SIJ tests Flashcards
SIJ orthopedic tests
SIJ compression
SIJ gapping
SIJ distraction
Sacral thrust
Thigh thrust
Gaenslens
Flamingo test
SIJ marching
Tests that make up there laslett cluster
SIJ compression
SIJ distraction
Thigh thrust
Gaenslens
SIJ gapping
SIJ compression
Looks for:
– SIJ posterior ligaments, fracture, SIJ dysfunction
– SIJ instability
+VE:
– reproduction of symptoms pt is suffering with
How:
– pt sidelying, hip flexed 45 degrees with the knee flexed 90 degrees
– contact on anterior rim of the ilium (ASIS)
– 3-6 vertical thrusts, with increasing pressure each one
SIJ distraction
looks for:
– Anterior SIJ or pubic joint strain, fracture
– distracts the nominates away from each other to open up the anterior SIJ joint
+VE:
– unilateral gluteal pain or posterior leg pain
—- indicates sprain of the anterior sacroiliac ligaments
How:
– pt is supine
– cross hands on both ASIS
– distract away from each other
SIJ gapping
Looks for:
– compresses the nominates to stress the posterior SIJ
+VE:
– pain
—- sacroiliac strain, sprain, fracture, SIJ dysfunction
How:
can be performed 2 ways:
– pt supine:
—- push laterally to medially on the ASIS
– pt sidelying:
—- hands on superior ilium, the same as compression
SIJ gapping
Looks for:
– compresses the nominates to stress the posterior SIJ
+VE:
– pain
—- sacroiliac strain, sprain, fracture, SIJ dysfunction
How:
can be performed 2 ways:
– pt supine:
—- push laterally to medially on the ASIS
– pt sidelying:
—- hands on superior ilium, the same as compression
Sacral thrust
Looks for:
– compress sacral apex
– shears the sacrum against the left and right ilium
– causes a rotational shift of the SIJ
+VE:
– pain produced on thrust
– indicates SIJ dysfunction
How:
– pt prone
– find apex of sacrum
– vertical pressure straight down (shears sacrum against ilium)
Can then follow this test up with the sacral glide/shear test
Thigh thrust
Looks for:
– SIJ and hip pathology
– shears the sacrum and the innominate
+VE:
– pain in the SIJ the thrusting
How:
– pt supine
– flex the testing side knee to 90 degrees
– palpate the SIJ underneath the pt
– use the other hand to thrust down on the knee
Gaenslen’s test
Looks for:
– SIJ sprain, instability
– iliopsoas contracture
– lumbar or hip pain
– stresses SIJ, hip and L4 NR
+VE:
– pain- sacroiliac or anterior thigh
– elevation of extended hip shows psoas contracture
How:
– pt supine towards edge of bed (asymptomatic leg 1st)
– put leg off the bed, ask pt to hold onto other side
– other leg flexed up to chest, pt hold that leg in place
– put pressure on the ASIS and push the flexed leg towards chest of pt
– swap legs
SIJ flamingo test
Looks for:
– ipsilateral SIJ dysfunction
– weight of trunk causes the sacrum to shift forward distally with forward rotation
– opposite will happen on no-weight bearing side
+VE:
– pain in pubic symphysis or SIJ indicates positive test
How:
– pt asked to stand on one leg
– increase the stress by asking the pt to hop on one leg
SIJ marching test
Looks for:
– sacroiliac or pubic joint strain, fracture
– hyper mobility, joint dysfunction
– ipsilateral SIJ dysfunction
+VE:
– localised pain
– excess motion
– decreased
How:
– pt standing
– palpate pt’s PSIS
– assess both sides
– thumb on S2 and thumb on one of the PSIS, if there’s no movement or excess movement when leg is flexed then that’s positive
Normal test:
– a normal test, the PSIS on the flexed leg side will drop below S2.
