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This is a key test to determine sacro-iliac joints (SIJ) dysfunctions. Practitioners should use it
systematically as it is the most reliable to assess the pelvis. Novice osteopaths should make it
usual in their practice.
Results:
Results:
Positions
Patient supine, practitioner at the patients feet looking at this face in the first
place. Using his thumbs placed under the medial malleolus and/or under the
heels, he evaluates both lower limbs length. Then, he faces the contralateral
knee to the SIJ to evaluate.
Technique
1- Using his caudal hand, the practitioner grabs the patients contralateral lower
limb, just above the ankle, and performs a light hip flexion + adduction.
2- The practitioner places his cephalic hand in the contralateral popliteal fossa,
thumb at 90, his fore arm parallel to the femur, elbow towards the symphysis
pubis. He then induces a lateral rotation of the contralateral hip and can add a
light traction in case of excessive stiffness.
3- The practitioner replaces the lower limb on the table, knee extended, and
back to the very initial position.
Results
1- The practitioner evaluates the gain of length of the SIJ / lower limb tested by
using his thumbs placed under the medial malleolus and/or under the heels.
2- Eventually, the practitioner performs a global reset maneuver, doubleflexing knee and hip on the tested side, his sternum applying extra pressure on
the leg to cancel the possible lower limb lengthening.
During the lengthening maneuver, flexion / adduction / lateral rotation of the hip cause a
tension of the iliofemoral ligament (aka Bertin ligament or Y-shaped or Welckers Z) and of
the anterior joint capsule and consequently bolts it.
This maneuver prevents all movement in the hip joint and allows us to mobilize forwards the
short horizontal part of the auricular L-shaped SIJ.
Iliofemoral Ligament
Greater
trochanter
Pubofemoral ligament
Lesser trochanter
Lateral rotation and adduction of the lower limb bolts the hip.
Positions
Patient supine, practitioner at the patients feet looking at this face in the
first place. Using his thumbs placed under the medial malleolus and/or
under the heels, he evaluates both lower limbs length. Then, he moves close
to the SIJ to evaluate, facing the feet.
Technique
1- Using his caudal hand, the practitioner grabs the patients ipsilateral
lower limb, just above the ankle, and performs a maximal hip abduction +
extension.
2- With his cephalic hand, the practitioner grabs the distal tip of the femur.
He then induces a knee flexion, maintaining abduction / extension of the
hip. On top of these, he performs a medial rotation of the hip. He can add a
light traction in case of excessive stiffness.
3- The practitioner replaces the lower limb on the table, knee extended, and
back to the very initial position.
Results
1- The practitioner evaluates the loss of length of the SIJ / lower limb tested
by using his thumbs placed under the medial malleolus and/or under the
heels.
2- Eventually, the practitioner performs a global reset maneuver, doubleflexing knee and hip on the tested side, his sternum applying extra pressure
on the leg to cancel the possible lower limb shortening.
During the shortening maneuver, extension / abduction / medial rotation of the hip cause a
tension of the ischiofemoral and iliofemoral ligaments (aka Bertin ligament or Y-shaped)
and of the posterior joint capsule and consequently bolts it.
This maneuver prevents all movement in the hip joint and allows us to mobilize the short
horizontal part of the auricular L-shaped SIJ.
Sacrospinous ligament
Posterior
iliofemoral
ligament
Greater
trochanter
Posterior
ischiofemoral
ligament
Lesser
trochanter
Medial rotation and abduction of the lower limb bolts the hip.
SARL IRFOR Modle dpos.
Linea aspera
RIGHT SIDE
LEFT SIDE
ILIAC DYSFUNCTION
Lengthening:
Shortening:
++
++
Lengthening:
Shortening:
++
++
BILATERAL ILIACS
Lengthening:
Shortening:
++
0
Lengthening:
Shortening:
++
0
Lengthening:
Shortening:
++
0
Lengthening:
Shortening:
++
++
Lengthening:
Shortening:
++
0
Lengthening:
Shortening:
0
++
Lengthening:
Shortening:
0
++
Lengthening:
Shortening:
0
++
BILATERAL
Lengthening:
Shortening:
++
++
Lengthening:
Shortening:
0
++
Lengthening:
Shortening:
0
++
Lengthening:
Shortening:
++
0
Lengthening:
Shortening:
+
+
Lengthening:
Shortening:
+
+
REDUCED ILIACS
Lengthening:
Shortening:
+++
+++
Lengthening:
Shortening:
+++
+++
Lengthening:
Shortening:
+++
0
Lengthening:
Shortening:
+
++
NORMALITY
ANTERIOR ILIACS
POSTERIOR ILIACS
MOBILITY
ILIACS HYPER
MOBILITY
nd