Cluster of Laslett | Sacroiliac Joint Pain Provocation
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- Опубликовано: 27 июл 2024
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This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The Cluster of Laslett is a pain provocation cluster for the sacroiliac joint. Unilateral back pain presenting below spinal level L5 with referred pain to the buttock and thigh may be indicative of low back pain originating from the SI joint.
Articles:
www.ncbi.nlm.nih.gov/pubmed/1...
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1:➡️Distraction test
2:➡️Thigh thrust test
3:➡️Compression test
4:➡️Sacral thrust test
I love how the thumbnail makes him look a little like Aang doing some airbending but on a man's leg
You guys are so smart the hand behind the si and pressing down is the best way to test for si pain. I’m a severe sufferer and have been telling these American Drs but they won’t listen and I’m American. American medical field just doesn’t care anymore they are too overwhelmed too many ppl. This is the best video of tests that I’ve seen and I’ve watched 3000 videos at least.
Appreciate it Danielle 👍🏼
I m from Thailand .Thank for making these video , smart posture and great explanation .
You’re very welcome! Cool to see you’re watching from Thailand
Keep these great videos coming! 🙂
+Aidan O'Connor Power thanks ! Will do
Thanks a ton for sharing this
Awesome!!! Thank you so much!!
Thanks Cintia! You're welcome and thank you for following!
omg you saved my life. greets from germany
Sauber, das freut uns! Grüße aus Amsterdam!
Thank you from Taiwan 🇹🇼
Nice video and model🥰
Thank you sir
Thanks
Thank you from S. korea
+Silkroader Park you're welcome and thanks for following from far away!;)
I have to say that I have been suffering from SI-Joint pain since 1995 due to a work accident. The impact with the corner point of a tombstone was what stopped my falling over as it hit my left SI-Joint or directly over it. What I guess after 12 years misdiagnosis, over time what nerves could regenerate may have grown through the space made by the impact as it spread my SI Joint apart. Now the nerve or nerves are being squeezed between the SI Joint's cartilage this does damage the nerves rather it is like a hard handshake... And the damaged area is on the front as we discovered after a RFA radio frequency ablation that sadly did not work for me. If you did these tests on me, my left leg would likely recoil up and my upper body would go into the fetal position simultaneously faster than I can blink. With a lot of force behind it. I am at level 8 out of 10 pain, and the pain fluctuates daily. It has taken me decades to get to this point where i can communicate better. Memory is shot, but I keep trying. At level ten I usually pass out from the pain. I may be out for seconds, or hours. Depends on how long it takes the nerve to settle back down, or the SI Joint to shift/move or unlock. Thank you for you videos. I use a wheelchair in order to safely get around as the pain makes it so standing is dangerous for me and others around me. 14 years full time in a wheelchair now, and 13 years since I had a drivers license, not safe to drive when the si joint goes off... I end up face planted into the steering wheel, and the left knee pinned under the steering wheel. Not a great position to be in. I explained for years to doctors what happened when and what I experience and 12 years these doctors pretty much thought SCIATICA. Thank for the videos they need to be seen by more back specialists and such.
Oh I am so sorry to hear this
Have you been given pain neuroscience education?
You’re the best thank you 🙏🏻
You’re welcome 😊
If 2 positive tests come out, and in addition the patient presents pain in the groin region when maximum hip flexion is performed passively, what tests would be indicated for the coxofemoral joint? thank you
dope video
This is gold guys! thanks so much
You’re welcome Gonzalo 👍🏼
You describe the test @ laslett on the symptomatic side. But didn't you mean a-symptomatic side? i tought vd wurff was standing on the symptomatic side, and all laslett's test on the a-symptomatic side?
thanks for your videos. they help a lot!!
Doesn’t matter which side they lay on the compression is most likely going to provoke symptoms if true SIJ
All test are nagative for me , but if you whole hip a side lil bit pain across.
Could you please give the reference for the flowchart. Thank you
Have a look into the description of the video
good my bro
Thx Fazal!
I have si joint pain did all these provocation tests they all came out negative what are the chances of still having SIJ pain even tho the provocation test still negative?
My physiotherapist saids I have a herniated disc but my pain is right on the si dimple on one side could it be referral pain from a herniated disc?
did you cavitate / create a crack at 2: 41 for that sacral thrust test?
@physiotutors first off, this is a great channel for a student like myself! I learned that Laslett's cluster included Gaenslen's test, was that not part of the literature you guys examined?
+Jeffrey Jue hey Jeffrey, thanks a lot for the compliment and for following. If you read the article from laslett you will see that they excluded the gaenslen's test because it has not much added value.
Physiotutors thanks for clarifying! keep up the great content
Physiotutors is this channel subscribed mostly to a single text or a variety of resources? would love a link to the resources used
+Jeffrey Jue ideally we base our videos on a good review, if that's not available, then RCTs or at last text books, mainly magee. Let me know if you could find the article from laslett o was referring to!
I reread the article and it described that (+) on 2 out of 4 of the described tests (no Gaenslen's test) had a +LR of 4.0 but if the Gaenslen's was included (both R and L) and there was 3 or more (+) tests then the +LR was 4.29. The conclusion didn't seem to disregard Gaenslen's test but said there was utility if it produced a positive
And what if both sides are symptomatic?
Is there any recommendation if and when you should avoid any of these tests on womens that are pregnant?
Not from laslett himself. But we see no reason why you couldn't do the Thighthrust, sidling compression test for example. Of course prone lying tests will not be possible
@@Physiotutors
What i think for pregnant ladies gaenlens and fabers could be enough..as they already have laxity in joint around pelvis to expand pelvis because of hormone relaxin ..
So any extra force could be dangerous ..better to take precaution....i may be wrong its just what i was thinking ..
Is there any difference between this one and the van der wurff cluster(except for the sacral thrust test that is)?
Yes, if you watch closely, the tests are executed differently (thigh thrust/femoral shear, crossed vs. uncrossed hands in distraction). In the cluster of laslett, the order of tests is set whereas in the cluster of v.d wurff the order doesn't matter. Vd. wurff includes the Gaenslen, which has later been excluded by Laslett. Furthermore, laslett describes thrusts and vd. Wurff build up of constant pressure. At last, the setup of the trials of laslett and vd. Wurff were different. Find the articles in the video description of both videos.
Physiotutors----- Great! Thanks for the very fast reply. Keep up the good work!
You're welcome Josh!
With the diagram at the end, what is the point for the "Compression test positive?" ? We could just remove this one right?
The diagram is flawed at the point where a positive compression test leads to the diagnosis of symptomatic SIJ pain if positive.
How it should be done is the following:
1) Thigh Thrust and Distraction --> both positive --> Symptomatic SIJ pain
2) 0 or 1 positive --> Do the Compression Test --> 2/3 positive? --> symptomatic SIJ pain --> still only 0 or 1 positive? --> 3)
3) Perform the Sacral Thrust Test --> 2/4 positive now? ---> Symptomatic SIJ pain
---> Only 1/4 positive --> SIJ pain unlikely
--> 0 Positive after 4 tests ---> Rule out SIJ pain
@@Physiotutors Thank you
Can you please suggest me a good book for electrotherapy ????
Help In practice physios
Save your money and focus on more evidence based and valuable treatments
@@Physiotutors
That is good enough...thank you for your valuable reply...where can i find good articles regarding same ..if you can tell me please..sorry to bother you again ...
Would you not also eliminate any Hip Pathology
In a patient with back pain you can indeed opt to rule out hip pathology as well although it more often refers pain to the groin.
Can these be used as treatment too?
They are not really designed for it, but to create shear forces in the joint. Possibly as high frequency oscillating movements in order to achieve pain reduction.
What we personally do is either to strengthen muscles that cross the SIJ or attach ether to the sacrum or ilium (so from the glutes, to errector spinae to lats and small external rotators of the hip) or to mobilize/manipulate into nutation or counternutation.
thank you
I thought the cluster of tests were 5, including Gaeslann's?
Yes, there are 5, but Laslett et al. propose an algorithm of 4 tests as the Gaenslen test does not really add much to the accuracy of this test battery.
@@Physiotutors Good morning, very nice work, I appreciate it. From which year is this paper from Laslett et al.? :)
@@patze9078 Link for the article in the bio. 2005 Aug
Do i have to position on symptomatic or asymptomatic side?
Mentioned in the video
Yes sir but because you are too slang i could not understand the word if its asymptomatic side or a symptomatic side
Is it SI rocking test??? I am confused 😓😓😓😭😭😭😭
This video makes me want to go to the gym.
If we can inspire you to do so we are glad!
The link doesnt seem to redirect to the correct article?
Then the publisher has changed the links
Should be the correct one now!
The last thing of algorithm is Q is all test is negative? Yes the SIJ pain rule out????? We U will roll out if all of them is negative 2Q is all test negative? No that mean 1test is positive then it point to SIJ pain unlikely? 🤦🏻♀️ pls look to this point and thax
I don't understand what you're saying
Is that eden hazard
Maybe 🤭
I feel like he didn't need to be wearing that little, but hey, if I looked like that I probably would be too.
where you’re coming from is understandable but they are demonstrating the technique as it would be in a clinical testing, and ideally in those cases the patient would need to be undressed to underwear so that practitioners examine they’re whole body and possibly notice something the patient isn’t aware of, or forgot to mention; maybe they didn’t think it was relevant/important, when it is
Was thinking the same thing lol
0:37 nuke em 0:52 stfd 2:14
Why do I share my name with what is really a gay softcore porno? 😂😂😂😂
That’s for you to explore 😉
@@Physiotutors 😂😂😂 oh I've explored many times just find it hilarious that this and my surname are the same. No harm was meant 😊😊
You could use this as your next party trick 🥳
@@Physiotutors 😂😂😂❤️
More of Kai in underwear! Love your videos guys