Pelvic Special Tasks Lab

Overview

• Focus on assessing the sacroiliac (SI) joint.
• Recommended to review online lectures on SI joint pathologies and pelvis anatomy.

Ipsilateral Prone Kinetic Test

• Purpose: Test for a posteriorly rotated ilium.
• Position: Patient lies prone (stomach facing down).
• Procedure:
  • Locate the posterior superior iliac spine (PSIS).
  • Apply pressure on PSIS.
  • Flex knee to 90 degrees, then lift heel towards the ceiling.
  • A positive test: No cranial movement of the thumb on PSIS or it moves inferiorly.
• Note: Always test bilaterally starting with the non-pathological side.

Passive Extension and Medial Rotation Test

• Purpose: Assess posteriorly rotated ilium.
• Position: Stand behind or in front of the patient.
• Procedure:
  • Rock pelvis in the opposite direction (anteriorly) to test posterior rotation.
  • Check for movement.
• Positive Test: No movement indicates a posteriorly rotated ilium.

Passive Flexion and Lateral Rotation Ilium Sacral Test

• Purpose: Assess anteriorly rotated ilium.
• Procedure:
  • Rock pelvis posteriorly.
  • Check for movement.
• Positive Test: Lack of movement indicates an anteriorly rotated ilium.

Compression or Gapping Stress Test

• Purpose: Test for anterior sacroiliac ligament sprain.
• Position: Hands crossed, placed on opposite ASIS.
• Procedure:
  • Apply a downward and outward push simultaneously.
• Positive Test: Pain suggests anterior sacroiliac ligament issue.

Yeomans Test

• Purpose: Similar to prone ipsilateral test but extends hip causing SI joint compression.
• Position: Patient prone.
• Procedure:
  • Extend hip while stabilizing.
• Positive Test: Pain in SI joint.

Approximation Test

• Purpose: Test posterior sacroiliac ligament.
• Position: Patient side-lying.
• Procedure:
  • Apply downward pressure on iliac crest.
• Positive Test: Pain indicates posterior sacroiliac ligament issue.

Squish Test

• Purpose: Test posterior sacroiliac ligament.
• Procedure:
  • Stand at head of patient.
  • Press on ASIS downward and at a 45-degree angle.
• Positive Test: Pain indicates ligament issue.

Sacroiliac Rocking Test

• Purpose: Test sacro tuberous ligament.
• Position: Patient supine.
• Procedure:
  • Flex leg, place on the shoulder, and rock the sacrum.
• Positive Test: Pain indicates sacro tuberous ligament sprain.

Sacral Shearing Test

• Purpose: Test SI joint dysfunction.
• Position: Patient prone.
• Procedure:
  • Apply chest compressions on the sacrum.
• Positive Test: Pain indicates dysfunction.

Gillette's Test

• Purpose: Assess SI joint movement.
• Position: Patient standing.
• Procedure:
  • Flex knee to chest, assess thumb movement on PSIS.
• Positive Test: Lack of inferior movement indicates dysfunction.

Standing Flexion Test

• Purpose: Assess SI joint movement.
• Procedure:
  • Patient bends to touch toes, observe thumb on PSIS.
• Positive Test: Lack of cranial movement suggests dysfunction.

Gaines Lens Test

• Purpose: Pain-provocation test for SI joint.
• Position: Patient supine, limb off the table.
• Procedure:
  • Rock hip into extension.
• Positive Test: Pain indicates SI joint issue.

Lager's Test

• Purpose: Test for SI joint dysfunction.
• Position: Patient supine.
• Procedure:
  • Flex hip and knee to 90, laterally rotate, apply pressure.
• Positive Test: Pain indicates dysfunction.

Sit to Stand Test (Long Sit Test)

• Purpose: Identify leg length discrepancy.
• Position: Patient supine to seated.
• Procedure:
  • Observe malleoli alignment when laying and seated.
• Positive Test: Change in limb length after sitting suggests pelvic rotation issue.

Conclusion

• Special tests help identify SI joint dysfunctions.
• Importance of identifying movement issues to determine treatment approaches.