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Pelvis/SI Joint

Functional Anatomy

primary stabilizing ligaments of the SI Joint Physically cross the SI joint; iliolumbar ligaments, ant sacroiliac ligament, short & long post sacroiliac ligaments, interosseus ligament
secondary stabilzers stabilize, but don't physically cross SI joint; sacrospinous & sacrotuberous ligaments
iliolumbar ligaments transv processes of L4 & L5 to iliac crests/sacral ala; strong bonds btwn L5 & ilium; stabilize lumbosacral joint; reinforce ant side of SI joint; decrs shearing btwn L4/L5 & sacrum
ant sacroiliac ligaments thickening of ant & inf regions of capsule
interosseous ligament deep to short posterior SI ligaments; fills gap of post & sup margins of SI joint; blends into capsule
sacrotuberous ligament PSIS, Inf lat angle of the sacrum, & the lat sacrum/coccyx to the ischial tuberosities
sacrospinous ligament controls lat/torsional strain & rotational strain; pelvic floor muscs have attachments to this ligament
sxs of SI joint dysfxn pain in lower lumbar & med buttock area; may be pain in the post thigh; wider distribution of pain
symphysis pubis end of each pubic bone is covered w/ articular cartilage, but joint itself contains a fibrocartilaginous disc.
ant stabilization of symphysis pubis musc expansion of TA, rectus abd, int abd oblique, & adductor longus muscs that forms an ant "ligament" restricting ant translation/shear
pelvic floor shares innervation with the TA musc; therefore, both TA & pelvic floor muscs help stabilize the pelvis
saggital plane motions of the SI joint nutation & counternutation; axis of motion= med/lat at S2 joint (mid transverse axis)
nutation aka sacral flexion; relative ant & inf motion of the sacral base; coupled with lumbar extension
counternutation aka sacral extension; post & sup motion of sacral base; coupled with lumbar flexion
sacral torsions named for the direction that the ant surface of the sacrum is facing
side of deeper sacral sulcus opposite side of torsion direction; ant sacrum is rotated in the opposite direction
stabilizing muscs of the SI joint pelvic floor, abs, erector spinae, quadratus lumborum, lats, hip flexors, hip abductors, hip adductors, hip extensors, hip IR, hip ER
hypomobile SI joint dysfxn pain increases with strain (activities involving rotation or torque through the joint); responds well to treatment
hypermobile SI joint dysfxn athletes, standing & walking increases pain, any act involving torque; treat w/ rest, supports, & stability exercises for gluts, pelvic floor, & multifidi.
testing for SI joint pathology 2/4 positive tests indicate SI joint is the source of the problem/pain; order of tests: distraction, thigh thrust, compression, & sacral thrust; Gillet's test; supine active straight leg raise
true leg length difference true diff in length of the femurs &/or tibia
apparent leg length difference pelvic rotation is contributing to the leg length diff- APT, PPT, etc...
tests for LLD long sit test, measure ASIS to med malleolus
distraction test hold for 30 secs, then quick force in direction of applied pressure; positive test= production of comparable sign
thigh thrust test examiner on opp to symptomatic side; positive test= reproduction of comparable sign on the thrust side
compression test pt in side lying & the symptomatic side uppermost;
Created by: MeganFultz2
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