sacroiliac joint dysfunction

[CenteredHealth]

Having yet to read the articles that JessPT has kindly posted, I will go out on a limb and ask... Does the absence of SIJ symptoms equate absence of SIJ dysfunction?

[sharileedahl]

Will jump back in on this discussion after reading the articles provided by jesspt (Thanks).

But first a few thoughts...

Regarding the initial post:
There are a lot of tests for the SIJ in terms of position, mobility... My understanding is that any of the tests on their own are iffy. However when multiple tests are used, the validity/reliability of your findings improve greatly. So best to know lots of tests....do lots of tests...understand what they (the tests) are telling you....then critically think your way through all your findings to solve the puzzle. I had once heard that Diane Lee said she felt she could get most of her findings from observing the client do a single leg stand test. As I practice longer, I can see what she is saying (although I'm not quite there yet!!) however when I was a new grad there is no way I would have been able to see everything I needed to see from that one test.

Regarding upslips, anteriorly rotated pelvis etc.....
Do you guys feel that you see true upslips very often ...
I ask this because when I compare my position testing to mobility testing etc I often find that the issue is somewhere else and not specifically at the SIJ. i.e. myofascial tightess (QL / psoas / gluts / / / ) or lower Lsp (L4/5, L5/S1...perhaps some segmental facilitation creating increased muscle tone???)
The handful of times that I have felt hypomobility at the SIJ along with either an upslip or fixation in rotation, manually treating the SIJ (mobilization - Grade 4 or 5) has worked great....great outcomes....lasting benefits....blah,blah,blah! HOWEVER, the majority of the time, I feel like I'm wasting my time even fiddling around with manual therapy in the area because the improvements may only last minutes. And yes, we spend alot of time trying to retrain muscle balance in the area too but I'm not convinced adding the SIJ manual therapy improves on outcomes more than just doing the exercise alone. What do you think????
(This is an area that I've put on my list of things to learn more about....course coming up this fall!)

[neuromuscular]

Having yet to read the articles that JessPT has kindly posted, I will go out on a limb and ask... Does the absence of SIJ symptoms equate absence of SIJ dysfunction?

Try the test for APAS. It will give you more insight.

Or try a simple test of PSIS to sacrum with hip abduction. The positive of other tests will be a negative with this test. The PSIS will move superior and lateral to the sacrum.

The true picture is APAS.


Hope you find this helpful.

Best regards,

Neuromuscular

A research papoer is being prepared on APAS by the OGI.