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Hi Nabil Have you definitively ruled out a Lx condition such as a pars defect/stress fracture (spondylolysis). The initial presentation was perhaps not typical of this injury but considering she is a gymnast (high risk group) and extension is a problem it would be worth considering this if you have not done so already. Dave r -----Original Message----- From: - for physiotherapists in education and practice [mailto:[log in to unmask]] On Behalf Of nabil keshavjee Sent: 06 January 2004 10:29 To: [log in to unmask] Subject: ?treating SI jt. Hi, Hope you all can give me some suggestions as I've run out of ideas. 11yo girl, came in with pain on the right side of SI jt. Mechanism: during landing from vaulting in gymnastics. Stuck the landing but was bent over. She has had this pain before a couple of years ago, but does not remember mechanism. But was participating in Gymastics then. Pain gradually dissipated. On first assessment 6 weeks ago, FABER, compression and distration produced the pn, but no longer do. Currently, Lumbar Extension in standing is pnful at the end of movement. Lumbar Flexion is not restricted and not pnful. During treatment, LEIS is increased and less pnful with facilitation of anterior mob of sacrum. Glute strength is 5/5. Hip Abductors is 5/5. Looking for a method to increase extension? Any suggestions would be greatly appreciated. --- David Riddell <[log in to unmask]> wrote: > Nabil > > Try the Physician and Sports Medicine - it's free > and has some very good > articles. You can find and print out full text > articles .PDF or copy > them to Word documents - it's at > <http://www.physsportsmed.com/> > www.physsportsmed.com. This one in particular may > help you: > Moeller James L., Rifat Sami F., (2001): > Spondylolysis in Active > Adolescents Expediting Return to Play. THE > PHYSICIAN AND SPORTSMEDICINE > - VOL 29 - NO.12 - DECEMBER 2001 . > I also suggest that you check hamstring and glut > length (glut max). I f > you are going to test rectus, hip flexors etc why > not rather do the > testing in the Thomas Test position - I am not going > to describe it in > detail: you or one of your colleagues probably > knows the test but > remember - butt at the edge of the bed. One knee > flexed to chest . Level > ASIS's, neutral spine etc. You can also > differentiate between rectus > tightness and tightness of the other quads - the > prone test may give > you a false positive for rectus as you are not able > to get enough knee > flexion if the other quads are relatively more > tight. > Hope this helps > Cheers > Dave riddell > > ______________________________________________________________________ Post your free ad now! http://personals.yahoo.ca