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Impairment-Based Examination and Disability Management of an Elderly Woman With Sacroiliac Region Pain

JJ Godges, PT, DPT, MA, OCS, is Coordinator, Kaiser Permanente Southern California Orthopedic Physical Therapy Residency, Los Angeles, Calif, and Assistant Professor, Department of Physical Therapy, Loma Linda University, Loma Linda, Calif
DR Varnum, PT, BS, is Staff Physical Therapist, Kaiser Permanente, Long Beach, Calif
KM Sanders, PT, DPT, ATC, CSCS, is Director, San Luis Sports Therapy and Orthopedic Rehabilitation, San Luis Obispo, Calif.

Address all correspondence to Dr Sanders at 1306 Johnson Ave, San Luis Obispo, CA 93401 (USA) (jason2kelly{at}aol.com)

Background and Purpose. The purpose of this case report is to describe the use of a cluster of sacroiliac tests in conjunction with an impairment-based model of examination, diagnosis, and management of sacroiliac region pain. Case Description. The patient was a 74-year-old woman with an 18-month history of low back, left buttock, and groin pain following a misstep. The initial symptoms were intermittent. The symptoms became constant and limited her walking tolerance to 5 minutes, which affected her ability to care for her grandchildren. She was examined using a cluster of sacroiliac tests that examined: (1) innominate active mobility, (2) innominate positional symmetry, and (3) sacroiliac ligament tenderness. Outcomes. Following 4 treatments for identified impairments, the patient had unlimited walking tolerance and she resumed an active caregiving role for her grandchildren. Discussion. This case illustrates the use of an impairment-based model for examination and management of an elderly patient with what appeared to be sacroiliac joint dysfunction.

Key Words: Low back pain • Manipulation • Sacroiliac joint