What is step 1 in performing the Mennell Test?

• A. Patient standing, pushing down on shoulders
• B. Patient prone, pressure outward at PSISs
• C. Patient supine, flexing the hip
• D. Patient sitting, rotating the trunk

Answer: (B)

In performing the Mennell Test, the first step involves positioning the patient in a prone position and applying pressure outward at the posterior superior iliac spines (PSISs). This position is crucial as it allows the examiner to assess the relationship of the sacroiliac joints in relation to the spine while minimizing the influence of other structures. By pressing outward on the PSISs, the examiner can evaluate for any movement or pain that may indicate dysfunction or irritation in the sacroiliac region. This specific pressure application also helps to isolate the sacroiliac joints and can highlight any asymmetry or abnormal movement patterns, which are key to determining the presence of dysfunction in this area.

Positioning the patient in other ways would not appropriately target the sacroiliac joint or would not facilitate the specific assessment that the Mennell Test aims to conduct. For instance, the standing position might introduce compensatory movements from the lower extremities actively interacting with gravity, while the supine position may not provide the leverage needed to accurately assess the sacroiliac joint's response. The sitting position with trunk rotation also diverts focus away from the specific assessment of the PSISs and could mask symptoms of the underlying issue.