Innominate/Pube Txt Flashcards
Dx- right anterior innominate
rotate innominate posterior
Dx- left posterior innominate
rotate innominate anterior
Dx- left superior innominate shear
pull the innominate inferior, leg tug, rotate foot medial
Dx- right innominate outflare
inflare the innominate- bend at the knee, push the knee medial
Dx- right innominate inflare
outflare the innominate- bend the knee, push the knee lateral
Dx- bilat pubic compression
decompress the pubes using hip adductors- preparatory phase is squeezing the knees together while the pt pulls them apart, direct method phase is pushing the knees apart while the pt pushes them together
Dx- left inferior pubic shear
posteriorly rotate the innominate while gapping the pubes- bend the knee and rotate up
Dx- right superior pubic shear
anteriorly rotate the innominate while gapping the pubes- push the leg down off the table
Dx- anterior pubic shear right (BLT)
carry left pubes posteriorly to point of balance, carry right ASIS laterally which outflares the right innominate, bringing the right pubes further anterior
L1 tenderpoint is where?
ASIS
L2, 3, and 4 tenderpoints are where?
AIIS
2 is medial, 3 is lateral, 4 in inferior
L5 tenderpoint is where?
pubic tubercle
AL1 is found on medial aspect of the ASIS, you will push medial to lateral. What is the treatment?
supine, Dr on side of dysfunction, lumbar flexion with sidebending torso toward and rotating torso away by flexing hips and knees and pulling hips and legs towards point
FStRa
AL5 found on anterior pubic rami 1cm lateral to pubic symphysis, you will push anterior to posterior. What is the treatment?
supine, Dr on side of dysfunction, lumbar flexion with sidebending torso away and rotating torso away by flexing hips and knees and pulling hips towards you while swinging hips and feet away from you
FSaRa
Which is more common with postural dysfunction? AL1 or AL5?
AL1
AL5 is more common with pubic somatic dysfunction and may also occur with bladder dysfunction
What will be weak and tight with lower cross syndrome?
erector spinae?
gluteal?
abdominals?
iliopsoas?
tight erector spinae
weak gluteal
weak abdominal
tight iliopsoas
AL2- medial AIIS, push medial to lateral
AL3- lateral AIIS, push lateral to medial
AL4- inferior AIIS, push inferior to superior
Treatment?
supine, standing on OPPOSITE side of dysfunction, lumbar flexion with sidebending torso away and rotating torso towards by flexing hips and knees and pulling hips and legs towards you
FSaRt
AL2-4 is common with ____ dysfunction- people who _____.
postural, sit a lot
What is found deep in anterior pelvis, 2/3 of distance from ASIS to midline? What is the treatment for this?
Psoas
supine, standing on side of dysfunction, marked bilat hip flexion and external rotation with knees bilat flexed with ankles crosses
What is found deep in iliac fossa, 1/3 of distance from ASIS to midline? What is the treatment?
Iliacus
supine, standing on side of dysfunction, marked bilat hip flexion and external rotation with knees bilat flexed and ankles crossed
What is found on lateral aspect of pubic tubercle at attachment of Inguinal ligament and pectineus muscle? You will push anterolateral to posteromedial. What is the treatment?
Inguinal (pectineus)
supine, standing on side of dysfunction, bilat hip and knee flexion, contralateral knee crossed over ipsilateral knee, ipsilateral hip adduction and internal rotation produced by pulling ipsilateral foot towards you
What is found on the superior surface of iliopectineal eminence associated with the attachment of psoas minor? You will push anterosuperior to posteroinferior. What is the treatment?
Low ilium
supine, standing on side of dysfunction, marked ipsilateral hip flexion to about 100º (bend the knee and push it toward head)
Posterior lumbar tender points on the spinous process treatment?
pure extension
Posterior lumbar tender points on the transverse process treatment?
ESaRt- stand on same side, slide your knee under their thigh
Where is the upper pole L5? Lower pole L5?
superior to PSIS, inferior to PSIS
Upper pole of L5 is found on the superomedial aspect of PSIS. What is the treatment?
prone, extend ipsilateral trunk by rotating pelvis towards point OR by extending ipsilateral hip with slight adduction, creating slight extension and sidebending away from point
ESaRt
Lower pole L5 is found on the inferior aspect of the PSIS. What is the treatment?
prone, ipsilateral hip flexion (90˚) with internal rotation and slight adduction
F IR Add
(flexion, internal rotation, adduction)
the foot will be toward the Dr, not the bed
Piriformis- found in the belly of the piriformis muscle midway between ILA and greater trochanter. What is the treatment?
prone, seated on side of dysfunction, ipsilateral hip flexion to about 120˚ with some abduction and external rotation
the foot will be toward the table
High ilium sacroiliac is found 2-3 cm lateral to PSIS at attachment of gluteus maximus. You will push lateral to medial. Treatment?
prone, standing on side of dysfunction, ipsilateral hip extension with slight abduction
you will grab the ankle and pick up the leg while pointing the toes away from the bed toward you
Lateral PL3 and PL4 (gluteus medius)
Lat PL3 is on the iliac crest in superomedial gluteus medius muscle about halfway between PSIS and posterior edge of tensor fascia lata at the level of the PSIS
Lat PL4 is on the iliac crest in superolateral gluteus medius at the posterior border of the tensor fascia lata
Treatment?
prone, extend ipsilateral hip with abduction and external rotation
E ER Abd
(extend, external rotation, abduction)
you will grab the knee and pull the leg up with the toes pointing away from the table and toward you
Mid pole sacroiliac found 10cm inferior and slightly lateral to PSIS at the level of the ILA. You will push anteromedial toward the ILA. Treatment?
prone, standing on side of dysfunction, ipsilateral hip abduction with slight flexion or extension as needed
pts knee bend with knee toward Dr, push ankle into table
High ilium flareout found on lateral aspect of coccyx at attachment of coccygeus muscle. You will push posterolateral to anteromedial at 45˚. Treatment?
prone, standing on side of dysfunction, ipsilateral hip extension and adduction, may need slight external rotation
you will cross the pts legs and push up on top leg (leg closest to you) at the knee
MPSI/gluteus is common with what?
sacral shears, USF, USE
HIPO/coccygeus is common with what?
coccydynia (pain in coccyx) and pelvic floor dysfunction
