Sacroiliac Joint Assessment & Treatment Flashcards Preview

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Flashcards in Sacroiliac Joint Assessment & Treatment Deck (21)
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1
Q

What is the function of the pelvis?

A
  • Weight-bearing & protective structure
  • Basic platform with 3 large levers acting on it (spine & legs)
  • Shock absorber (2 x SIJ & pubic symphysis)
  • Birth canal capable of accommodating baby
2
Q

What is the purpose of form and force closure?

A

To stop the bones of the pelvis from falling apart

3
Q

What is form closure?

A
  • Shape (form) of the sacrum & pelvic bones creates a keystone
4
Q

What is force closure?

**Exam Q on form/force closure + diagrams

A
  • Additional closing force from compression (ligament & muscle)
5
Q

How is the stability of the SIJ further increased?

A

Matching ridges & depressions on the articular surfaces

6
Q

What is the most recent observation about the movement of the SIJ?

A
  • Largest movement occurs when moving from lying to standing

- But still ongoing debate

7
Q

How is the movement of the sacral promontory relative to the ilium described?

A
  • Nutation (forward nodding, i.e. coccyx moving posteriorly)

- Counternutation (backward nodding, i.e. coccyx moving anteriorly)

8
Q

Why can you get pain in the SIJ?

A

Articular cartilage contains sensory nerve fibres

9
Q

What are the causes of LBP in pregnancy?

A
  • Hormonal changes (relaxin)
  • Biomechanical changes (weight of baby/placenta sitting anteriorly, causes increased lumbar lordosis)
  • AAA can caused referred back pain
10
Q

What is the role of the hormone relaxin in pregnancy?

A
  • With progesterone, relaxes ligaments in the pelvic girdle

- Softens the public symphysis (preparation for delivery)

11
Q

What are the pain provocation tests for the SIJ?

A
  • Compression
  • Distraction
  • Posterior pelvic pain provocation test (p4)
  • Gaenslen’s test
  • Sacral thrust test (sacral PA)
  • Faber
12
Q

What are the load transfer tests for the SIJ?

A
  • Stork test

- Active SLR

13
Q

What are the 2 categories of degenerative damage to the the SIJ?

A
  • Insufficient compression (positive ASLR)
  • Excessive compression (trauma, ankylosing spondylitis)
  • Usually caused by trauma or micro trauma
14
Q

What are the management paradigms for the SIJ?

A
  • Motor control (TA, multifidus, diaphragm, pelvic floor)
  • Muscle slings
  • Strengthening (global muscles)
  • Joint mobilisations
15
Q

What is the best positioning for a non-elastic SIJ belt in rehabilitation?

A

Positioning at the ASIS is more effective than at the level of the pubic symphysis in reducing laxity

16
Q

What are the symptoms of ankylosing spondylitis?

A
  • Morning stiffness >30 mins
  • Eased by exercise, not by rest
  • Night pain (2nd half of the night)
  • Buttock pain alternating sides
17
Q

What are the clinical features of AS?

A
  • Stiff lumbar slide
  • Positive SIJ tests
  • Reactive arthritis, IBD, Crohn’s disease
18
Q

What does the treatment of AS involve?

A
  • Medical monitoring & management

- Home-based/group exercise (strength & flexibility)

19
Q

What is osteitis pubis?

A
  • Overuse of pubic symphysis & adjacent bone
  • Caused by abnormal stress at symphysis
  • Pain with palpation, running, change of direction, kicking
20
Q

How is osteitis pubis diagnosed?

A
  • Adductor squeeze test
  • XR (moth-eaten appearance)
  • MRI
21
Q

What is the treatment for osteitis pubis?

A
  • Hip ROM
  • SIJ & lumbosacral movement/control
  • Gradual introduction of activity while monitoring symptoms
  • Prolonged rest & passive treatment associated with delayed recovery & ongoing symptoms