03 SI 1 Flashcards Preview

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Flashcards in 03 SI 1 Deck (50):
1

Why don't we do MMT and gonio for the SI joint?

- When you do lumbar and hip ROM, you get Si as well for gonio
- When you do lumbar, abdominal, and hip MMT, it takes care of SI as well

2

Why do some therapists choose not to treat SI?

- don't believe it moves at all
- anatomically can't produce pain
- doesn't get pathology or symptoms

3

Why do some therapists base a lot of their treatments on SI joint?

- believe it's a huge pain generator
- primary cause for most butt pain

4

Before you treat for SI, you should always check this first

lumbar spine

5

SI is the articulation between which two bones?

- sacrum
- ilium

6

Pain over this landmark can refer pain to the SI joint

PSIS

7

Can you palpate the SI joint directly?

- no
- palpate the PSIS instead

8

What is one of the biggest indicators of true SI joint dysfunction according to research?

- pain surrounding the PSIS

9

primary symptoms for the SI joint

unilateral buttock pain

10

What are some other reasons for developing buttock pain?

- SI
- piriformis syndrome
- hamstring strain
- referral from lumbar spine
- hip problem
- ischial tuberosity bursitis

11

Must you always clear lumbar spine first?

- yes
- even if you have palpable pain over PSIS
- if you don't clear lumbar spine, you'll be sure to miss something

12

What are some of the most important things to check when clearing lumbar spine?

- ROM
- repeated motion testing (if distal s/s)

13

What would make you think it's not lumbar?

- full, unrestricted lumbar ROM
- pain free
- doesn't reproduce their symptoms

14

differentiating between lumbar spine and piriformis

- repeated flexion tugs on sciatic nerve and could bring on symptoms
- repeated extension will not have a centralizing effect because it has nothing to do with the disc

15

If there is centralization with repeated motion testing, should you move on to SI?

- no, don't perform tests
- If there's centralization, SI joint testing is completely inaccurate

16

SI issues can be _____ or ______

traumatic
atraumatic

17

traumatic etiology of SI problems

- SI joint sprain
- fall and land on the butt
- jumping and landing one legged

18

Why would jumping and landing on one leg cause SI problems?

get shearing of the sacrum on the ilium

19

atraumatic etiology of SI problems

- idiopathic
- pregnancy

20

Why are pregnant women more susceptible to SI problems?

- relaxin released during 3rd trimester
- causes ligamentous laxity
- may make SI hypermobile

21

Why do we not test MMT and ROM at the SI joint?

- There's really no motion at the joint
- test ROM and MMT at the hip and lumbar spine instead

22

Because the ASIS area is potentially ticklish, what can you do to stop this?

firmer pressure

23

What are the posterior structures to palpate?

- sacrum
- SI joint/PSIS
- posterior greater trochanter
- ischial tuberosity

24

What are the anterior structures to palpate?

- ASIS
- iliac crest
- iliac tubercle
- greater trochanter
- pubic tubercle

25

When you observe the SI structures, what are you checking for?

asymmetry

26

When you're assessing for symmetry in standing, where should the patient's arms be?

down by their sides

27

How do you know if there's something going on with the ischial tuberosity?

may feel one further than the other

28

What covers the ischial tuberosity that can become inflamed?

bursa

29

If you palpate your patient in standing, do you need to palpate them lying down as well?

- yes
- need to test in WB and non-WB positions
- improved reliability and accuracy

30

What must you always do when palpating in this area?

Tell your patient everything you're going to do. Ask their permission!

31

How do you determine which side is abnormal?

- depends on the side with pain
- if they have a difference without pain, we aren't concerned about it

32

How do you name the abnormality if there's asymmetry?

based on the side that has pain

33

If there's pain on the right side and the ASIS is lower on the right, what would I call it?

right anteriorly rotated innominate

34

If there's pain on the right and the ASIS is higher on that side, what would I call it?

right posteriorly rotated innominate

35

two types of leg length differences

- true leg length difference
- functional/apparent leg length difference

36

true leg length difference

What is considered a significant difference?

- greater than ½ inch will cause symptoms » treat

37

How do you treat a true leg difference?

- build up the shoe
- insert for the shoe

38

What is a functional leg length difference?

- SI joint mobility has allowed a pelvic rotation on one side
- makes it look like one side is longer than the other

39

What may be indicative of a true leg length difference?

- ALL pelvic landmarks are higher on the right than on the left
- NOT rotation

40

For a rotated innominate, how would you name it if the patient is symptomatic bilaterally?

name based on the more symptomatic side

41

How do you determine femur length difference?

- hooklying position, feet together
- look at height of knees

42

How do you determine tibia length difference?

- prone, bend knees to 90˚
- look at heel height

43

What is the gold standard for determining leg length difference?

scanogram

44

Why would you need to use a scanogram?

- significant difference in leg length
- want to know how much needs to be corrected

45

Why do radiologists not like doing the scanogram?

- have to take measurements of every single bone
- measuring femur and tibia length vis their bony landmarks

46

How would you measure for true leg length difference for the whole leg?

- measure from belly button to medial malleolus on both feet
- some PTs use the ASIS

47

What could potentially be a problem with measuring leg length from the ASIS?

If they have a rotated pelvis, may skew the measurement

48

What positions can you do leg length measurements in?

- supine
- standing

49

At what point will a shoe lift be a likely treatment?

over 1 inch asymmetry and symptomatic

50

For a standing measurement of leg length, what is the position of the feet

shoulder width apart without shoes