CPA 1.4: Innominate Diagnosis & Treatment MET Flashcards
What’s a positive Trendelenburg Test; indicates what?
Pelvis on the unsupported side side drops; indicates gluteus medius weakness on the side of the stance leg
What is the Thomas Test and what is a positive test; indicates what?
- Pt supine and pull knee to chest, one leg is lowered to the table
- Inability to fully extend at hip is a (+) test
- Indicated psoas (hip flexor) tightness/contracture
What is the Ober test, positive test, and what does it indicate?
- Pt lateral recumbent w/ hips and knees flexed.
- Passively ABduct and extend the upper leg, or let upper lef hang off the table
(+) test = leg will not fully adduct, OR cannot easily press down on the leg
- Indicates IT band contracture
What is a positive standing flexion test?
- One PSIS moves farther superiorly
- Indicates SI joint dysfunction on the side that elevates first
What is a positive ASIS compression test?
- Hard end feel or restriction of motion on one side
- Indicates SI joint dysfunction on the side of restriction of motion
What must always be done prior to evaluating the hips in a supine position, especially when re-assessing after a treatment?
Have the patient reset their hips
What is the supine ME technique for a Anterior Innominate Rotation; modification?
- Physican standing on side of dysfunction, passively flexes the pt’s hip and knee until restrictive barrier reached
- Pt then pushes knee into physicians hand, while physician resists for 3-5 secs. Physican then flexes hip to next barrier and ME is repeated
- Reassess (i.e., reset hips)
*Patient can also full extend their knee and flex at the hip (modification)
What is the prone ME technique for a Anterior Innominate Rotation?
- Pt prone with the dysfunctional innominate off the table, physican stands on side of dysf.
- Physician places one hand on the pt’s sacrum and pelvis to stabilize, using other hand to place the pt’s foot against their thigh
- Physician passively flexes hip to the barrier and tech. of ME is applied.
- Reassess
What is the supine ME technique for a Posterior Innominate Rotation?
- Pt supine, lying near side of table w/ SI joint off the table. Physician on side of dysfunction
- Physician puts cephalad hand over the contralateral ASIS and uses caudal hand to extend the pt’s ipsilateral hip off the table until barrier met
- Pt pushes their leg toward the ceiling while the physician provides equal counterforce for 3-5 secs. Pt relaxes and physician extends hip until new barrier is met
- Reassess
What is the prone ME technique for a Posterior Innominate Rotation?
- Pt prone and physician stands on either side of the dysfunction
- Physician places cephalad hand on the patien’t PSIS on dysf. side, while caudal hand passively extends the pt’s hip until barrier is reached, principles of ME are applied
- Reassess
What is the ME technique for a Superior Innominate Shear; modification?
- Pt is supine w/ feet off the end of table. Physician at foot of table
- Physicans grasps the pt’s tibia and fibua above the ankle, while IR and ABducting the pt’s leg to gap the SI joint
- Physician leans back to maintain axial traction and instructs the pt to pull ipsilateral hip toward the shoulder for 3-5 secs, then relaxes, while more traction is applied to new barrier
- Reassess
*May also use respiration. Maintain force on inhalation and increase force on exhalation (modification)
What is the ME technique for a Inferior Innominate Shear?
- Pt is supine w/ feet off the end of table and physican standing at foot of table
- Physician grasps the patient’s tibia and fibula above the ankle and IR/ABducts the pt’s leg to gap the SI joint
- Pt’s ipsilateral foot placed on physicians thigh, while applying cephalad force toward the ipsilateral hip. Pt pushes their foot into the physician’s leg for 3-5 secs, pt relaxes, more compression to new barrier applied
- Reassess
What is the ME technique for a Inflare of the Innominate?
- Pt is supine, while physician stands opposite the dysf. Pt’s dysf. hip and knee are flexed and their foot is places on the lateral side of the opposite knee
- Physican places cephalad hand on the pt’s ASIS (opposite the dysf.) and their caudal hand is places on the pt’s knee (side of dysf.)
- Pt’s hip is abducted/ER (FABER) until restrictive barrier is reached.
- Pt instructed to ADduct/IR their hip, by pushing their knee into the physicians hand while the physician resists for 3-5 secs, pt relaxes, new restrictive barrier is engaged
- Reassess
What is the ME technique for Outflare of Innominate?
- Pt is supine w/ physician standing opposite the dysf. Pt’s dysf. side hip and knee are flexed and their foot is placed on the lateral side of the opposite knee
- Physician places cephalad hand on the pt’s ASIS (side of dysf.) and their caudal hand is placed on the pt’s lateral knee (side of dysf.)
- Pt’s hip is ADducted/IR until barrier is reached, pt is instructed to ABduct/ER against resistance for 3-5 secs, then relax, and a new barrier is engaged.
- Reassess
How are pubic dysfunctions treated?
- An alternating fashion to treat both a fixed compression and fixed gapping of pubic symphysis
- Pt is supine, hips flexed to 45 degrees and knees flexed at 90 degrees with feet flat on table
- Physician ABducts pt’s knees and places forearm in between. Pt then pulls knees medially for 3-5 sec against counterforce (fixed compression)
- Physician ADducts pt’s knee and knee closest to physican rests on their abdomen, while grasping the lateral aspect of the other knee. Pt then abducts their knees against resistance for 3-5 secs (Fixed gapping of pubic symphysis)
