Purpose: To assess for sacroiliac contributions to the patient's symptoms. SIJ Compression/Distraction are often separated into two different tests
Test Position: Supine.
Performing the Test: The examiner is standing at the side of the patient. Examiner crosses arms and places them at the medial aspects of the patients ASIS's. A gapping pressure is applied in an outward direction bilaterally and simultaneously. The examiner then uncrosses his/her arms and places his/her hands on the iliac crests to apply an inward/downward force. Pain indicates a positive test.
Diagnostic Accuracy: Compression: Sensitivity: .69; Specificity: .69. Distraction: Sensitivity: .60; Specificity: .81 ("Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests").
Importance of Test: The gapping pressure gaps takes pressures off (or gaps) the anterior side of the SI joint and compresses the posterior side of the joint. The compression force takes pressure off (or gaps) the posterior side of the SI joint and compresses the anterior side of the joint. Because the joint places pressure off different areas of the joint, a pain reproduction can lead to the thought process of SI involvement to the patient's symptoms. Whether one force or the other produces the pain should not guide your treatment plan. It is important to remember that this test alone does not have high diagnostic accuracy and should be clustered with other tests (check out the Lumbar Spine/Sacroiliac Joint Homepage!).
Note: tests should only be performed by a properly trained health care practitioner.