SACROILIAC (SI) JOINT
STRESS TEST
• Test positioning #1
The client lies supine.
The therapist stands next to the client and with the arms crossed, places the heel of both hands on the client's anterior superior iliac spines.
• Action
The therapist applies outward and downward pressure with the heel of the hands.
• Positive finding
Unilateral pain at the sacroiliac joint or in the gluteal or leg region indicates an anterior sacroiliac ligament sprain.
• Special considerations & comments
The client may complain of pain that could be related to sacroiliac joint compression.
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• Test positioning #2
The client lies on their side.
The therapist stands next to the client and places both hands, one on top of the other, directly over the client's iliac crest.
Repeat on the other side.
• Action
The therapist applies downward pressure.
Compare to the other side.
• Positive finding
Increased pain or pressure is indicative of sacroiliac joint pathology, possibly involving the posterior sacroiliac ligaments.
• Special considerations & comments
The client may complain of pain that could be related to sacroiliac joint distraction or gapping.
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• Test positioning #3
The client lies supine.
The therapist places both hands on the lateral aspect of the client's iliac crests.
• Action
The therapist applies inward and downward pressure.
• Positive finding
Increased pain or pressure is indicative of sacroiliac joint pathology, possibly involving the posterior sacroiliac ligaments.
• Special considerations & comments
The client may complain of pain that could be related to sacroiliac joint distraction or gapping.
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• Test positioning #4
The client lies prone.
The therapist places both hands, one on top of the other, over the client's sacrum.
• Action
The therapist applies downward pressure, creating a shear of the sacrum on the ilium.
• Positive finding
Pain at the sacroiliac joint is indicative of sacroiliac joint pathology.
• Special considerations & comments
The client may complain of pain that could be related to sacroiliac joint compression.
The Sacroiliac Joint Stress Test is influenced by the work of Dr. James Cyriax in orthopedic assessment, with further contributions from Dr. John Mennell and Dr. Pierre Gillet in understanding the mechanics of sacroiliac joint pathology and its stress responses.