Dr. Dougherty Innominates Lecture (Test 1) Flashcards
Palpatory Landmarks- Anterior
- ASIS
- Pubic Tubercles
- Iliac Crest
- Greater Trochanter
- Medial Malleoli Heights
Palpatory Landmarks - Posterior
- PSIS
- Sacral Sulci
- Ischial Tuberosity (Spine)
Posterior Pelvic Tilt
- Causes INCREASED Kyphosis
- ISCHIAL travels forward
- New pressure points at Sacrum and Spine
Pelvic Diaphragm
- Levator Ani
- Iliococcygeus
- Pubococcygeus
- Coccygeus
Pelvic Motion
1) ROTATION
- Anterior
- Posterior
2) “SHEAR”
- Superior
- Inferior
3) FLARE (SCAPATION)
- Out
- In
Pelvic Motion while Walking
1) At RIGHT HEEL STRIKE:
- RIGHT Innominate has rotated in a POSTERIOR and LEFT Innominate in an ANTERIOR
- ANTERIOR Surface of Sacrum is ROTATED to LEFT and SUPERIOR Surface is Level, while Spine is STRAIGHT but ROTATED to the LEFT
2) At RIGHT MID STANCE:
- RIGHT LEG is STRAIGHT and Innominate is ROTATING ANTERIOR
- SACRUM has ROTATED RIGHT and SIDE BENT LEFT, while LUMBAR SPINE has SIDE-BENT RIGHT and ROTATED LEFT!!!!
3) At LEFT HEEL STRIKE:
- LEFT Innominate begins ANTERIOR ROTATION; After Toe-Off, RIGHT Innominate begins POSTERIOR ROTATION
- SACRUM is LEVEL but with ANTERIOR Surface ROTATED to the RIGHT. The Spine, although STRAIGHT, is also ROTATED to the RIGHT
Form and Force Closure
FORM CLOSURE:
- Joint Congruency
FORCE CLOSURE:
- Open vs Closed
- Compressive Forces applied to promote Stability
EVALUATION:
- Static
- Dynamic
Innominate Testing
Static Testing
Boney Landmark Assessment:
- Anterior
- Posterior
Leg Rotation:
- Internal
- External
Leg Length:
- Medial Malleolus
Innominate Testing
Dynamic Testing
- AP Compression
- Lateral to Medial Compression
- Flexion Testing
a) Standing
b) Seated
Sacral vs Innominate Dysfunction
1) Standing (+) and Seated (+) = SACRAL
2) Standing (+) and Seated (-) = INNOMINATE!!!!!!!
3) Standing (-) and Seated (+) = SACRAL
4) Standing (-) and Seated (-) = NORMAL!!!!
ANTERIOR INNOMINATE ROTATION
- ASIS is INFERIOR
- PSIS is SUPERIOR
- Medial Malleolus is INFERIOR (Long)
POSTERIOR INNOMINATE ROATION
- ASIS is SUPERIOR
- PSIS is INFERIOR
- Medial Malleolus is SUPERIOR (Short)
Innominate Shear
1) SUPERIOR SHEAR
- ASIS, PSIS and Medial Malleolus are SUPERIOR on the Affected Side (Short)
2) INFERIOR SHEAR
- ASIS, PSIS, and Medial Malleolus are INFERIOR on the Affected Side (Long)
MUST DO PELVIC COMPRESSION or STANDING FLEXION to determine LATERALITY!!!!!!!!!!!*****
Innominate Flare
- Flare is apparent when the ASIS is more MEDIAL (Towards Midline) on one side compared to the other
- Measure fro the TYPHOID (or Umbilicus) to each ASIS
- The CLOSER ASIS is the INFLARE if found on the side with the POSITIVE PELCIV COMPRESSION!!!!!!!!!!!
Pubic Shears
Determination of Affected Side
1) POSITIVE STANDING FLEXION TEST:
- On Dysfunctional Side the Innominate as it articulates with the Sacrum will LOCK OUT and Move MOST CEPHALAD
2) PELVIC COMPRESSION TEST:
- Pain on AFFECTED Side
** Often seen with ROTATIONS or UPSLIPS!!!!**
