OMM Final Practical Flashcards
steps of innominate dx
ID dysfuntion side:standing flexion test (reset pelvis) ASIS compression ID dysfunction: ASIS/PSIS positions (reset pelvis) Leg lengths
standing flexion test findings
side that moves first/furthest is side of dysfunction (+)
ASIS compression test findings
side that’s harder to press in dysfunction side (+)
ASIS/PSIS position findings
ASIS lo, PSIS hi --> ant rot ASIS hi, PSIS lo --> post rot ASIS hi, PSIS hi --> sup shear ASIS lo PSIS lo --> inf shear ASIS med, PSIS lat --> inflare ASIS lat, PSIS med --> outflare
leg length findings
short –> post rotation or sup shearlong –> ant rot or inf sheareven –> in/outflare
ME innominate ant rot
pt supine flex hip/knee monitor PSIS3-5 x for 3-5 s final stretch return, RESET, reassess
ME innominate post rot
pt supine, dysfunctional leg off table stabilize opp ASIS extend hip to barrier 3-5 x for 3-5 s final stretch return, RESET, reassess
ME innominate inflare
pt supine stabilize opp ASIS flex hip 90 abduct to barrier 3-5 x for 3-5 s final stretch return, RESET, reassess
ME innominate outflare
pt supine monitor dysfunctional PSIS flex hip 90 adduct into barrier pull PSIS lat during contraction 3-5 x for 3-5 s final stretch return, RESET, reassess
HVLA innominate superior shear
pt supine dr @ foot of table grasp tib/fib, int rot apply traction to barrier thrust return, RESET, reassess
sacral dx steps
seated flexion testspring testsacral sulcusinferior lateral angle(need 3/4)
ME sacral ant torsion
up up up - use gluteus maximus pt in lat recumbent, chest up flex hips monitor base of dys side lift legs 3-5 for 3-5 final stretch return, reassess
ME sacral post torsion
up down down - use piriformis pt in lat recumbent, chest up flex hips monitor base of dys side lower legs (or just top) 3-5 for 3-5 final stretch return, reassess
ME sacral unilateral flexion shear
pt prone abduct/int rotate lower leg on dys side contact ILA of dys side push on INhalation resist on EXhalation return, reasses
ME sacral unilateral extension shear
pt prone, sphinx abduct/int rotate lower leg on dys side contact base of dys side push on EXhalation resist on INhalation return, reasses
ME sacral bilaterals
same as uni, but push on middle of base or ILA
pubis dx steps
ASIS compression pubic tubercle positionstenderness
ME inferior pubic shear
(same as ant rot innominate) pt supine gap PS (dr force open) flex hip/knee monitor ischial tuberocity 3-5 x for 3-5 s final stretch close PS (dr force close) return, RESET, reassess
ME superior pubic shear
(same as post rot innominate) gap PS (dr force open) pt supine, dysfunctional leg off table stabilize opp ASIS extend hip to barrier 3-5 x for 3-5 s final stretch close PS (dr force close) return, RESET, reassess
piriformis dx steps
internal rotation
FAIR (flexion, adduction, internal rotation)
piriformis internal rotation findings
more difficult to IR –> piriformis dysfunction
FAIR findings
pain –> + –> piriformis dysfunction
piriformis counterstrain
spot: midpoint btwn sacrum and greater trochanter
pt prone, dys leg off table
hip/knee flex/abduct
fine tune w/ ER
psoas major counterstrain
spot: 2/3 from ASIS to midlinept supinehip knee flexST
tibiofibular dx steps
seesaw lateral malleolus and fibular head
tibiofibular dysfunctions
foot supination/inversion –> posterior fibular headfoor pronation/eversion –> ant fibular head
ME post fibular head
pt supine, knee bent monitor post aspect of fibular head dr force EXternal rotation 3-5 x for 3-5 s final stretch return, reassess
ME ant fibular head
pt supine, knee bent monitor ant aspect of fibular head dr force INternal rotation 3-5 x for 3-5 s final stretch return, reassess
HVLA post fibular head
pt prone pronate foot (barrier) MCP behind fibular head flex knee into barrier thrust with MCP return, reassess
HVLA ant fibular head
pt supine, pillow under knee supinate foot (barrier) heel of hand over fibular head thrust into fibula (valgus) return, reassess
medial hamstring CS
spot: medial popiliteal fossa pt supine hip flex (cptn) knee: F, IR, Add (can add compressive @ calcaneous) return, reassess
lateral hamstring CS
spot: lateral popiliteal fossa
pt supine, leg off table
knee: F, ER, Ab
return, reassess
gastrocnemius CS
spot: med/lateral head of gastroc
pt prone
knee flex, plantarflex (capt)
return, reassess
fibularis CS
spot: post to lateral malleolus pt supine
plantarflex, evert
return, reassess
tibialis ant CS
spot: inf to med malleolus
pt supine
invert, dorsiflex
return, reassess
tibialis post CS
spot: post to med malleolus plantarfelx, invert
return, reassess
anterior tibia on talus signs
easy post translation (drawer)deep sulcusprefer dorsiflexion
post tibia on talus signs
easy ant translation (drawer)
shallow sulcusprefer plantarflexion
HVLA ant tibia on talus
pt supinecup calcaneous contact tibia @ distaldr force down into tibiareturn, reassess
HVLA post tibia on talus
pt supinefingers woven over dorsum, thumbs @ ball of footbring to dorsiflxion barrierthrust thrureturn, reassess
subtalar (talocalcaneous) joint dx
inversion vs eversion
MFR subtalar
pt supinehold calcaneous and forefootin/direct for 30 s
HVLA subtalar (ankle decompression)
pt supinehold calc and forefoottraction into in/eversion barrierthrusrreturn, reassess
midfoot HVLA
pt prone, leg off tablethumb contact inf bonewhipreturn, reassess
midfoot MFR
plantar fasciitispt supinefascia into planes of resistance/ease30-60 s
midfoot CS
plantar flex, push inferior
HVLA plantar styloid process
plantar force @ 5th head w/ thumbdorsal force w/ MCP
HVLA phalanges
tractionuse flex/extend too
