SI Joint Manual Therapy

Question 1

The inferior lateral angle (ILA) is located at the transverse process of ____.

Answer 1

S3

Question 2

The sacral base is the [top/bottom] of the sacrum.

Answer 2

top

Question 3

What is the sacral sulcus?

Answer 3

It is the depth of the sacral base compared with the ilium

Question 4

The iliolumbar ligament connects the ___ and ____ transverse processes with the ilium.

Answer 4

L4 and L5

Question 5

What 3 ligamentous structures are there in the pelvis that are important to palpate?

Answer 5

iliolumbar, sacrotuberous, and dorsal SI ligaments

Question 6

What muscles are important influences on the SI joint and treatments for SI dysfunctions?

Answer 6

piriformis, longissimus, hamstrings, rectus femoris, iliopsoas, hip adductors, hip abductors, gluteus maximus/medius, abdominal muscles, and pelvic floor

Question 7

The longissimus is attached to the _____ base and the _____ spine.

Answer 7

sacral base, thoracic spine

Question 8

What influences “form closure”?

Answer 8

The pelvis bony architecture, which contributes to stability, along with body weight which wedges the sacrum between the ilia

Question 9

The sacrum is most stable in [anterior/posterior] nutation.

Answer 9

anterior nutation

Question 10

The sacrum is wider [superiorly/inferiorly] than [superiorly/inferiorly].

Answer 10

wider superiorly than inferiorly

Question 11

What influences “force closure”?

Answer 11

muscles of the abdomen, hip, and latissimus dorsi, as they provide dynamic stability across SI joint

Question 12

What does poor form closure lead to?

Answer 12

decrease force closure

Question 13

An SI joint dysfunction is a poor [form closure/force closure].

Answer 13

form closure

Question 14

With a neutral lumbar spine, the sacrum is [anteriorly/posteriorly] nutated.

Answer 14

anterior nutated (flexed)

Question 15

With a flexed lumbar spine, the sacrum is [anteriorly/posteriorly] nutated.

Answer 15

posteriorly nutated (extended)

Question 16

With a extended lumbar spine, the sacrum is [anteriorly/posteriorly] nutated.

Answer 16

anteriorly nutated (flexed)

Question 17

Across what axis does nutation and counternutation occur

Answer 17

transverse axis

Question 18

During nutation, which way does the sacral base move?

Answer 18

anteriorly (flexion)

Question 19

During counternutation, which way does the sacral base move?

Answer 19

posteriorly (extension)

Question 20

An anteriorly nutated sacrum rotates on the [same/opposite] sided oblique axis.

Answer 20

same or “left on left”

Question 21

An posteriorly nutated sacrum rotates on the [same/opposite] sided oblique axis.

Answer 21

opposite or “left on right”

Question 22

Why are innominate rotations fairly common iliosacral dysfunctions?

Answer 22

Because of hip muscle imbalacnes and single leg stnading, etc.

Question 23

What iliosacral dysfunctions are rare and from traumatic experiences?

Answer 23

upslips (shears), downslips (shears), and outflare/inflares

Question 24

Pubic dysfunctions are [common/uncommon] and result from hip abductor/adductor imbalances, leg length discrepancy, etc.

Answer 24

common

Question 25

Backward sacral torsion results in limited lumbar [extension/flexion] and commonly occur with lifting mechanics.

Answer 25

extension

Question 26

Forward sacral torsions result in limited lumbar [extension/flexion] and is not problematic due to normally occurring in the gait cycle.

Answer 26

flexion

Question 27

Combination of what special tests make up the Laslett cluster and improve sensitivity? (5)

Answer 27

compression, distraction, thigh thrust, sacral thrust, and gaenslen

Question 28

Describe a positive forward bending test.

Answer 28

The side where the PSIS moves first or furthest is the side of dysfunction

Question 29

What is the purpose of the forward bending test?

Answer 29

To determine the side of the SI dysfunction

Question 30

An inferior position of the innominate based off of ASIS position would indicate a [anterior/posterior] innominate rotation.

Answer 30

anterior innominate rotation

Question 31

A superior position of the innominate based off of ASIS position would indicate a [anterior/posterior] innominate rotation.

Answer 31

posterior innominate rotation

Question 32

When a long leg gets shorter in sitting with the long sitting test, it suggests a [anterior/posterior] innominate rotation.

Answer 32

anterior innominate rotation

Question 33

When a short leg gets longer in sitting with the long sitting test, it suggests a [anterior/posterior] innominate rotation.

Answer 33

posterior innominate rotation

Question 34

During palpation of ILA, the side which is more [anterior/posterior] and inferior is the side of dysfunction.

Answer 34

posterior

Question 35

The direction of rotation in a sacral dysfunction is to the [same/opposite] side of the most posterior ILA.

Answer 35

same side (i.e. left ILA posterior = left rotated facing sacrum)

Question 36

With an ILA being more posterior in lumbar extension, this would be a [forward/backward] sacral torsion.

Answer 36

backward sacral torsion

Question 37

What is limited in a backward sacral torsion?

Answer 37

The sacral base will not move forward during lumbar extension

Question 38

The axis a backward sacral torsion is moving over (or not moving over) is the [same/opposite] direction the sacrum is facing.

Answer 38

opposite (i.e. left ILA = left on right [axis] backward sacral torsion)

Question 39

With a forward sacral torsion, the ILA will be more posterior in lumbar [extension/flexion].

Answer 39

lumbar flexion

Question 40

In a forward sacral torsion, the axis the sacrum is moving over (or not moving over) is the [same/opposite] direction the sacrum is facing.

Answer 40

same direction (i.e. left ILA posterior in flexion = left on left [axis] forward sacral torsion)

Question 41

What muscle is recruited to provide movement in the case of a posterior innominate dysfunction?

Answer 41

iliopsoas (hip flexors)

Question 42

What muscle is recruited to provide movement in the case of a anterior innominate dysfunction?

Answer 42

gluteus maximus

Question 43

What muscle is recruited to provide movement in the case of a backward sacral torsion?

Answer 43

piriformis