Posterior Landmarks — Patient is in Prone

Evaluate for Symmetry:

When evaluating the landmarks, you are assessing for symmetry of each – which one is superior/inferior?

Iliac Crest Levelness

Keep both fingers/hands (level) over the iliac crest and push caudad

PSIS

Put hands on iliac crests, point your thumbs down at a 45 degree angle, there you will feel the PSIS. When assessing from symmetry make sure you HOOK underneath the PSIS with your thumbs and push cephalad (same as with flexion tests)

Ischial Tuberosities

Moving up the back of the thigh into the glutes with your hands medial press your thumbs into the inferior portion of the ischial tubes directing your force cephalad

Iliolumbar Ligaments

Palpate from iliac crest to L4, L5 to evaluate tension differences

Sacrotuberous Ligaments

Walk down the sacral sulcus inferior to the sacral inferior lateral angle (sacral ILA). Palpate between sacrum and ischial tuberosites to evaluate for tension differences. Ask the patient if one is more tender to touch.