LAB - Sacrum/Innominate BLT Flashcards
How do you do the Pelvis TART evaluation?
what specifically do you do for TTA?
Palpate for TTA, Asymmetry (through innominate / Sacral dx), and Tenderness.
Quadratus lumborum (lateral), go midline ish to erector spinae around L1-L5 region,
go even farther for piriformis (just superior to the but cheek crease)
feel the hamstrings to make sure you’re good.
flip them over and check the rectus abdomens, the quadriceps, and the adductors.
Explain BLT, supine Dx: Bilaterally Extended Sacrum?
you want to push it into extension more
You’re putting your hand underneath their butt and their apex is between your thenar and hypothenar eminence. your fingers are in the sacral sulcus
since the patient is extended, you push with your thenar and hypothenar eminence upwards (anterior) on the apex to the point of “ligamentous balance”
Have them take a DEEP BREATH AND HOLD AS LONG AS POSSIBLE. (can do exhalation instead too)
repeat until best motion obtained (3x)
explain BLT Dx: Bilaterally flexed sacrum?
you want to push it into flexion more you do the same thing as extended, put your hand underneath and push your FINGERS UP instead of your thenar and hypothenar eminence!
hold exhalation because that accentuates flexion (but sometimes inhalation works better.. do exhalation)
repeat 3x
Explain BLT Dx: Left on Left oblique axis?
This means that the right sulcus is the issue and its ANTERIOR (facing left)
in this one you are on the ipsilateral side of rotation and pushing on the RIGHT base (sacral sulcus) to induce more motion at that right sulcus for balanced ligamentous strain
breathing in and out and finding which ones work
air hunger, repeat 3x
Explain BLT Dx: Right on Left axis
This means the right sulcus is facing posteriorly (facing right)
seated ipsilateral side as the rotation and applying anterior pressure to the left ILA. to induce more posterior motion of that right sulcus
breathing in and out and finding which ones work
air hunger, repeat 3x
If you were treating a Right on Right, where would you be pushing?
You would be pushing anteriorly at the Left sulcus to induce more motion
If you were treating a Left on Right, where would you be pushing?
Right ILA to induce more posterior motion of the left sacral sulcus
How do you do BLT, seated Dx: Left sacral torsion on a Right axis?
Put their arm behind their neck on the side of the axis or OPPOSITE the moving side.
grab the arm and flex them down to the sacral sulcus that you’re monitoring.
Rotate them in the direction of their preferred rotation. (since this is a left on right, rotate them left)
side bend them opposite. hold them there. breathe in and out until air hunger. etc. (side affected is left, side bend them right)
How do you do BLT, seated Dx: Right on Right?
Induce extension from above in the seated patient after monitoring until the posterior sacral base is palpated as moving anterior to balance with the other side.
rotate the pt through their upper body in the direction of sacral motion (right in this case)
sidebend to the contralateral side
breathe
what do you do.. extension or flexion for (seated)
L on R or R on L
R on R or L on L
flex them
Extend them.
what do you do for rotation for (seated)
L on R
R on L
R on R
L on L
L
R
R
L
How do you do Posterior Innominate Rotation BLT?
they’re seated with their legs off the table.
since posterior, you PUSH up on the affected leg and pull down on the contralateral leg.
the patient then rotates the trunk to the IPSILATERAL SIDE until the IPSILATERAL LEG begins to draw upward with the motion.
hold breath or exhale for 5-10 seconds
release and reassess.
How do you do Anterior Innominate rotation?
Anterior, so pull down on the affected leg, and push up on the contralateral leg.
have the patient rotate the trunk to the CONTRALATERAL side until the CONTRALATERAL leg begins to draw upward with the motion.
hold breath for 5-10 seconds
release and reassess
