Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

What indicates a positive spring test in the context of bilateral sacral shear?

1. Extension of the sacrum

2. Flexion of the sacrum

3. Neutral position of the sacrum

4. Rotation of the sacrum

The correct answer is: Flexion of the sacrum

A positive spring test in the context of bilateral sacral shear indicates that the sacrum is in a flexed position. When performing the spring test, the practitioner applies pressure to the sacrum to evaluate its motion. In a healthy sacrum, when pressure is applied, there should be a springing motion, indicating that it is freely moving. However, in the case of a positive spring test, the sacrum does not move easily in response to this pressure, suggesting that it is stuck in a flexed position. This is indicative of a dysfunction known as bilateral sacral shear, where the two sacral sides are not moving in harmony, leading to a loss of the normal motion that should occur when pressure is applied. Understanding that the positive response correlates with the sacrum being flexed clarifies the mechanics involved in the test. Recognizing the correct position of the sacrum is critical for diagnosis and treatment planning in osteopathic manipulative treatment.