Pelvic Special Tests Lab Lecture Notes

Overview

• Focus on assessing the sacroiliac (SI) joint.
• Related online lectures: SI joint pathologies/dysfunction and pelvis anatomy.

Ipsilateral Prone Kinetic Test

• Purpose: To test for a posteriorly rotated ilium.
• Position: Patient prone, stomach down.
• Procedure:
  • Locate the posterior superior iliac spine (PSIS).
  • Apply pressure to the PSIS.
  • Flex the knee to 90 degrees; lift heel to ceiling.
  • Positive Test: Thumb stays or moves inferiorly instead of cranially.
• Notes: Test bilaterally, starting with the non-pathological side.

Passive Extension and Medial Rotation of Ilium on Sacral Test

• Purpose: Assess a posteriorly rotated ilium by moving pelvis into an anterior position.
• Procedure:
  • Stand behind or in front of the patient.
  • Place one hand on ASIS, other on the sacrum.
  • Positive Test: Ilium does not move into an anterior position.

Passive Flexion and Lateral Rotation Ilium Sacral Test

• Purpose: Assess an anteriorly rotated ilium by moving pelvis into a posterior position.
• Procedure:
  • Position hands on ASIS and sacrum.
  • Rock pelvis into a posterior position.
  • Positive Test: Ilium does not move posteriorly.

Compression/Gapping Stress Test

• Purpose: Assess anterior sacroiliac ligament.
• Procedure:
  • Cross hands on opposite ASIS.
  • Apply downward and outward pressure at the same time.
  • Positive Test: Deep seated pain, increased laxity.

Yeoman's Test

• Purpose: Assess SI joint by hip extension.
• Procedure:
  • Patient prone, knee at 90 degrees.
  • Extend the hip.
  • Positive Test: Pain in the SI joint region.

Approximation Test

• Purpose: Assess posterior sacroiliac ligament.
• Procedure:
  • Patient side-lying.
  • Apply downward pressure on iliac crest.
  • Positive Test: Increased pain, laxity.

Squish Test

• Purpose: Assess posterior sacroiliac ligament.
• Procedure:
  • Patient supine.
  • Press down on ASIS at 45-degree angle from the head.
  • Positive Test: Pain indicates posterior sacroiliac sprain.

Sacroiliac Rocking Test

• Purpose: Assess sacro tuberous ligament.
• Procedure:
  • Patient supine, leg flexed and placed on clinician's shoulder.
  • Rock sacrum by flexing hip.
  • Positive Test: Pain indicates sacro tuberous ligament sprain.

Sacral Shearing Test

• Procedure:
  • Patient prone.
  • Apply pressure in a CPR position on sacrum.
  • Positive Test: Pain indicates SI joint dysfunction.

Gillette’s Test

• Purpose: Assess SI joint dysfunction in standing.
• Procedure:
  • Patient stands, locate PSIS.
  • Flex knee to chest.
  • Positive Test: Thumb does not move inferiorly.

Standing Flexion Test

• Procedure:
  • Patient bends to touch toes.
  • Positive Test: One thumb does not move cranially.

Gaines Lens Test

• Purpose: Pain provocation test for SI joint.
• Procedure:
  • Patient supine, one leg off table.
  • Extend hip.
  • Positive Test: Pain during extension.

Lager’s Test

• Procedure:
  • Patient supine, hip and knee flexed to 90 degrees.
  • Laterally rotate hip and apply posterior force on femur.
  • Positive Test: Pain in SI joint.

Sit to Stand Test (Long Sit Test)

• Purpose: Assess leg length discrepancy related to pelvic rotation.
• Procedure:
  • Compare alignment of malleoli in supine and sitting positions.
  • Positive Test: Changes in limb length suggest pelvic rotation.

Conclusion

• Tests help determine dysfunction cause in SI joint.
• Next steps involve determining treatment: stretching, strengthening, etc.
• Review and practice in lab for clarity and application.