Methods 4 Comp Eval #1

Question 1

SI Joint Play: Flexion Restriction

Answer 1

-Thenar contract over the sacral base (cephlad), grasp the ipsilateral ASIS (Caudal)
-Apply a shearing force inducing flexion of ilium
-No spring = Flexion Restriction

Question 2

SI Joint Play: Extension Restriction

Answer 2

-Hypothenar contact over PSIS (cephlad), knife-edge opposite sacral apex (caudal)
-Apply a shearing force inducing extension of the ilium
-No spring=Extension Restriction

Question 3

SI Internal/External Rotation

Answer 3

-Cephlad: Place fingertips of the superior hand into the joint-line of the SI joint
-Caudal: Grasp the ankle of your patients flexed knee on the same side
-Move ankle toward/away from midline
-Internal rotation: gap should close
-External rotation: gap should open

Question 4

Sacral Nutation/Counternutation

Answer 4

-Palpate/compare the depth of the sacral base (just medial to PSIS)
-Palpate alignment of the sacral apex
-Flexed: Deeper/potential deviation to the opposite side
-Extended: Shallower/potential deviation towards IL side

Question 5

Sacral nutation (standing)

Answer 5

-Thumbs contact sacral apex, fingertips contact BL PSIS
-Patient asked to actively extend backwards towards the waist
-Thumbs and fingers should approximate

Question 6

Sacral counternutation

Answer 6

-Thumbs contact sacral apex, fingertips contact the BL PSIS
-Patient asked to actively flex toward the waist
-Thumbs and fingers separate

Question 7

SI Static Palpation: Flexion/Extension

Answer 7

-Extension: ASL of PSIS/Higher
-Flexion: PIM of PSIS/Lower

Question 8

SI Static Palpation: Nutation/Counternutation

Answer 8

Deeper: Anterior/Inferior AND/OR Deviation Away of Sacral Apex
Shallower: Posterior/Superior AND/OR Deviation Towards of Sacral Apex

Question 9

Prone BL Hypothenar Ilium Sacral Apex Push

Answer 9

-Flexed ilium/Extension restriction (PSIS-PIM) AND/OR Nutation/Counternutation Restriction (Sacral Apex-AI)
-Doctor Position: Square OR modified fencer stance on OPPOSITE side of dysfunction
-Contact Hand: Cephlad; Hypothenar Pisiform over CL PSIS (P-A, M-L, slight I-S)
-Indifferent Hand: Caudal; Knife edge on side of sacral apex closest (P-A, slight S-I)

Question 10

Prone Unilateral Reinforced Pisiform Ilium Push

Answer 10

-Used for: Flexed Ilium/Extension Restriction
-Doctor Position: Square or Modified Fencer stance on the side OPPOSITE of dysfunction
-Contact Hand: Cephlad hand; Hypothenar Pisiform on opposite PSIS (P-A/M-L)
-Indifferent Hand: Reinforcing CH

Question 11

Prone BL Hypothenar Ischium Sacral Base Push

Answer 11

-Used w/: Extended ilium/Flexion Restriction (PSIS-ASL) AND/OR Counternutation/Nutation Restriction (Sacral Base-Posterior/Superior)
-Doctor Position: Square/Modified Fencer on side opposite of dysfunction
-Contact hand: Caudal hand, Hypothenar (calcaneal) contact on opposite Ischial Tuberosity (P-A/S-I)
-Indifferent Hand: Cephald hand Hypothenar (pisiform) on sacral base (P-A/I-S)

Question 12

Prone Hypothenar Ilium Push with Hip Extension

Answer 12

-Used w/: Flexed Ilium/Extension Restriction (PSIS is lower/PIM) *Contraindicated with patients w/ Meraglia Paresthetica
-Doctor Position: Square or Modified Fencer on side OPPOSITE of dysfunction
-Contact Hand: Cephlad hand Hypothenar (pisiform) on opp PSIS (P-A/M-L)
-Indifferent Hand: Caudal Hand grasps distal thigh on same side as adjustive contact (shallow lift)

Question 13

Prone Unilateral Reinforced Pisiform Sacral Base Push

Answer 13

-Used w/: Counternutation/Nutation Restriction (Sacral Base is Posterior/Superior)
-Doctor Position: Modified fencer stance on the SAME side of dysfunction
-Contact Hand: Caudal hand Hypothenar (pisiform on the superior margin on the sacral base just medial to the PSIS (P-A/I-S)
-Indifferent Hand: Reinforcing CH

Question 14

Side Posture Hypothenar (Pisiform) Ilium Push

Answer 14

-Used w/: Flexed Ilum/Extension Restriction (PSIS is posterior, medial, inferior)
-Doctors Postion: Modified fencer stance on side of dysfunction
-Contact hand: Caudal hand Hypothenar (pisiform) on the PSIS (P-A/M-L/I-S)
-Indifferent Hand: Cephlad hand upper traction on patients shoulder or overlapping hand

Question 15

Side Posture Hypothenar Ischium Push

Answer 15

-Used w/: Extended Ilium/Flexion Restricton (PSIS-ASL)
-Doctor Position: Modified fencer stance on side of dysfunction
-Contact Hand: Caudal hand, soft broad contact over ischium (P-A along shaft of femur for SIJ flexion)
-Indifferent Hand: Cephalic hand slightly upward on patients shoulder overlapping arm

Question 16

Side Posture Forearm Ischium Push

Answer 16

-Used w/: Extended Ilium/Flexion Restriction (PSIS-ASL)
-Doctor Position: Modified fencer on side of dysfunction
-Contact Hand: Caudal forearm, soft broad contact pull inferior and lateral over the medial, inferior margin of the ischium (Thrust P-A, along shaft of femur to induce SIJ flexion)
-Indifferent Hand: Cephalic hand slightly upward traction over shoulder/overlapping hand