SIJ MET

Question 1

If an ASIS is positioned medial to the midline, what is the diagnosis?

Answer 1

• Iliosacral inflare

Question 2

If an ASIS is found lateral to the midline, what is the diagnosis?

Answer 2

• Iliosacral outflare

Question 3

Which side of the pelvis is treated in an outflare/inflare?

Answer 3

• The hypomobile

Question 4

Describe the treatment of a iliosacral outflare.

Answer 4

• Pt supine
• Flex hip and knee with foot on table
• Move knee medially (combined IR and ADD) to movement barrier
• Resist ABD and ER by the patient producing a lateral force
• If the outflare is stubborn, hook fingers medial to the PSIS and posterior ilia and distract the joint laterally between contractions
• Repeat 3 - 5 times

Question 5

Describe the treatment of an iliosacral inflare.

Answer 5

• Pt supine hook lying
• Move knee laterally (combined ER and ABD) to movement barrier
• Resist combined ADD and IR by the patient pushing medially
• Repeat 3 - 5 times

Question 6

What landmarks are assessed for an iliosacral upslip/ downslip?

Answer 6

• ASIS
• PSIS
• Pubic tubercles
• Ischial tuberosities

Question 7

How are the bony landmarks of the pelvis oriented in an iliosacral upslip?

Answer 7

• Cephalad on hypomobile side

Question 8

How are the bony landmarks of the pelvis oriented in an iliosacral downslip?

Answer 8

• Caudal on the hypomobile side

Question 9

Describe MET for an ilial upslip.

Answer 9

• Pt positioned supine or prone
• Grip the paitent at the level of malleoli
• Find loose packed position of the hip and provide traction force through the hip and knee while monitoring the patient’s reaction
• Take up the slack caudally, then provide an HVLA thrust

Question 10

What is the open packed position of the hip?

Answer 10

• 30 degrees flexion
• 30 degrees abduction
• Slight ER

Question 11

Describe MET for a downslip of the ilia.

Answer 11

• Pt sidelying on uninvolved side
• PT positioned behind patient
• PT grips ischial tuberosity and pubic ramus with thumb and webspace of the caudal hand
• Other hand grips under iliac crest using webspace of hand
• Distract ilia laterally towards the ceiling
• Maintain a lateral distraction and move the ilia cephalad

Question 12

How is anterior/ posterior ilial rotation assessed?

Answer 12

• Compare ASIS caudad with PSIS cephalad (anterior rotation)
  VS
• ASIS cephalad with PSIS caudad (posterior rotation)

Question 13

Describe MET for anterior rotation of the injominate.

Answer 13

• Pt supine
• Flex hip and knee to barrier
• IR hip to barrier
• ADD hip to barrier
• Resist hip extension
• Hold 6 - 10 seconds
• Repeat 3 - 5 times

Question 14

Describe MET for posterior rotation of the innominate

Answer 14

• Pt supine with hypomobile side at the edge of the bed
• Extend hip off the edge of the bed to the barrier
• ER hip to barrier
• ABD hip to barrier
• Resisted hip flexion
• Hold 6 - 10 seconds
• Repeat 3 - 5 times