Sacroiliac joint Test (SI Joint Provocation Tests)


Sacroiliac joint Test (SI Joint Tests)




Provocation Cluster


1. SI Compression test

2. SI Distraction Test

3. Gaenslen`s Test

4. Posterior Pelvic Pain Provocation ( P4) Test

5. Sacral Spring Test

6. 3(+) out of 5 indicates SIJ as the source of the pain


SI Joint Provocation Test:-


1. SI Compression Test:-

si joint


-Patient assumes a side lying position with his or her painful side up superior to the plinth.Resting symptoms are assessed.

-Examiner cups the iliac crest of the painful side and applies a downward force through the ilium.This position is held for 30 seconds.As with the other sacroiliac,considerable vigor is required to reproduce the symptoms;in some cases,repeated force is necessary.

-(+) test is reproduction of the concordant sign of the patient.


2. SI Distraction Test:-

si joint distraction








-Patient assumes a supine position.Resting symptoms are assessed.

-The medial aspect of both anterior superior iliac spines are palpated by the examiner .The examiner crosses his or her arms,creating an X at the forearms,and a force is applied in a lateral-posterior direction.For comfort,it is often required that the examiner relocate his or her hand on the anterior superior iliac spine ( ASIS) several times.

-Examiner holds the position for 30 seconds,then applies a vigorous force repeatedly in an attempt to reproduce the concordant sign of the patient.

-  (+) test is reproduction of concordant symptoms.


3. 4P Test or Thigh thrust Test.

si thigh


-Patient is positioned in a supine position.Resting symptoms are assessed.

-Examiner stands opposite the painful side of the patient.

-The hip on the painful side is flexed to 90degree.

- Examiner places his or her hand under the sacrum to form a stable “bridge” for the sacrum.

-A downward pressure is applied through the femur to force a posterior translation of  the innominate.The patient`s symptoms are assessed to determine if they are concordant.

-  (+) test is concordant pain that is posterior to the hip or near the sacroiliac joint.A (+) test requires reproduction of pain on the thrust side ( the side of the loaded femur).

4. Sacral Thrust test:-

si saceal


-Patient lies in a prone position.Resting symptoms are assessed.

-Examiner palpates the second or third spinous process of the sacrum.Using the pisiform,the examiner places a downward pressure on the sacrum at S3.By targeting the midpoint of the sacrum,the examiner is less likely to force the lumber spine into hyperextension.

-Vigorously and repeatedly ( up to six thrust),examiner applies a strong downward force to the sacrum in an attempt to reproduce the concordant sign of the patient.

-  (+) test is a reproduction of the concordant sign during downward pressure.


5. Gaenslen`s Test:-



-Patient is positioned in a supine position with the painful leg resting very near the end of the treatment table.Resting symptoms are assessed.

- Examiner sagittal raises the no painful side of the hip ( with the knee bent ) up to 90 degree .Examiner tests both sides if the patient complains of pain bilaterally.

- A downward force ( up to six bouts ) is applied to the lower leg ( painful side ) while a flexion-based counterforce is applied to the flexed leg ( pushing the leg in the opposite direction ). The effect causes a torque to the pelvis.Concordant symptoms are assessed.

-  (+) test if the torque reproduces pain of the concordant sign.


Read more about :

Sacroiliac Joint Pain (Sacroiliitis) and physiotherapy management

Lower limb Musculoskeletal Tests:-

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