OK, so the SIJ moves. How best to assess what moved where?

[alophysio]

Hi!

Jerry, your site was not working at the time of this post so i cannot review your method at this time.

I agree that the biomechanical model is limited but since the original post was about how to assess and treat it, I thought it is a good way to start.

Also, Barb Hungerford does not teach MET exclusively but fits it into Diane's intergrated model of function. From Diane's book, you have...
1. Excessively compressed joints - fixated (often with underlying instability), stiff, compressed (often by muscles)
2. Insufficiently compressed joints - motor control problems or ligament laxity etc.

As far as I am aware, the arthrokinematics and osteokinematics of the sacrum are not under dispute. Coupled movements have been described and nutation/counter-nutation proven and demonstrated in no-pain and pelvic-girdle pain groups.

Reliability tests in research papers often look to quantify dysfuctions and thus show differences between testers but what if they actually studied if there was symmetry or asymmetry (i.e. positive or negative tests). This is more useful clinically. A positive stork test is a general sub-heading for a dysfunction but it feels different for different causes and you see different movement patterns during the test (e.g. L5/S1, SIJ, overactive muscles, poor core stabilisers, tight hip, fixated joint, etc etc).

The Muscle Energy Technique is but one bullet in a stockpile of weapons to use on SI problems. It has been refined and modified. Like your model as described, I treat according to dysfunctions I discover during testing and not so much the pain and symptoms the patient describes (although some Syndey Uni people will tell you that the pain-producing structure is the most reliable way of treating!).

I have taught non-physios (podiatrists, exercise physiologists and myotherapists) how to do the stork and standing FF test and they can do so easily, discover dysfunctional SIJs and refer them off to physios who know how to treat them in a similiar model to the one I use.

Thanks.