIJ pain
SIJ distraction SIJ compression Sacral thrust Thigh thrust Gaenslen’s test
What movement is nutation associated with?
extended lumbar spine
What movement is counternuation associated with?
flexed lumbar spine
Questions for SI joint pain?
pain relieved by standing?
pain relieved by walking?
pain relieved by sitting?
What is nutation synonymous with?
stability (heel strike), and increased lordosis
extended lumbar spine
What is counternutation associated with?
Sitting and Laying down
flexion of lumbar spine
loss of lordosis or flat back
What does counternutation load?
Loads long dorsal sacral ligament
What does nutation load?
Loads interosseous and sacrotuberous
Pelvic tilt with kyphosis-lordosis posture:
anterior pelvic tilt with lumbar extension
Pelvic tilt with sway back posture:
posterior pelvic tilt with lumbar flexion
Anterior innominate
a condition in which the movement of the hipbone is restricted in upward and rearward directions and unrestricted in downward and forward directions, because the anterior superior iliac spine (ASIS) is positioned in front of and below the contralateral point
Location of ASIS in anterior innominate:
ASIS lower, PSIS Higher, Leg Length issues
What muscle dysfunctions are associated with anterior innominate?
Associated with excessive iliacus activation or adductor muscle tension
Location of ASIS in posterior innominate?
ASIS superior, iliac crest high, PSIS inferior, deep sacral sulcus
outflares of pelvis
What muscle dysfunctions are common in posterior innominate?
tender sacrotuberous ligament
hypertonic hamstrings
weakness in adductors and hip IR
Upslip:
said to be very common after excessive jumping, landing asymmetrically, or other traumatic incidence such as stepping in a hole
Short leg on the side of the upslip. Every part of the pelvis is higher on the affected side
Downslip:
said to be rare in their occurrences. Traction injury to the leg as a possible cause
associated with outflares
Long leg on the side of the Downslip. Every part of the pelvis is lower on the affected side
Superior Innominate Shear:
Higher PSIS, ASIS and pubic symphysis
Inferior Innominate Shear:
Lower PSIS, ASIS and pubic symphysis
INFLARE
ASIS is closer to the umbilicus than the non-lateralized side. I.E. With a right inflare, there is a shorter distance between the umbilicus and the right ASIS than the left ASIS.
OUTFLARE
ASIS is further away from the umbilicus than the non-lateralized side. I.E with a right outflare there is a shorter distance between the umbilicus and the right ASIS than the left ASIS.
