Chapter 10

LUMBO-PELVIC: TESTING OF SACROILIAC (SI) JOINT ANTERIOR GAPPING


The patient is lying supine on a firm surface. The therapist is standing to the side of the patient. The therapist crosses his forearms and places the heel of each hand over the medial edge of the patient’s ASIS (for mobilization).


MOBILIZING FORCE:

The therapist applies firm, equal pressure to each ASIS in a lateral (outward) direction through the heel of his hands. The therapist takes up the slack in the SI joint, then gives a quick lateral glide to the ASIS.


PALPATION:

Normal motion is suspected when there is a slight separation of the ASIS in the absence of SI joint symptoms. Hypermobility is suspected when there is a guarding response associated with pain over the SI joint posteriorly, or deep pain over the SI joint anteriorly.

* This test often yields a guarding response over the general abdominal region. It is important to differentiate this from a positive finding of SI joint pain associated with this test. Check hand placement carefully to avoid pressure over the muscular region of the abdomen and elicit a “ticklish” response.

* This test is designed to gap the SI joint anteriorly and compress the joint posteriorly.

TESTING OF SACROILIAC (SI) JOINT ANTERIOR GAPPING

Testing of Sacoriliac Joint Gapping (Image 1)

 

Testing of Sacoriliac Joint Gapping (Image 2)

TESTING OF SACROILIAC (SI) JOINT POSTERIOR GAPPING

The patient is lying on his left side on a firm surface. The therapist is standing behind the patient. The therapist places the heel of his right hand over the patient’s right lateral ASIS (form mobilization). The therapist’s fingertip of the left index or long finger (for palpation) is on the patient’s right SI joint.


MOBILIZING FORCE:

The therapist applies firm pressure to the patient’s right ASIS in a downward and slightly forward direction through the heel of his hand. The therapist takes up the slack in the SI joint, then gives a quick “spring” to the ASIS.


PALPATION:

Normal SI joint motion is suspected when there is a slight give of the ASIS in the absence of SI joint symptoms. Hypermobility is suspected when there is pain over the SI joint or pubic symphysis or when there is a guarding response.

* This test is designed to gap the SI joint posteriorly and compress the joint anteriorly.

TESTING OF SACROILIAC (SI) JOINT POSTERIOR GAPPING

Testing of Sacoriliac Joint Gapping (Image 3)

 

Testing of Sacoriliac Joint Gapping (Image 4)

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