Random Stuff [MDDR]

Question 1

Posterior Sling SIJ

Answer 1

Gluteus Maximus, latissimus dorsi, ITB tract, thoracolumbar fascia

Question 2

Anterior Sling SIJ

Answer 2

Internal oblique, external oblique, rectus oblique, traverse abdominal muscle

Question 3

Longitudinal Sling

Answer 3

multifidus (attaching to sacrum)
deep layer of the thoracolumbar fascia
Long heads of biceps femoris connected to the sacrotuberous ligament

Question 4

Types of SIJ trauma

Answer 4

Macro Trauma (i.e. direct fall on to the SIJ, sudden jar through leg)

Micro Trauma (repetitive loading over time, e.g. running /lifting can be associated with poor force closure)

Question 5

Management of Hypomobile SIJ

Answer 5

• Mobilise
• Joint mobilisation / manipulation
• stretch muscles that contribute to force closure

Question 6

Osteoporosis, Rheumatoid Arthritis, Ankylosing Spondylitis are all examples of

Answer 6

Bone weakening & destructive disorders

[contraindications of manipulation]

Question 7

What are some articular factors contraindicating manipulation

Answer 7

Scoliosis, kyphosis (i.e. in ankylosing spondylitis / scheuremann’s disease], spondylolisthesis, advanced degenerative changes

Question 8

What are some circulatory disorders contraindicating manipulation?

Answer 8

Symptoms associated with VBI
Severe Haemophilia (a genetic disorder that impairs the body's ability to control blood clotting)

Question 9

What are some drugs contraindicating manipulation?

Answer 9

long term steroid use (can cause osteoporosis) 
under the influence of alcohol
anticoagulants e.g. warfarin 
strong pain relief (can mask pain)
anti-depressants

Question 10

What are some neurological factors contraindicating manipulation

Answer 10

Cauda Equina Symptoms
disturbed reflexes
altered muscle power
altered sensation

Question 11

What some UNCLASSIFIED factors contraindicating manipulation

Answer 11

Severe pain
undiagnosed pain
no patient consent
when the physiotherapy senses that the joint will not ‘give’
adverse reactions to previous manual therapy
children of teenagers
any patient with a condition that is worsening significantly

Question 12

Indications for a HVT

these characteristics are the safest people to manipulate

Answer 12

Stiffness greater than pain

Stiffness that has not resolved

Plateau of mobilisations

Local/central somatic pain (dull ache [DON’T MANIPULATE RADICULAR PAIN]

Biomechanically linked with the actual problem your trying to fix

No contraindications

Patient consent

Question 13

What are the main two points to note during the performance of spinal movement control tests?

Answer 13

1) Can the patient move the limbs without causing motion in the lumbar spine
2) Does the test provoke the patients lumbar pain