Modern SIJ Assessment and Treatment Part 2 | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

Modern SIJ Assessment and Treatment Part 2

Sacroiliac Joint Assessment tests that involve palpation of bony landmarks, and palpation of motion are considered some of the least reliable orthopaedic tests.
It was identified by Laslett et al as far back as 2005 that we should use provocation testing and a lumbar repeated motions to rule out lumbar and rule in SIJ.

  • perform the expected test
  • get a functional test-retest baseline (squat, lunge etc)
  • instead of doing the expected passive treatment, like a manip, MET, mobilization, use a repeated loading strategy like repeated sidegliding or extension
  • retest the function AND the expected test, like supine to long sit - then ask the question, if this is now even, without "putting something back into place, what just happened?" 
Modern Manual Therapy is all about avoidance of palpation based motion testing or provocation testing. Why not get right to relief? Do you really need to diagnose by provocation or is alleviation enough? You'll have a happier patient and improve therapeutic alliance if you don't go around provoking people's complaints.

Modern SIJ Assessment and Tx Part 2

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