Innominates Flashcards
What are the key influences on the body by the innominate?
painless gait and trunk control, balance, lymphatic, GI and GU system
What are the bones of the innominate?
Ilium, pubis, ischium
What are the key joints of the pelvis?
2 SI joints, 1 pubic symphysis, 2 hip joints
What are the major anterior bony landmarks of the pelvis?
iliac crest, anterior superior iliac spine, anterior inferior iliac spine, pubic tubercle/symphysis
What are the major posterior bony landmarks of the pelvis?
posterior superior iliac spine, posterior inferior iliac spine, ischial tuberosity
What are the common ligaments of the innominates and sacrum that cause pain due to overuse
iliolumbar, posterior superioriliac, sacrospinous, sacrotuberous
What does the pelvis do for body systems?
support sGI and GU systems, lymphatic trunks from LE, pelvic floor and diaphragm
What are the biomechanical functions of the innominate?
foundation of trunk, maintain stability of trunk during movement, transmit force during gait
What are the primary motions of innominate rotation?
rotates anterior (toe off during walking), rotates posterior (heel strike during walking), shear, in flare, out flare
What tests are used to lateralize the dysfunction?
ASIS compression, standing flexion
What is the ASIS compression test?
posterior medial compression to assess SI joint
What is the standing flexion test?
assess ability of SI joint to stabilize during motion, PSIS will move superior on dysfunctional side
What are the steps of diagnosing and treating innominate dysfunction?
- Lateralization test
- palpate landmarks
- Diagnose somatic dysfunction
- Treat
- Reasses
What landmarks are important to identify in an innominate diagnosis?
PSIS, ASIS, iliac crest heights, medial malleoli, ASIS to midline, pubic tubercle
What is an anterior innominate rotation?
Superior PSIS, inferior ASIS, inferior malleoli, iliac crests even
What is a posterior innominate rotation?
PSIS inferior, superior ASIS, superior malleoli, iliac crests even
What is a superior innominate shear?
PSIS superior, ASIS superior, Malleoli superior, Iliac crest superior, pubic tubercle superior
What is an innominate shear?
PSIS inferior, ASIS inferior, Malleoli inferior, iliac crest inferior, pubic tubercle inferior
What is an outflare of innominate?
ASIS to midline longer on side of dysfunction
What is an inflare of innominate?
ASIS to midline shorter on side of dysfunction
What is a superior pubic shear?
pubic tubercle superior
What is an inferior pubic shear?
pubic tubercle inferior
What is the supine treatment for an anterior innominate rotation?
patient supine, physician passively flexes patients hip until the edge of the restrictive barrier is reached – ME
What is the prone treatment for a posterior innominate rotation?
patient prone, physician extends patients hip until restrictive barrier is reached – ME
What is the treatment for superior innominate shear?
Pt supine, physician grasps tibia and fibula above angle, internally rotate and abduct pt leg and apply axial traction
What is the treatment for inferior innominate shear?
Pt supine, physician grasps pt tibia and fibula, internally rotate and abduct pt leg and apply cephalad compression
What is the treatment for inflare of innominate?
Pt supine, knee and hip flexed, foot placed on lateral side of opposite knee, abduct and externally rotate until barrier is reached
What is the treatment for outflare of innominate?
pt supine, knee and hip flexed, foot placed on lateral side of opposite knee, adduct and internally rotate until barrier is reached
What is the pubic dysfunction shotgun treatment?
Flex hips to 45 degrees and knees to 90 degrees, use isometric contractions and alternate between adduction and abduction
What is the superior pubic shear MET?
Pt supine, abduct and extend leg off table, have pt flex hip medially toward ceiling to activate adductor muscles
What is the inferior pubic shear MET?
Pt supine, flex and adduct until barrier is reached, have patient try to abduct and extend hip for 3-5 seconds
What is the setup for posterior innominate rotation BLT?
pt seated, doc holding tibias, push up on IPSI leg and pull down on CONTRA leg to attain balance point, have pt rotate trunk towards SD until IPSI leg draws upward
What is the setup for anterior innominate rotation BLT?
pt seated, doc holding tibias, pull down on IPSI leg and push up on CONTRA leg, have pt rotate trunk away from SD until CONTRA leg draws up
