Sij testing

[neuromuscular]

I would like some input on why we do so much SIJ testing, when admittedly, the SIJ does not prove to be the problem in the majority.

True structural SIJ problems or "form closure" problems of a structural nature are admittedly rare. Therefore, is not SIJ testing just a repeat of the Patient information gathered in the patient history?

We already know that the patient has low back, hip or pelvic pain or a pain in the lower extremities. What does the SIJ test add if the SIJ is not the cause in the majority, but only the effect? Are we not taking up time that could be used on other tests? Is it not focusing too much of our attention on an area of no great importance? To me, this is like every MD in Canada doing a malaria test on every patient when admittedly malaria is very, very rare in Canada unless the patient has been to a tropical climate.

Every text starts with the standing SIJ test with hip or torso flexion using the landmarks of the PSIS to sacrum as in the "Gillett" test or in the 'swing phase" or "stance phase" of the stork test and adds other joint movement assessments. Why bother, it very little in relevant information is gained, but that we need to do more tests to determine what the cause is? Why not just go to the passive, active, ROM, resisted, etc., etc., types of tests without taking the precious time to do the SIJ test? As a note of interest, if you do a standing SIJ test using the PSIS to sacrum with hip ABD the PSIS moves superior and lateral to the sacrum in every positive for the Gillett test for a "fixation" or "stuck" SIJ. What is the significance of that?

I use the innominate bone position test as it gives me a starting point that moves through a successive steps of assessment that are relevant to the patient's condition. It is a starting point on which the other tests build successively. It gives me the information on which tests I need to do next.

What viewpoints are out there?

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