OMM 4 Posterior Lumbar/Pelvis CS and FPR

Question 1

Describe the location and treatment position for PL 1-5 Spinous

Answer 1

Inferior midline or inferolateral aspect of the spinous process tip.

Prone. Extension to spinal aevel, S-R of pelvis Toward

Question 2

Describe the location and treatment position for PL 1-5 Transverse

Answer 2

Lateral aspect of transverse process (these will be Supero-lateral Compared to PL Spinous

Prone. Extension to spinal aevel, S-R of pelvis Toward

Question 3

Describe the location and treatment position for Piriformis

Answer 3

Midway between lateral sacrum (at level slightly above ILA) and Greater trochanter??

Prone. Marked flexion of the hip and abduction. Fine tune with Internal/External rotation

Question 4

Describe the location and treatment position for Upper Pole L5

Answer 4

Superio-medial aspect of PSIS

Prone. Hip extension, fine tuning with adduction and internal/external rotation.

Question 5

Describe the location and treatment position for Lower Pole L5

Answer 5

On the ilum, just inferior to PSIS (press up from underneath).

Hip flexion to about 90, adduction, slight internal rotation.

Question 6

Describe the indication and procedure for FPR Pelvis-Piriformis, Patient prone

Answer 6

Piriformis tenderpoint tenderness.

Patient prone, Physician on same side as tenderpoint. Monitor tenderpoint with cephalad hand. Use caudad hand to drop patien’ts leg off the table with their leg flexed and resting on physician’sthigh. Flex 120-130 then abduct and internally rotate for fine tuning. Once localized, introduce vector force from the patella, through the femur and towards the tender point until localized. Hold for 3-5 seconds, reutrn to neutral, reassess.

Question 7

Describe the indication and producer for FPR Sacrum, Patient Prone

Answer 7

SI pain at the upper or lower poles. Patient prone. Physician sitting on same side as tender sacral pole.

Monitor tender sacral pole with cephalad hand. Caudad hand drops patient’s leg off table and rests on physyician’s thigh. Flex to >120, Internal/Extrenal rotation for fine tuning until position of ease felt at sacral pole (tenderness won’t be obvious). Now introduce vector force through patella, along femur until felt at the pole. Hold and release after 3-5 seconds, retur to neutral, reasses.