Flashcards in SIJ MET Deck (14):
1
If an ASIS is positioned medial to the midline, what is the diagnosis?
- Iliosacral inflare
2
If an ASIS is found lateral to the midline, what is the diagnosis?
- Iliosacral outflare
3
Which side of the pelvis is treated in an outflare/inflare?
- The hypomobile
4
Describe the treatment of a iliosacral outflare.
- Pt supine
- Flex hip and knee with foot on table
- Move knee medially (combined IR and ADD) to movement barrier
- Resist ABD and ER by the patient producing a lateral force
- If the outflare is stubborn, hook fingers medial to the PSIS and posterior ilia and distract the joint laterally between contractions
- Repeat 3 - 5 times
5
Describe the treatment of an iliosacral inflare.
- Pt supine hook lying
- Move knee laterally (combined ER and ABD) to movement barrier
- Resist combined ADD and IR by the patient pushing medially
- Repeat 3 - 5 times
6
What landmarks are assessed for an iliosacral upslip/ downslip?
- ASIS
- PSIS
- Pubic tubercles
- Ischial tuberosities
7
How are the bony landmarks of the pelvis oriented in an iliosacral upslip?
- Cephalad on hypomobile side
8
How are the bony landmarks of the pelvis oriented in an iliosacral downslip?
- Caudal on the hypomobile side
9
Describe MET for an ilial upslip.
- Pt positioned supine or prone
- Grip the paitent at the level of malleoli
- Find loose packed position of the hip and provide traction force through the hip and knee while monitoring the patient's reaction
- Take up the slack caudally, then provide an HVLA thrust
10
What is the open packed position of the hip?
- 30 degrees flexion
- 30 degrees abduction
- Slight ER
11
Describe MET for a downslip of the ilia.
- Pt sidelying on uninvolved side
- PT positioned behind patient
- PT grips ischial tuberosity and pubic ramus with thumb and webspace of the caudal hand
- Other hand grips under iliac crest using webspace of hand
- Distract ilia laterally towards the ceiling
- Maintain a lateral distraction and move the ilia cephalad
12
How is anterior/ posterior ilial rotation assessed?
- Compare ASIS caudad with PSIS cephalad (anterior rotation)
VS
- ASIS cephalad with PSIS caudad (posterior rotation)
13
Describe MET for anterior rotation of the injominate.
- Pt supine
- Flex hip and knee to barrier
- IR hip to barrier
- ADD hip to barrier
- Resist hip extension
- Hold 6 - 10 seconds
- Repeat 3 - 5 times
14