SI Joint Hypermobility

Question 1

Describe SI joint hypermobility.

Answer 1

An increase in movement at the SI joint or instability often secondary to ligamentous laxity (ex. gr II sprain).

Question 2

What are some likely subjective complaints from a patients with SI joint hypermobility?

Answer 2

i) pain with prolonged sitting/standing
ii) pain on transitional movements on affected side
iii) occasional locking/catching

Question 3

What would be an appropriate outcome measure for a patient with SI joint hypermobility?

Answer 3

Quebec Back Pain Disability Questionniare: it includes transitional movements and ADLs, validated for post-partum women with posterior pelvic pain.

Question 4

What are key objective tests to determine the presence of SI joint hypermobility?

Answer 4

i) ROM: +ve Gillet’s, possible restrictions
ii) Palpation: long dorsal ligament
iii) Provocative: (3 +ve) FABER, Gaenslen’s, gapping, compression, thigh thrust, sacral thrust.
iv) Functional: pain on single leg stance, stairs, turning. etc.
v) Inner unit core stability/motor control: overuse of compensations, inability to maintain stability

Question 5

What are two differential diagnoses for SI joint hypermobility?

Answer 5

i) pubic symphysis dysfunction: location of pain, pain on ROM with hip ABD and ER.
ii) lumbar facet syndrome: location of pain