With Valeria Ferreira Laura Maidment Lsp, Sacro-iliac Sacrum Pubic symphysis Standing, Sitting, Supine, Prone Abandon negative findings and only record positive findings! 1) Palpate iliac crest levels 2) Assess A/P and Sup/Inf fascial glide of innominates 3) Palpate PSIS’s 4) Lsp Active examination a) b) c) Skin drag/ superficial fascial pull= Lsp involvement Deep bony feel of thumb being pulled in flexion=Iliosacral involvement Innominate moves without sacrum and pulling in hamstrings= Sacral involvement 5) Trendelenberg’s test: Tests for contralateral gluteus minimus/ medius weakness. Palpate the iliac crest for subtle differences. 6) Stork Test: Identifies whether there is dysfunction with the ilium or sacrum PSIS and S2 SP: palpating right ilio-sacral movement, then sacral-ilio movement then the left side. 7) Sitting Lsp flexion: Confirm whether the pelvis or Lsp are involved Fasical pull= Lsp No Fasical pull= Pelvis 8) Assess Legs: Ease of movement, heavier one side, internally/ externally rotated? 9) ASIS levels: One side anteriorly rotated 10) Palpate Pubic symphysis: harder on one side, more restrictions one side, any tenderness? 11) Assess SIJ’s: Usual supine examinationtests integrity of posterior SI ligaments 12) Assess Hips 13) Thomas test: Test for muscular tightness/ shortening affecting the pelvis a) Leg lifts up flexed at the knee= Rectus fem b) Leg lifts up straight knee= Iliopsoas c) Leg externally rotates= TFL 14) Leg length inequalities: Palpate medial malleolus supine and sitting a) One longer supine and still longer sitting= true leg length discrepancy b) One longer supine and then equal sitting= Pelvis involvement 15) Assess PSIS levels 16) Assess sacral angle: Make a V with hands and determine if side bent 17) Assess Sacrum: A/P, Lateral movements and counternutation and nutation. a) A/P movements= Anterior SI ligaments b) Counternutation/ nutation c) Laterally= rotated sacrum= Piriformis involvement