Modern SIJ Assessment and Treatment Part 1

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.

In Part 1 of this video series, I go over a simplified version of the way I rule in SIJ and rule out the lumbar spine. True SIJ pathology is less than 10% of the non-specific lumbopelvic pain presentations you'll see in the clinic.

• Assess repeated lumbar flexion, extension, and sidegliding to see if pain, ROM, and function changes
• If any of the above improve the symptoms or function, it's most likely not SIJ dysfunction
• If pain is asymmetrical, doesn't radiate to below the knee, and repeated lumbar motions DO NOT affect, pain, function, or motion then try treating the SIJ through external stabilization via a belt instead of trying to provoke it with the Laslett recommended provocation tests

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.

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