Groin Pain (non-traumatic)

Sacroiliac Joint Dysfunction

Physical Findings & Clinical Presentation

  • Tenderness directly over the PSIS
  • Lower Lumbar pain occurs in 72% of cases
  • Radiating pain:
    • over the buttocks (94% of cases)
    • Down the posterior-lateral thigh (50%)
    • Past the knee to the ankle (14%)
    • Lateral foot (8%)
  • Groin or pubic pain in 14% of cases (click for more information)
  • Anterior thigh pain in 10%

Special Tests

  • FABER or Patrick’s Test (see video below)
  • Anterior gapping of SIJ
  • Posterior gapping of SIJ
  • Forward Bending in Standing Test
  • Ipsilateral Hip Flexion Test in Standing
  • Test for Form Closure
  • Test for Force Closure and Motor Control (ASLR)
  • Pubic Stress Test
  • Sacrotuberous Ligament Stress Test
  • Sacral Compression Test
  • Rotational Stress Test
  • Gaenslen’s Test
  • Yeoman’s Test

Red Flags Associated with SI Symptoms

    • History
      • Sacroiliac/sacral pain without a history of trauma or overuse (rule out assault, anal intercourse)
      • Previous history of cancer
      • Previous history of gastrointestinal disease (ulcerative colitis, Crohn’s disease, irritable bowel syndrome)
    • Risk Factors
      • Osteoporosis
      • Sexually transmitted infection
      • Long-term use of antibiotics (colitis)
    • Clinical Presentation
      • Lack of objective findings
      • Anterior pelvic, suprapubic, or low abdominal pain at the same level as the sacrum
    • Associated signs and symptoms
      • Pain relieved by passing gas or having a bowel movement
      • Presence of gastrointestinal, gynecological, or urologic signs and symptoms
  • When to refer:
    • If the condition suspected is not of musculoskeletal origin or if several of the red flags or risk factors are present, refer to a physician.