Innominate MET

Question 1

What is the first test you do to lateralize the hip dysfunction?

Answer 1

standing flexion test

Question 2

How do you perform a standing flexion test?

Answer 2

pt standing
doc at eye level w/ PSIS
pt bends forward
higher PSIS is dysfunctional side

Question 3

What are the six levels you need to check on static tests?

Answer 3

iliac crest
ASIS
ASIS to umbilicus
pubic tubercle
medial malleoli
PSIS

Question 4

Where do you place your thumbs and pressure when checking ASIS and PSIS?

Answer 4

on the inferior aspect
(hooked under)

press cephalad

Question 5

How do you check the iliac crests?

Answer 5

start with index fingers lateral and just below crests

slide fingers up and medial

Question 6

What are the characteristics of an anterior innominate rotation?

Answer 6

PSIS superior
ASIS inferior
medial malleolus inferior

iliac crests even

Question 7

What are the characteristics of a posterior innominate rotation?

Answer 7

PSIS inferior
ASIS superior
medial malleolus superior

iliac crests even

Question 8

What are the characteristics of a superior innominate shear?

Answer 8

iliac crest superior
ASIS superior
PSIS superior
medial malleolus superior
pubic tubercle superior

Question 9

What are the characteristics of an inferior innominate shear?

Answer 9

iliac crest inferior
ASIS inferior
PSIS inferior
medial malleolus inferior
pubic tubercle inferior

Question 10

What is the characteristic of an innominate outflare?

Answer 10

ASIS to midline is longer on dysfunctional side

Question 11

What is the characteristic of an innominate inflare?

Answer 11

ASIS to midline is shorter on dysfunctional side

Question 12

What is the characteristic of a superior pubic shear?

Answer 12

pubic tubercle superior

Question 13

What is the characteristic of an inferior pubic shear?

Answer 13

pubic tubercle inferior

Question 14

What should you have the patient do before you measure the six anatomical levels?

Answer 14

reset the hips

Question 15

What should you do after the treatment before you re-assess?

Answer 15

reset the hips

Question 16

How do you treat anterior innominate rotation with MET?

Answer 16

pt supine, doc standing ipsi
flex pt hip and knee
pt extends leg against doc counterforce

Question 17

How do you treat posterior innominate rotation with MET?

Answer 17

pt supine, doc standing ipsi
extend pt leg off table
hand on contra ASIS
pt raises leg against doc counterforce

Question 18

How do you treat a superior innominate shear?

Answer 18

pt supine
doc standing at foot of table
abduct and IR leg
pull leg
have pt pull leg back up into hip

Question 19

How do you treat an inferior innominate shear?

Answer 19

pt supine
doc stand at foot of table
abduct and IR leg and place on thigh
push up against pt leg
have pt push foot down into your thigh

Question 20

How do you treat an innominate inflare?

Answer 20

pt supine and doc contra to dysfunction
flex pt hip and knee
place pt foot lateral to contra leg
brace contra ASIS
abduct pt's knee against their counterforce

Question 21

How do you treat an innominate outflare?

Answer 21

pt supine and doc contra to dysfunction
flex pt hip and knee
place pt foot lateral to contra leg
adduct pt PSIS and knee against their counterforce

Question 22

How do you perform a pubic dysfunction shotgun treatment?

Answer 22

pt supine, hips flexed, knees flexed, feet flat on table
pt abducts legs for 3-5s against counterforce
then adducts legs 3-5s against counterforce
Repeat 3-5x

Question 23

How do you treat a superior pubic shear?

Answer 23

pt supine, doc stands ipsi
pt leg extends off table
doc stabilize contra ASIS
pt pulls leg up and medial against doc counterforce

Question 24

How do you treat an inferior pubic shear?

Answer 24

pt supine, doc stands ipsi
monitor ipsi ischial tuberosity with cephalad hand
pt flex hip and knee and adduct
caudad hand on pt’s knee
pt presses knee down and out against counterforce