Does a ”positive” test and some muscle guarding around the pelvis mean that the pelvis is unstable?

Our study demonstrated that simply inducing experimental pain over the posterior sacro-iliac ligaments in painfree people resulted in the kind of findings often reported in patients with pelvic pain; a positive active straight leg raise (ASLR) and muscle guarding. This indicates that pain alone, regardless of the position or mobility of the pelvic bones, can mimic the clinical findings previously associated with ‘pelvic instability’ or lack of ‘ force closure’. The findings have implications for how we interpret what we find among patients in the clinic. It has often been assumed that these findings when present in patients with pain are the cause of their pain. In contrast, these findings suggest the opposite – that simply experiencing pain causes the body to move in slightly unusual ways, and these are signs of pain, not necessarily the cause of pain.


Thorvaldur Skuli Palsson

Thorvaldur finished his bachelor’s degree in physiotherapy from the University of Iceland in 2003 and a got his master’s degree in Manipulative Therapy from Curtin University, Perth in 2009. He completed one year of clinical and theoretical training in Norway in 2010 awarding him the title Manual Therapist. The same year he received a grant allowing him to start his PhD studies at the Center for Sensory-Motor Interaction at Aalborg University, Denmark where the focus of the project are the sensory and motor aspects of lumbopelvic pain. In the project he has mainly been interested in investigating the relationship between pain and the outcome of manual tests which are commonly used in clinical practice to diagnose lumbopelvic pain originating in the pelvic girdle. He received a research grant from the Danish Ministry of Innovation and Higher Education enabling him to set up a study with researchers from Curtin University investigating the somatosensory profile of pregnant women. Thorvaldur defended his PhD thesis at Aalborg University in the beginning of October 2014 and was awarded a PhD in Clinical Science.


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