*Overview of Sacroiliac Dysfunction with LBP
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1 *Overview of Sacroiliac Dysfunction with LBP Sacroiliac Dysfunction as it Co-Exists with: Pelvic/Leg Length Discrepancy Facet Syndrome Discogenic Pain Chris Resch, DC Kari Resch, PT
2 Learning Objectives Anatomical Characteristics of the SI Joints regarding ligaments, muscles, joint surfaces and joint orientation { Subjective and Objective measures to differentiate a hypermoble and/or hypomoble SI Joint. Construct a treatment plan for a patient with a hyper and/or hypo mobile SI Joint.
3 SI Joint Anatomy
4 { Bone Anatomy Sacrum Ilium 2x Anatomy of the SI Joint
5 { Ligaments Iliolumbar Sacroiliac Sacrotuberal Anatomy of the SI Joint
6 { { Anterior Musculature Posterior Musculature SI Joint Anatomy
7 { { Hamstring Group Quadriceps SI Joint Anatomy
8 Diarthrodial Joint Sacrum concave thick hyaline Ilium-convex thin fibro { Mobility Under Debate 2-17 Degrees Most Common Agreement is 8 degrees in either direction SI Joint Anatomy
9 { Joint Orientation is Very Complex Oblique degrees Difficult to x-ray joint space SI Joint Anatomy
10 { Mobility degrees { In both directions SI Joint Angle degrees from sagittal SI Joint Anatomy - mobility
11 Hyper-mobile vs. { Hypo-mobile or BOTH SI Joint Conditions and LBP
12 Sacroiliac Hypermobility Sacroiliac joint hypermobility, refers to increased and/or abnormal movement of the joint. { The condition is the result of the joint becoming too loose as a result of ligaments and muscles designed to stabilize it in place have become overly loose as a result of damage. Trauma Pregnancy
13 Hypermobility SI Joint Symptoms { Lower back pain (below L5) Sensation of lower extremity: pain, numbness, tingling. Pelvis / buttock pain. Hip / groin pain. Feeling of leg instability (buckling, giving way) Disturbed sleep patterns due to pain. Same Side Disturbed sitting patterns (unable to sit for long periods, sitting on one side) Pain with prolonged walking
14 SI Joint Hypermobility Tests
15 { { Prone Passive Motion Weight Bearing Active Sacroiliac Hypermobility
16 SI Joint Provocative Tests
17 SI Joint Hypermobility Treatment
18 SI Joint Hypermobility Treatment posture/body mechanics
19 Joint Manipulation of hypomobile Joints Co-Existing with the hypermobile SI Joint. { A body of evidence exists indicating that spinal manipulation impacts primary afferent and efferent neurologic structures affecting motor and sensory control systems within the ligamentous joint capsules of the spine. SI Joint Hypermobility Treatment
20 SI Joint Mobility Demonstration
21 { Structural Functional Movement Assessment Customized Therapeutic Exercise Program SI Joint Hypermobility Treatment
22 SI Joint Belt { placement when to use SI Joint Hypermobility Treatment
23 SI Joint Injection { Diagnostic And Therapeutic SI Joint Hypermobility Treatment
24 { Sacroiliac Surgical Fusion SI Joint Hypermobility Treatment
25 SI Joint Hypo-mobility { Sacroiliac joint hypo-mobility/fixation, refers to reduced movement of the joint. When the joint surfaces separate enough to move out of alignment, the main ridge, and/or smaller ridges, may move out of their respective grooves, and wedge out of position causing hypo-mobility.
26 SI Joint Hypo-mobility Symptoms { Sacroiliac joint dysfunction can mimic numerous other back and hip injuries. Sacroiliac joint dysfunction can cause lower back, hip, groin, buttock and sciatic pain. Sacroiliac pain is typically worse with standing and walking and improved when lying down, but not always.
27 SI Joint Hypo-mobility Tests
28 { { Prone Passive ROM Prone Active Hip Extension SI Joint Hypo-mobility Tests
29 { Seated Rotation and { Extension Marching SI Joint Hypo-mobility Tests
30 SI Joint Hypo-mobility Treatment
31 SI Joint Hypermobility Treatment posture/body mechanics
32 Joint Manipulation of hypomobile Joints Co-Existing with the hypermobile SI Joint. { A body of evidence exists indicating that spinal manipulation impacts primary afferent and efferent neurologic structures affecting motor and sensory control systems within the ligamentous joint capsules of the spine. SI Joint Hypo-mobility Treatment
33 SI Joint Mobility Demonstration
34 Structural Functional Movement Assessment { Customized: Muscular imbalance flexibility/strength Proprioception Somatics SI Joint Hypo-mobility Treatment
35 Learning Objectives Summary Anatomical Characteristics of the SI Joints regarding ligaments, muscles, joint surfaces and joint orientation { Subjective and Objective measures to differentiate a hypermobile and/or hypo-mobile SI Joint. Construct a treatment plan for a patient with a hyper and/or hypo mobile SI Joint.
36 Chris Resch, DC Kari Resch, PT Questions:
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