SIJ/Pelvis Flashcards
Would increased or decreased activation of gluteus maximus and biceps femoris lead to SIJ stiffness?
increased
Impaired gluteus maximus and biceps femoris motor control may lead to what at SIJ
functional laxity
What changes happen in cartilage at SIJ as you age?
shift from hyaline cartilage to fibrocartilage.
This leads to decreased motion
The transverse acetabular ligament is a continuation of what structure?
labrum
What ligament is engaged with optimal sitting position, and what effect does this have on SIJ
sacrotuberous ligament in engaged due to sacral nutation. Lead to SIJ stability
How innervated is the SIJ
highly innervated
How can SIJ radiate pain?
L5 and all sacral dermatomes/myotomes
which nerve root passes through piriformis?
S2
How high does force on swing leg get during SLS
3-4x body weight
Which muscle group has long lever arm to overcome forward bend forces?
erector spinae
What is role of multifidus in producing extensor torque?
tension erector spinae aponeurosis and correct motions/support specific joints
What limits force production by multifius?
short length
What muscle recruitment pattern is more common in response to LBP?
hamstring dominant pattern
With LBP, what happens to gluteal musculature?
inhibited.
What muscle groups triangulate to stabilize ribs/spine with compression
rectus abdominus
QL
erector spinae
When hip is flexing, can psoas provide stabilization at spine?
yes, can provide compressive forces
Which hip motions is coupled with pelvic anterior rotation?
hip extension
Which pelvic motion is coupled with hip flexion?
posterior rotation
Which ligament controls anterior rotation of pelvis?
long posterior sacroiliac ligament
Which ligament controls posterior rotation of pelvis?
sacrotuberous
What sacral motion occurs with trunk extension?
flexion
Which trunk motion occurs with sacral extension
flexion
What is a positive active straight leg raise test?
ASLR strength improving with pelvic compression.
Indicative of joint hypermobility on weak side
What may lead to false negative on ASLR?
not using weight.
Sometimes weight of leg is not enough to discern weakness
Cluster of findings to seperate hypermobile pubis from hypomobile SIJ
positive ASLR tenderness of superior pubic ligament tenderness of psoas tenderness of iliacus tenderness of adductors excessive motion of imaging
SIJ CPR
Thigh thrust compression distraction sacral thrust Gaenslan
3/5= SN.91, Sp.87
Patients must not centralize to use CPR
SIJ CPR 2
Distraction Compression FABER thigh thrust Gaenslan
if less than 3 are positive, between 72 and 99% chance of no SIJ pain
Distraction and compression are (sensitive/specific) for pelvic fracture/instability?
sensitive
Fortin test
When patient points at pain, should be within 1cm of PSIS
Patrick test is also known as?
FABER
Is hip scour more sensitive or specific?
sensitive
Hip OA by restricted motion
3 or more planes of restricted motion
Hip OA CPR
pain IR less that 15 pain with IR PROM morning stiffness of up to 1 hour older than 50
Stenosis CPR (5 items)
bilateral symptoms leg pain worse than back pain pain during standing/walking pain relief with sitting older than 48.
Sp: 3 test: .88
Which level disc herniation is femoral nerve tension test hypothesized to be sensitive for
L4/5
HABER test
can reproduce SIJ pain, may discriminate from LBP
what percentage of SIJ pain has symptoms below the knee
40%
What is most common location of pain with SIJ involvement?
slightly lateral and inferior to PSIS
In posterior pelvic pain since pregnancy, is hip weakness thought to be due to muscle weakness, or difficulty using muscles
difficulty using muscles.
in forward bending, what percentage of movement should be lumbar and what should be pelvid
50/50
Key characteristics of cauda equina syndrome (5)
saddle anesthesia bladder dysfunction sexual dysfunction bowel dysfunction neurological deficits of LE
Clinical test for pelvic fractures
inability to perform hip flexion with knee extension
Risk factors for lumbar fracture
trauma, point tenderness and uce of corticosteroids
Male or female, who is more likely to get a stress fracture?
female. 3.5x
What s/s may rule in potential zygaphophyseal joint pain
absence of pain with coughing/sneezing and when rising from chair
If pain is not present with coughing or stand from sitting, what may likely be source of pain
zygapophyseal joint pain.
Which test have best sensitivity and specificity for SIJ CPR
thigh thrust and distraction
What impact does an SIJ belt have?
relieves tension on ligaments
Does wearing an SIJ belt have an impact on muscle activity
no
