There are few areas of Physical Therapy practice more controversial than the SI Joint. Disagreements exist among clinicians and researchers on the diagnosis and treatment of this joint. Many commonly used clinical examination and even medical diagnostic procedures’ false positive and negative rates make accurate diagnosis difficult. Conversely, clusters of examination findings remain the clinical...
Background Sacroiliac (SI) joint pain is an less common source of low back pain but has a higher incidence pregnant and post partum patients, as well as, after trauma. The incidence of SI pain in patients with low back pain is 13% (9-26%) (1). The majority of patients will report buttock pain (94%), lower lumbar...
Healthcare demonstrates significant swings of the pendulum in examination and treatment trends. Thankfully the medical evidence helps balance these swings allowing us to come to a more appropriate balance in clinical practice. Unfortunately, unchecked bias in a clinician, such as confirmation bias, can lead to missed diagnoses and inappropriate treatments. In Physical Therapy, this can...
Manipulation, along with strength training, remains one of the most effective treatments for patients with sacroiliac (SI) pain. Spinal manipulation by a Physical Therapist provides a unique stimulus to the nervous system creating a complex therapeutic response in the patient. Researchers continue to investigate the mechanisms behind its’ effectiveness including central and peripheral nervous system...
There are few clinical examples that remind me of how far we have come in orthopedic Physical Therapy practice than assessing bony SI landmarks. As the popular clinical pendulum swung these landmarks were assessed in patients presenting with low back pain to hip pain and even to distant regions such as ankle and neck. Thankfully,...
Physical Therapists aim to utilize clinical objective tests to confirm their evolving hypotheses on the source of patient’s current symptoms. One of the most beneficial areas of our Physical Therapy and orthopedic research has involved the confirmation or refute of known clinical tests to identify patients with or without a given diagnosis such as an...
Diagnosis: Pelvic girdle pain (PGP) is musculoskeletal pain that occurs at either SI joint, the pubic bone, the groin, or some combination. PGP is very common during pregnancy, affecting between 52-70% of the pregnant population, particularly during late pregnancy. As with many musculoskeletal dysfunction during pregnancy it is common, but it does not have to...
During arm movements, a relative ratio of degree measurements occurs between the ball and socket of the shoulder and the shoulder blade on the rib cage. This ratio or rhythm is thought to preserve spacing in the shoulder joint and optimize the length tension relationship in the surrounding muscles. Abnormal rhythms have been associated with...
In our Boulder County physical therapy practice, we are observing a resurgence of the use of clinical tests by some area providers to determine mobility and position of the sacroiliac joint (SIJ) not only to explain posterior pelvic girdle pain, but also lower back, hip issues and beyond. Approximately 20 years ago, the tides began...
Rock climbing requires extensive strength of the shoulder and scapular stabilizer muscles. Having good strength to these muscles not only helps with climbing performance but also with injury prevention. During arm movements, a relative ratio of degree measurements occurs between the ball and socket of the shoulder and the shoulder blade on the rib cage....
