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Flashcards in Sacroiliac Joint Assessment & Treatment Deck (21):

What is the function of the pelvis?

- 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


What is the purpose of form and force closure?

To stop the bones of the pelvis from falling apart


What is form closure?

- Shape (form) of the sacrum & pelvic bones creates a keystone


What is force closure?

**Exam Q on form/force closure + diagrams

- Additional closing force from compression (ligament & muscle)


How is the stability of the SIJ further increased?

Matching ridges & depressions on the articular surfaces


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

- Largest movement occurs when moving from lying to standing
- But still ongoing debate


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

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


Why can you get pain in the SIJ?

Articular cartilage contains sensory nerve fibres


What are the causes of LBP in pregnancy?

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


What is the role of the hormone relaxin in pregnancy?

- With progesterone, relaxes ligaments in the pelvic girdle
- Softens the public symphysis (preparation for delivery)


What are the pain provocation tests for the SIJ?

- Compression
- Distraction
- Posterior pelvic pain provocation test (p4)
- Gaenslen's test
- Sacral thrust test (sacral PA)
- Faber


What are the load transfer tests for the SIJ?

- Stork test
- Active SLR


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

- Insufficient compression (positive ASLR)
- Excessive compression (trauma, ankylosing spondylitis)
- Usually caused by trauma or micro trauma


What are the management paradigms for the SIJ?

- Motor control (TA, multifidus, diaphragm, pelvic floor)
- Muscle slings
- Strengthening (global muscles)
- Joint mobilisations


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

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


What are the symptoms of ankylosing spondylitis?

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


What are the clinical features of AS?

- Stiff lumbar slide
- Positive SIJ tests
- Reactive arthritis, IBD, Crohn's disease


What does the treatment of AS involve?

- Medical monitoring & management
- Home-based/group exercise (strength & flexibility)


What is osteitis pubis?

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


How is osteitis pubis diagnosed?

- Adductor squeeze test
- XR (moth-eaten appearance)


What is the treatment for osteitis pubis?

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