SIJ Flashcards
Role of Sacroiliac Joints
-expand to provide outlet for birth
-shock-absorbing function
Sacroiliac Joint: Close pack
“Nutation”
Most stable position
Sacroiliac Joint: Loose pack
“Counternutation”
Sacral Locking
-Closed packed position
-forward motion of sacrum, backward rotation of ilium
-Nutation = posterior pelvic tilt
Sacral Unlocking
-Open packed position
-backward motion of sacrum, forward rotation of ilium
-Counternutation = anterior pelvic tilt or “lordotic” position
How does SIJ manage ground reaction forces?
Form Closure and Force Closure with neuromuscular control
Form Closure Theory
Passive Locking System (enhanced during weightbearing)
no outside forces necessary to hold joint stable bc of its shape, friction on surfaces & ligaments
Force Closure Theory
Compression generated by muscles and through them tensing of the ligaments. requires muscles to contract & lock things in place resulting in a self-bracing mechanism
Neuromuscular Control
Two closures (form + force) act together to form a self-bracing mechanism in pelvis. Neuro control prepares muscles/helps them fire in unison so movement is seamless
Fortin Finger Sign
patient points slightly inferior and medial to PSIS as source of pain
Pre-examination odds of SIJ
-past or current pregnancy (C-sections?)
-significant trauma to region
-reporting pain at PSIS (Fortin’s sign)
When ruling out Lumbar and doing AROM w/ overpressure and repeated movements, what should you do if pain/symptoms centralize?
Continue with lumbar exam and treatment, it is unlikely SIJ
What are the 6 provocation tests?
SIJ compression
SIJ Gapping/Distraction
Sacral Spring/Thrust
Gaenslen’s
Thigh Thrust
FABER
SIJ Provocation tests do NOT test for ______, they test for the effect the movement has on the patient’s _______.
Mobility; pain
When 2/4 of these are positive, you can rule SIJ in
Thigh Thrust
SIJ Distraction
SIJ Compression
Sacral Spring/Thrust
