8. Pelvic Adjustments Flashcards
Extension and distraction of the SI joint in side posture can be done using:
- ilium contact with forearm, hypothenar or fingertips and thigh to thigh, genu pincer, caudad leg kick and cephalad leg kick
- sacrum contact with hypothenar or forearm contact on sacral apex and any stance that takes hip flexion past 90 degrees.
What is the vector for side posture adjustment of extension and distraction of the SI joint with ilium contact?
P->A
M->L
I->S
What is the vector for side posture adjustment of extension and distraction of the SI joint with sacrum contact.
P->A
L->M
Extension and distraction of the SI joint in prone can be done using:
- two handed contact over PSIS and sacral apex
- One handed (reinforced) contact over PSIS
- genu ilium with PSIS contact
In the prone, two handed contact over PSIS and sacral apex adjustment for extension and distraction of the SI joint, what is the PSIS vector and the scrap apex vector?
- PSIS vector: P-A, I-S
- sacral apex vector: P-A & S-I
In the prone, one handed contact over PSIS adjustment for extension and distraction of the SI joint, what is the vector?
P->A
I->S
M->L
In the prone, genu ilium with PSIS contact adjustment for extension and distraction of the SI joint, what is the vector?
P->A
M->L
What are the adjustments for flexion and distraction of the SI joint in side posture?
- ischial tuberosity contact with palm or forearm contact and low fencer, straddle thigh, double thigh to shin or split leg stance
- hypothenar-sacral base contact with dysfunctional side up or down
What is the vector for all flexion and distraction adjustment of the SI joint in side posture with ischial tuberosity contact?
P->A with scooping
Is the patient’s hip flexed at 90 degrees or above 90 degrees when adjusting flexion and distraction of the SI joint in side posture?
Above 90 using low fencer stance, straddle thigh, double thigh to shin or split leg/knee to popliteal fossa
When adjusting flexion and distraction in side posture with a hypothenar-sacral base contact and dysfunctional side down or up, what static listing is being fixed?
PS sacrum
What is the vector for all flexion and distraction adjustments of the SI joint in side posture with hypothenar-sacral base contact?
P->A (pound down the high spots)
What are the adjustments for flexion and distraction of the SI joint in prone?
- two handed contact over inferior ischium and sacral base
- one handed contact over sacral base
When doing a flexion and distraction adjustment of the SI joint in prone using Two-handed Contact Over Inferior Ischium & Sacral Base, what are your ischial and sacral base contacts?
- inferior ischium vector: P-A, S-I
- sacral base vector: P-A, I-S
If you want to gap the SI as well as extend it, which would be better, Innominate Contact vs. A Sacral Contact?
Innominate contact using a PI type setup will gap the joint more than a sacral contact suing an AI type setup.
What factors should be considered when choosing an Innominate Contact vs. A Sacral Contact?
- dr. Preference
- mechanical advantage
- patient comfort
- possibility of lumbosacral dysfunction
- trial and error
Upper and lower SI joint dysfunction is palpated separately using what test?
Gillet’s
If there is more of an upper SI joint dysfunction, what contact would deliver more force to the upper part of the joint?
PSIS contact or a sacral base contact
If there is more of a lower SI joint dysfunction, what contact would deliver more force to the lower part of the joint?
Ischial tuberosity contact or a sacral apex contact
How would you treat an SI extension dysfunction using blocking when patient is in prone?
- block placed at the level of the ischial tuberosity
on side where extension is desired - block placed under the ASIS of the opposite side may increase the effect
- gravity or combined thrust/mobilization can be used to create desire motion in joint
How would you treat an SI extension dysfunction using blocking when patient is in supine
- block placed under PSIS on side where extension is desired
- block placed under the ischial tuberosity of the opposite side may increase the effect
- force of gravity creates the desired joint motion over time
How would you treat an SI flexion dysfunction using blocking when patient is in prone?
- block placed under ASIS on side where flexion is
desired - block placed at the level of the ischial tuberosity of the opposite side may increase the effect
- gravity or combined thrust/mobilization can be used to create desire motion in joint
How would you treat an SI flexion dysfunction using blocking when patient is in supine?
- block placed under ischial tuberosity on side
where flexion is desired - block placed under the PSIS of the opposite side
may increase the effect - force of gravity creates the desired joint motion
over time
When would you suspect pubic symphysis dysfunction?
- patient complains of pain in the pubic symphysis region
- SI pain and dysfunction unaffected by your best efforts to treat the SI joints
What are some static physical finding that may be found with pubic symphysis dysfunction?
- pain
- vertical displacement of one pubic bone palpated or seen on x-ray
- anterior displacement of one pubic bone palpated (uncommon)
- separation of the pubic symphysis palpated or visualized on x-ray (uncommon and usually related to pregnancy/childbirth)
What are some motion physical findings that may be found with pubic symphysis dysfunction?
- pain
- lack of translational/shearing motion
- excessive translational/shearing motion
