4- Sacrum ME Flashcards
Need 3 things to diagnose the sacrum
- Deep Sulcus
- Posterior ILA
- spring OR sphinx OR seated flexion OR oblique axis test
what does a standing flexion test tell you
Tell you it is an iliosacral or sacroiliac dysfunction.
what does a seated flexion test tell you
Tells you it is a sacroiliac problem- Positive side is side of dysfunction.
3 tests done while supine
hip flop, ASIS, medial malleoli/pebic tubercles
4 tests while prone
Iliac crest, PSIS, sacral sulci, ILA
What does a positive seated flexion tell you and what would you evaluate after
sacroiliac dysfunction, diagnose the sacrum
What does a negative seated flexion tell you, and what would you evaluate after
iliosacral dysfunction, evaluate innominate
What does a spring test tell you
Nice Normal Negative– formward sacral torsion
Painful Posterior Positive– backward sacral torsion
Sphinx, assymetries decrease, diagnosis and why
Forward Torsion, extension of the lumbar spine so the sacrum goes into flexion
Sphinx, assymetries increase, diagnosis and why
Backward torsion, sacrum is stuck in extension
what does an oblique test tell you
if the deep sulcus persists, this means that the sacrum is rotated forward and the sacral base at the sulcus is restricted
How do you set up muscle energy for a forward sacral torsion
Sim’s axis side down, pt pushes up
How do you set up muscle energy for a backward sacral torsion
Lateral recumbent, axis side down, pt pushes up
How to treat a bilaterally flexed sacrum
applying anterior pressure to the ILAs bilaterally
How to treat a biltaerally extended sacrum
index and middle fingers in the sulci bilaterally with the other hand reinforcing, and continuously applying an anterior pressure
when we inhale the sacrum ______
moves backwars/extends (lumbar in flexion)
when we exhale the sacrum ______
moves forward/flexion (lumbar in extension)
how to treat general sacral torsion
prone with knees bent, exert a lateral force on the legs and have the pt push medially OR spread them tubes like a mofo
how to treat unilateral flexion and extension
place one hand on salcral sulci (for extended) or ILA (for flexion) and with the ipsilateral leg perform abduction and internal rotation
Three rules of sacral torsion
oL5 sidebending will engage oblique axis on that same side
oL5 rotation and sacral rotation is opposite
o Seated flexion test is opposite the side of the oblique axis
How does sacral torsion differ between neutral and non-neutral mechanics
Neutral- superior pole moves forward relative to L5
Non-Neutral: Superior pole moves backward relative to L5
Diagnosis: L5NSlRl, _____ mechanics, ___ oblique axis is engaged, (+) seated flexion on the _____, sacrum rotates____, Right superior pole moves____, and the sacral diagnosis is______
Neutral, Left, Right, Right, Forward, Left on Left
What is the difference in lordotic curve between forward and backward sacral torsion (same applies for bilateral sacral flexion and extension)
Forward torsion– increases lordosis
Backward torsion– decreases lordosis
Symptoms for forward and backward sacral torsion
Forward– SI, inguinal, and groin discomfort
Backward– low back pain when bending backwards
in short leg syndrome the deep sulcus is on which side, and how do you know which axis is engaged
the side of the short leg, engaged axis will be the side of the long leg,
