SIJ/Pelvic Clinical Presentations Flashcards
Where are sacral fractures often observed?
observed vertically at ala (parallel to SIJ)
symptoms of sacral stress fracture
- LBP/pain into buttock
- may be similar to cauda equina syndrome
physical exam findings of sacral stress fracture
- similar presentations associated with HNP, spinal stenosis, tumors
- antalgic gait
- TTP area of stress fracture
- lumbar spine ROM more likely normal
symptoms of mechaincal SIJ disorder
- pain in butt/groin/thigh
- aggravated by transitions, sitting, activities that require longer strides
physical exam findings of mechanical SIJ disorders
- asymmetry with postural landmark exam
- TTP affected SIJ stabilizers
- provocation with procedures that stress affected SIJ ligament/capsule structures
- Laslett’s cluster
Laslett’s cluster
- thigh thrust test
- distraction test
- sacral thrust
- compression test
- gaenslien’s test
Van der Wurff’s cluster
- thigh thrust test
- distraction test
- Patrick’s sign - FABER sign
- compression test
- gaenslen’s test
who is at increased risk for athletic pubalgia
- males
- 3rd and 4th decades of life
history of athletic pubalgia
- insidious onset
- sports injury
- cutting sports
symptoms of athletic pubalgia
- unilateral pain, progression to bilateral pain
- lower abdominal/groin pain
- bilateral presentation over time
physical exam findings of athletic pubalgia
- L-spine and hip should be eliminated
- TTP pubic tubercles, rectus abdominis insertion, adductors, inferior pubic rami
- painful/weak resisted hip abduction
- painful with resisted sit-up or crunch
- squeeze test + - squeeze fist inbetwee knees in supine with hips and knees flexed reproduces concordant pain
- active straight leg raise
normal coccygeal flexion and extension
flexion - > 25 deg
extension - > 20 deg
symptoms of coccydynia
- pain in coccyx
- aggravated by transitions, sitting without weight-shift, defecation, intercourse
physical exam findings of coccydynia
- TTP coccyx
- sitting posture - weight-shifted
- painful provocation testing
physical exam findings of PPPP
- pain in lumbar region and over SIJs
- findings consistent with mechanical SIJD
- active SLR test
stress incontinence
- urethral or pelvic floor weakness
- incontinence with increased abdominal pressure
urge incontinence
- overactive bladder
- often idiopathic but can be caused by meds, alcohol, bladder infections, bladder tumor, neurogenic bladder, bladder outlet obstruction
- trigger: cold, running water, “key in the door”
mixed incontinence
combination of urge and stress
overflow incontinence
- overdistention of the bladder and the bladder cannot empty completely
- urine leaks or dribbles out
- client does not have any sensation of fullness or emptying
- caused by acontractile or deficient detrusor muscle
functional incontinence
- occurs when bladder is normal but mind and body are not working together
- occurs secondary to mobility or access deficits like confined to wheelchair, altered mentation
What is diastasis recti abdominis (DR/DRA)? How do you treat this?
split between the 2 rectus abdominis muscles to the extent that the linea alba may split under the strain
- normal 1-2 finger width
- treat with TA activation
