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Flashcards in Random Stuff [MDDR] Deck (13):

Posterior Sling SIJ

Gluteus Maximus, latissimus dorsi, ITB tract, thoracolumbar fascia


Anterior Sling SIJ

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


Longitudinal Sling

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


Types of SIJ trauma

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)


Management of Hypomobile SIJ

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


Osteoporosis, Rheumatoid Arthritis, Ankylosing Spondylitis are all examples of

Bone weakening & destructive disorders

[contraindications of manipulation]


What are some articular factors contraindicating manipulation

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


What are some circulatory disorders contraindicating manipulation?

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


What are some drugs contraindicating manipulation?

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


What are some neurological factors contraindicating manipulation

Cauda Equina Symptoms
disturbed reflexes
altered muscle power
altered sensation


What some UNCLASSIFIED factors contraindicating manipulation

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


Indications for a HVT
(these characteristics are the safest people to manipulate)

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


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

1) Can the patient move the limbs without causing motion in the lumbar spine

2) Does the test provoke the patients lumbar pain