We recently have had a change in stance regarding the assessment of SIJ Dysfunction. In the past, we had been strong advocates for primarily utilizing clusters of pain provocation tests for SIJ Dysfunction as they consist of greater specificity/sensitivity and reliability values than motion restriction tests. In fact, we have even had posts about avoiding those motion restriction tests altogether.
Upon reviewing the APTA SIJ monograph by Jackson and Porter, the topic of non-painful SIJ Dysfunction was introduced. When we assess other joints, we are always accounting for any restrictions present. Take the cervical spine, for example. If a patient has cervical pain, we always assess the shoulder and thoracic spine for restrictions as well and follow up with treatment in the area. The reason being that hypomobility in the shoulder can lead to hypermobility in the cervical spine in order to fulfill movement requirements. This added stress often becomes painful. The same applies to the sacroiliac joint. Low back pain often results from hypermobility, secondary to hypomobility in nearby joints. The hip is one of the usual suspects (and rightly so), but shouldn't we also consider the chance that SIJ restrictions contribute to the excessive motion in the lumbar spine?
Jackson R and Porter K. The Pelvis and Sacroiliac Joint: Physical Therapy Patient Management Utilizing Current Evidence. Current Concepts of Orthopaedic Physical Therapy, 3rd Ed. La Crosse, WI. 2011.