Sacroiliac joint

Question 1

During gait, which piriformis is active?

Answer 1

The one on the weight bearing side

Question 2

Why is the flexion test positive in the event of SI joint dysfunction?

Answer 2

If the SI joint is locked up, it drags the innominate with it.

Question 3

What does a flexion test tell us in relation to the SI joint?

Answer 3

Which side may have a dysfunction

Question 4

Dysfunctions of the pelvis

Answer 4

Innominate rotation, innominate flare and subluxation at the pubic symphysis

Question 5

Which muscles will pull the pubic symphysis into subluxation?

Answer 5

The adductors

Question 6

Sacral dysfunctions

Answer 6

Sacral torsions (anterior or posterior)

Question 7

Anterior torsions of the sacrum involve…

Answer 7

Sacral flexion and rotation

Question 8

Anterior sacral torsions

Answer 8

Right on right and left on left

Question 9

Posterior sacral torsions involve…

Answer 9

Extension and rotation

Question 10

Posterior sacral torsions

Answer 10

Right on left and left on right

Question 11

What does the first blank in a sacral torsion name tell you?

Answer 11

Which way the sacrum is rotated

Question 12

What does the second blank in a sacral torsion name tell you?

Answer 12

The axis that it’s stuck on

Question 13

How is the side of rotation in a sacral torsion identified?

Answer 13

By palpating the depth of the sacral ulcus and the inferior lateral angle.

Question 14

Neutral spine mechanics

Answer 14

Rotation and side bending occurs to oppostie sides

Question 15

Non-neutral spine mechanics

Answer 15

Rotation and side bending occur to the same side

Question 16

Spine mechanics of the neck

Answer 16

Non-neutral; rotation and sidebending occur to the same side.

Question 17

MOI in a same on same sacral torsion

Answer 17

Same multifidus, opposite piriformis, same psoas, opposite quadratus lumborum

Question 18

MOI in a same on opposite sacral torsion

Answer 18

Opposite piriformis, same multifidus, same psoas, opposite QL

Question 19

Why is the multifidus the primary MOI in anterior torsions?

Answer 19

It holds the sacrum in a flexed position

Question 20

Why is the opposite side piriformis the primary MOI for posterior torsions?

Answer 20

It holds the sacrum extended.

Question 21

The effects of psoas and QL on sacral torsions

Answer 21

They don’t usually cuase the torsions, but they can reinforce previously created issues.

Question 22

Psoas is on the same side as which primary MOI in sacral torsions?

Answer 22

Multifidi

Question 23

QL is on the same side as which MOI in sacral torsion?

Answer 23

Piriformis

Question 24

What does the psoas do in response to sacral torsion?

Answer 24

It adaptively shortens to the rotated positions.

Question 25

What does the QL do in response to sacral torsion?

Answer 25

It increases isometric or eccentric tone to match the multifidus on the oppostie side.

Question 26

False positives in the standing flexion test

Answer 26

Trust the seated flexion test over the standing due to the effects of the hamstrings.

Question 27

Why does sitting down make the hamstrings shorter?

Answer 27

The femur just spins in the acetabulum, but the knee joint rolls and glides. It travels enough that the total path length is altered.

Question 28

MOI in anterior innominate rotation

Answer 28

Tight rectus femoris, weak hamstrings

Question 29

MOI in posterior innominate rotation

Answer 29

Tight hamstrings, weak rectus femoris

Question 30

MOI of innominate inflare

Answer 30

Tight iliacus, weak TFL, glute med or glute min. Tight fibers of the internal oblique below the ASIS may also contribute.

Question 31

MOI of innominate outflare

Answer 31

Tight TFL, glute med or glute min, weak iliacus. Weak fibers of the internal oblique below the ASIS may also contribute.

Question 32

Apparent short leg test application

Answer 32

The patient lies prone. The therapist palpates the medial malleoli and compares their distance from the body.

Question 33

What can the apparent short leg test be used for?

Answer 33

If the right leg appears shorter, it may indicate that the sacrum is rotated right. Can be used as a backup if the sulcus and ILA show opposite findings.

Question 34

Springy lumbar test application

Answer 34

Patient lies prone and the therapist compares the springiness of the thoracic and lumbar vertebrae.

Question 35

Positive sign in springy lumbar test

Answer 35

The thoracic and lumbar vertebrae have the same springiness.

Question 36

If the lumbar vertebrae is not springy, what does this mean?

Answer 36

The lumbar vertebrae is stuck flexed. This means that the sacrum is extended and there may be a posterior sacral torsion.

Question 37

What can a non-springy lumbar confirm?

Answer 37

A posterior sacral torsion