Innominate SD Treatments

Question 1

Explain the ME treatment for an Inflare of the Innominate; how do you reassess

Answer 1

Inflare of Innominate

Patient is supine with doctor on side of table opposite of SD; flex the effected leg across the other legs knee so the foot is facing you; stabilize the patients ASIS near you and place caudad hand on top of knee; apply a downward force and have patient resist; repeat until no new barriers

Reassess- reset hips, pelvic compression, and ASIS to midline

Question 2

Explain the treatment for an Outflare of the Innominate; how do you reassess

Answer 2

Outflare of Innominate

Patient supine with doctor on side of table opposite of SD; flex effected hip and knee over other leg so foot is flat on table; stabilize ASIS of effected leg and place caudad hand on lateral surface of effected knee; pull leg towards your body and have patient resist; repeat until no new barriers

Reassess- reset hips, pelvic compression, ASIS to midline

Question 3

Explain the treatment for Superior Innominate Shear and HVLA; how do you reassess

Answer 3

Superior Innominate Shear

Patient supine so feet are off table and doctor at foot of table; abduct and internally rotate effected leg then grab just superior to malleoli; pull leg caudad and have patient resist; repeat until no new barriers; for HVLA apply caudad thrust at end

Reassess- reset hips, pelvic compression, ASIS height

Question 4

Explain treatment for Inferior Innominate Shear and HVLA; how do you reassess

Answer 4

Inferior Innominate Shear

Patient lies lateral recumbent with effected side up and doctor standing behind patient; cross top leg so foot is in popliteal fossa; hold PSIS and ASIS and pull laterally and cephalad during exhale and resist inhale; repeat until no new barriers; HVLA apply thrust on last exhale

Reassess- reset hip, pelvic compression, ASIS height

Question 5

Explain supine treatment for Anterior Innominate Rotation; how do you reassess

Answer 5

Supine Anterior Innominate Rotation

Patient supine with doc at side of SD; flex patients hip and knee towards patient chest like you are stretching them; have patient resist; repeat until no new barriers

Reassess- reset hip, pelvic compression, ASIS height

Question 6

Explain prone treatment of Anterior Innominate Rotation; how do you reassess

Answer 6

Prone Anterior Innominate Rotation

Patient prone with effected leg hanging off table and doctor at side of SD; stabilize pelvis; flex patients leg so foot is against your thigh and apply force cephalad; have patient resist; repeat until no new barriers

Reassess- reset hip, pelvic compression, ASIS height

Question 7

Explain supine treatment of Posterior Innominate Rotation; how do you reassess

Answer 7

Supine Posterior Innominate Rotation

Patient supine so effected leg is hanging off side of table and doctor at side of SD; stabilize opposite ASIS; push knee down towards floor and have patient resist; repeat until no new barriers

Reassess- reset hip, pelvic compression, ASIS height

Question 8

Explain prone treatment of Posterior Innominate Rotation; how do you reassess

Answer 8

Prone Posterior Innominate Rotation

Patient prone and doctor at side of table opposite of SD; stabilize opposite PSIS; pull patients hip into extension and have patient pull leg towards table; repeat until no new barriers

Reassess- reset hip, pelvic compression, ASIS height

Question 9

Explain treatment for pubic restrictions aka Shotgun technique and HVLA; how do you reassess

Answer 9

Pubic Restrictions/Shotgun Technique

Have patient supine with doctor at side of table; have patient flex knees so feet are flat on table; put closed fist between patients legs then have them adduct; then put hands on lateral surface and knee and have patients abduct against resistance; repeat until no new barriers; HVLA thrust patient into abduction on exhale

Reassess- reset hip, pelvic compression, pubic tubercle

Question 10

Explain HVLA for Anterior Innominate Rotation; how do you reassess

Answer 10

HVLA Anterior Innominate Rotation

Patient lateral recumbent with SD side up and doctor at side facing patient; monitor lumbosacral junction and flex patients legs until motion; straighten bottom leg and drop top leg off of table; have patient interlock fingers across chest; place forearm of caudad arm from the greater trochanter to the PSIS and cephalad hand under patients arms on their back; apply force to push back toward table and apply caudad force on hip; then apply thrust in direction of patients hanging leg

Reassess- reset hip, pelvic compression, ASIS height

Question 11

Explain HVLA for Posterior Innominate Rotation; how do you reassess

Answer 11

HVLA Posterior Innominate Rotation

Patient lateral recumbent with SD up and doctor facing patient; monitor lumbosacral junction and flex hip and knees; straighten bottom leg and put top leg so foot hangs across popliteal fossa; have patient interlock fingers across their chest; place cephalad arm under their arms on patients back and place caudad forearm across PSIS and iliac crest; apply force pushing back toward table and pulling pelvis toward you body; then apply thrust

Reassess- reset hip, pelvic compression, ASIS height