A full assessment is required to identify the causes of Sacroiliac Joint Pain. Specifically this may include leg length differences, the Stork Test and Ilia Rotation.
Leg Length Differences
As discussed on the last page, differences in leg length can be a contributing factor to sacroiliac pain. Leg length can be measured with a tape measure, using bony landmarks as reference points. However, this is not easy as bony landmarks are covered in flesh which can move about when you are trying to use a measuring tape. There is a much better way to check leg length and with a trained eye and practice you can soon learn to do this reasonably well.
Initial Check With Bent Knees
- The athlete is placed on their back with knees bent and heels together, taking care to ensure the heels and hips are as square as possible.
- The therapist then looks from the front and side at the knees to assess if they are level or not.
- If one knee is higher than the other, this could indicate a longer tibia in this leg.
- One knee forward of the other may indicate a longer femur in that leg.
- Ensuring the hips are level can be difficult so a further test is needed to give a better picture.
Straight Leg Test
- In order to get the hips square the athlete raises the hips off the couch and lowers them down again.
- This should help ensure they lie in a natural position.
- The therapist then gently pulls the legs straight and places the thumbs on the ankle bone on the inside (medial malleoli).
- From here it should be evident if one leg is longer than the other as one thumb will be higher than the other.