once pain has subsided. If using deep tissue techniques to treat the piriformis muscle, the therapist should take care Piriformis length test Tests for hypertonicity of piriformis. The client should be in the prone position on the table. Their legs should be straight with knees together before the massage therapist passively flexes the knees to 90 degrees. Together, the legs are rotated laterally to test the length of piriformis. Hip quadrant test Tests for hypertonic muscles or a dysfunction of the hip joint. The client is placed in the supine position on the table. The massage therapist passively flexes the client’s hip to 90 degrees and moves the leg into adduction until there is resistance. Maintaining resistance, the therapist moves Posterior sacroiliac joint test Tests for a posterior SI joint dysfunction. The client should be in the side-lying position. Both their hips and legs should be together and flexed to 90 degrees. The massage therapist places their fingers on the ASIS and their other Anterior sacroiliac joint test Tests for an anterior SI joint dysfunction. The client is in the supine position on the table. The massage therapist places criss-crossed hands, fingers facing away from the body, across client’s ASIS and pushes them laterally and inferiorly SI joint squish test Tests for the posterior ligament integrity of the SI joint. The client should be should in the supine position on the table with their legs laid out straight. The massage therapist places criss-crossed hands, fingers facing the midline of the SI joint motion test/ stork-gillet test Testing for ROM at the SI joint. The client should be standing with the massage therapist’s thumbs on both the client’s PSIS. The client flexes the hip of the side being tested while standing on the unaffected side. Then the other hip will be tested. This should be repeated several Gaenslen’s test Tests for an SI joint dysfunction. The client is in the side- lying position on the table and flexes their hip and the knee of the unaffected side toward their chest. The massage therapist stands behind the client and stabilizes the superior pelvis with one hand, while extending the affected side’s thigh as far as possible. A positive result is indicated by pain at the SI joint when the affected side’s thigh is moved Straight leg test Tests for the cause of lower back pain. The client should be supine on the table with their legs fully extended. Beginning with the client’s leg adducted and medially rotated, the massage therapist grasps the client’s heel and, keeping the knee in extension, slowly raises the leg until the client feels pain or discomfort. The leg is slowly lowered until no pain is felt. Hypertonicity of the hamstrings is indicated by pain at the ischial tuberosity, in the posterior thigh and/or the posterior knee. A lumbar or sacral dysfunction is indicated Supine to sit test Tests for leg length discrepancy. The client is supine on the table with both legs fully extended. The massage therapist makes a note of each ankle’s malleolus in relation to each other. Client is then asked to sit up while the therapist takes note of any changes in malleolus position. An anterior hip rotation is indicated on the leg side that becomes longer
not to innervate the sciatic nerve that is deep to piriformis itself.
A hypertonic piriformis is indicated if there is less than 45 degrees lateral rotation to the affected side. As in the previous case, similar precautions should be taken when working on piriformis.
the thigh superiorly and inferiorly in an arc along the body’s midline. Hypertonic muscles are indicated by a low ROM while a dysfunction of the joint itself is indicated by crepitus or pain deep in the hip joint during movement of the thigh.
palm on the ischial tuberosity of the side being tested. The therapist attempts to rotate the hip posteriorly. Pain at the posterior SI joint indicates an SI joint dysfunction.
away from each other on the side that is being tested. Deep pain in the inferior abdomen, at the anterior SI joint, indicates a dysfunction.
body, across client’s ASIS and presses both ASIS medially. A sprain of the posterior SI joint ligaments is indicated by pain in the posterior SI joint region during the test.
times so the therapist has a good sense of the client’s hip movement. An anterior tilt to the pelvis, commonly attributed to hypertonic iliopsoas, may be indicated by a lack of movement of the PSIS on the side of the raised knee or if the PSIS moves superiorly instead of inferiorly. beyond 20 degrees of extension. Note that the pain may be due to either injured ligaments or a hypertonic gluteus maximus origin along the superior aspect of the border of the sacrum. Cross-fiber friction between the sacrum and ilium may be massaged by the therapist within the client’s pain tolerance. if the client is in pain after 70 degrees of flexion at the hip. A herniated disc is indicated if the client experiences pain down the leg not being raised. A sciatic nerve impingement is indicated by pain down the client’s leg when the leg is lowered while the foot is dorsiflexed. If a herniated disc is the source of dysfunction, the therapist will not attempt to correct the hernia and will not move the client through any ROM at their hips.
while a posterior hip rotation is indicated on the leg side that becomes shorter. Treat hip flexors for the longer leg and extensors of the spine, such as the erector spinae group, for the shorter leg.
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