How do you correctly make a diagnosis of pelvic girdle pain?
Answer
To make a diagnosis of pelvic girdle pain, you must have three positive tests. That can be provocation tests, pain palpation tests, or load transfer tests. The provocation tests can include Patrick's Faber tests, the P4 test, Gaenslen’s test, and a modified Trendelenburg test. Pain palpation tests are also provocation tests, but they are performed by palpating structures to find out if those structures have become sensitized, the pubic symphysis palpation and a long dorsal ligament test. For load transfer tests, we look at again the Trendelenburg test, the active straight leg raise test and the Stork test. If we have three positive out of any of these tests, we can make a diagnosis of pelvic girdle pain and we can proceed to treatment in our examination, and begin to do the intervention.
Cynthia Neville, PT, DPT, WCS, BCB-PMD
Dr. Cynthia (Cindy) Neville, PT, DPT, WCS is Assistant Professor of Physical Therapy, Mayo Clinic Alix College of Medicine, in Jacksonville, Florida. She is a Women’s Health Certified Specialist (WCS), board certified by the American Board of Physical Therapy Specialties. She serves on the faculty of the Mayo Clinic Florida Orthopedic Physical Therapy Residency Program, and advises multiple medical specialty programs at Mayo Clinic Florida. Her outpatient clinical practice at Mayo Clinic Florida serves women and men with pelvic floor disorders. Dr. Neville has authored and co-authored several research articles and book chapters on the topics of pelvic health rehabilitation, pelvic pain, and urinary incontinence. She has presented her research and provided rehabilitation and medical education nationally and internationally. She has developed successful Pelvic and Women’s Health Rehabilitation Programs at premier healthcare organizations including the Rehabilitation Institute of Chicago (now the Shirley Ryan Ability Lab) and Mayo Clinic Florida. At Brooks Rehabilitation in Jacksonville, Dr. Neville developed the first institutional pelvic health rehabilitation program across all levels of care, and the first credentialed physical therapy women’s health residency program in the state of Florida. She has trained more than a thousand physical therapists, occupational therapists, physical therapist assistants, and physicians in pelvic floor examination and pelvic health rehabilitation.
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