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Sacroiliac Joint Special Test: Mennell's Test
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Mennell's test (aka, Distraction-Compression Test of the Sacroiliac joint) is a physical examination and diagnostic test used to detect dysfunction or pathology of the Sacroiliac (SI) joint. The test is performed by performing an anterior distraction of the posterior SI joint while compressing the anterior aspect of the joint. During the procedure, the patient is asked to alert the clinician if he or she experiences any sensations of pain or discomfort. An overall increase
Transcript
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This is Brent of Brookbush Institute
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in this video we're going over another
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special or orthopedic tests for sacroiliac joint pain, this is the
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Mennell's test. I'm going to have my friend Melissa step out she's going to help me
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demonstrate. Now the way we're going to set this up is Melissa is going to be supine,
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with the sacroiliac joint I think that's involved, closer to me. Now this test
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isn't very hard to perform it is kind of tough on your patient though, you'll see
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why in a second, I have to to hold her leg in kind of a difficult position. The test
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itself is just Melissa's going to bring herself into ten degrees of flexion,
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thirty degrees of abduction and then she has to be able to hold that, which is
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tough, and then she has to resist some extension force and some force into
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flexion, and we're going see if that brings on her concordant sign or her
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complaints of sacroiliac joint pain. So one more time I mean that that's the
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whole test, that's it, it's not that hard. So she's going to go into ten
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degrees of flexion, thirty degrees of abduction and I'm actually pushing down
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and then up in the sagittal plane. Alright so down how does that feel? Pain,
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and then up, okay good how does that feel? Fine okay.
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Here's the problem with this test though, when you felt pain where did you feel it?
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So if she feels it in her anterior hip, okay not her pubis but her anterior hip,
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what do you guys think the likelihood of this being sacroiliac joint pain is?
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Probably not very good right, like we were pushing down as she was trying to
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lift up, she probably felt it more like in her psoas or maybe her TFL as it
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cramped to try to pull her leg back up against my force. I wouldn't call that a
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positive sign, and that is one of the bigger issues with this particular
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test is if anybody has any hip issues this probably isn't a good test to use,
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but again this test ends up in one of our SIJ clusters, not the one that we
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prefer here at the Brookbush Institute but one of the sacroiliac joint clusters
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does use the Mennell's test as one of the three or five tests options
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in this cluster. So it is important for you guys to have in your repertoire so
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that you're aware of this test and if you're going to use it in that cluster
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you've got to be pretty proficient at it. So again let's just kind of go through
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the test itself and contraindications. Hip flexion, thirty degrees of abduction,
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Melissa hold this okay don't let me push you down, alright how does that feel? Okay
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but it's still pain here right, and then go don't let me pull you up, good
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how does that feel? That feels fine, so that's definitely a negative
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Mennell's. Now if I pushed down or pushed up and she felt it back in in that
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sacroiliac joint region, that would definitely be a positive test. We could
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probably make a good argument that if she felt it in her pubis right that that
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still would be a positive test, because we know we have some sort of instability
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of the pelvic ring there. Thank You Melissa. Guys if you have any questions
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please leave them in the comments box below, I look forward to hearing from you
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