Positive sign: If one side moves higher than the other it indicates hypo-mobility on that side.
There is a host of other orthopaedic tests that aim to ascertain the possible role of the SI joint in low back pain. As therapists we love the idea that we can carry out some tests and come to a firm conclusion – just like a doctor! Clients also trust the idea of ‘tests’ being carried out to determine the exact cause of pain as this fits into the predominant worldview of health and pain that is dominated by the medical model. In this worldview, faulty or misaligned structures lead directly to pain; there is a single cause which if corrected can reduce the pain.
So if you are a practitioner using these tests should you throw them out? Not necessarily, but just be informed about which combination of SI joint tests is the most useful. There is a good research paper by Mark Laslett (2008) available free on the web that summarises the most helpful tests – see the link in the references and give it a read. Also make sure you are not just putting emphasis on the results of your orthopaedic testing as being the last word in the assessment and treatment of SI joint dysfunction. Make sure you are also asking your client about their stress levels, attitudes to pain, levels of activity and exercise and many other factors which we know have just as much influence on our experience of pain.
So it seems that how ‘loose’ or ‘stuck’ our SI joint is may have less relevance in the phenomenon of SI joint dysfunction than previously thought. For example, the common idea that pregnant women are susceptible to SI pain because of their ligament laxity seems to have little research validity. A study of 163 pregnant women found that: “Increased SIJ laxity is not associated with pregnancy related pelvic pain. In fact, pregnant women with moderate or severe pelvic pain have the same laxity in the SIJs as pregnant women with no or mild pain” (Damen et al 2001).
A: Use any acupressure points you know for low back pain. S: Stretches for the muscles treated above. T: Teach and recommend self-care exercises for your client. This could include encouragement to exercise (well known to be a great healer in any pain situations), self-trigger point treatment or any other rehab exercises you know.
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