Pelvic Categories (2020)

Question 1

Category I

Answer 1

Right Category I Prone:

The patient is always prone for this procedure. The inferior wedge is applied first to the side of lesion, pointing slightly cranially. Only small variations to these illustrated angles will be proper.

1. Simultaneously, challenge the ilium and contralateral ischium P-A, with a crisscross vector over the S3 tubercle, then immediately challenge each PSIS for posterior positioning (usually side of lesion).
2. Cat. I confirmation is an ipsilateral first rib head fixation.
3. While prone:
   a. use inferior wedge under trochanter on side of lesion
   b. use superior wedge under ASIS to correct the anterior ilium, creating counter-rotation.

Question 2

Category II

Answer 2

Right Category II Supine:

The patient is always supine for this procedure. The superior wedge is applied first to the side of lesion pointing caudally. Only small variations to these illustrated wedge angles will be proper.

1. If Spine / Pelvic / Supine / Local / PL / Priority / Structure / Bone displacement is positive, test superior, medial, and parallel to inguinal ligament with straight ulnar hand contact. Confirm Cat. II by confirming three disc pattern by engaging disc mode.
2. If Cat. II is positive, check wedge angle at iliac crest on side of lesion and trochanter opposite side of lesion.
3. If not positive, its just an SI bone displacement…correct with compression
4. 30 seconds under the wedges then PL Cat. II test point (by inguinal ligament) and test Local / Remote for additional findings. Usually its an acupoint.
5. (Rarely) Local / Priority / Bone Displacement will show up after correction, but if so move wedges to new angles for correction.
6. Challenge ischium and trochanter over respective wedges, if positive then remove the wedges.
7. Test Sacral Wobble, Level Sacrum, and SI Fixation

Question 3

Category III

Answer 3

Right Category III Prone:

The patient is always prone for this procedure. The inferior wedge is applied first to the side of lesion pointing slightly caudally. The superior wedge is always parallel to the inferior wedge angle.

1. If Spine / Pelvis / Prone / Local / Priority / Structure / Bone Displacement is positive, test PSIS to determine side of posterior rotation, then immediately challenge ipsilateral styloid.
2. Confirmation of Cat. III is a positive challenge to the ipsilateral styloid.
3. If the challenge is not positive, then the Bone Displacement SI challenge is only an SI bone displacement…correct with compression in priority posture.
4. While prone:
   a. place the inferior wedge under trochanter on side of lesion
   b. place the superior wedge slightly superior under ASIS, parallel to the other wedge.
5. Wedge position should cancel styloid challenge, and fixations of the first rib, AC, and lower thoracic fixations.
6. Stabilize the correction by testing Local / Remote from positive SI Bone Displacement.

Question 4

Category IV

Answer 4

Category IV:

Original teaching by George Goodheart used a pelvic and shoulder wedge position to reduce this counter rotation of pelvis and shoulder planes. BSI has found no need to use wedges for this Category IV. Test the bilateral Coccygeus muscles and make the correction. Additional testing of More Local or More Remote will satisfy the muscle imbalance.

After Spine / Pelvis / Local / Priority / Bone Displacement, leads you to the pelvis, challenge for the Category IV. The anterior challenge is to touch the finger tips into the lower half of the Iliac fossa, and the posterior challenge is to challenge the Ischium for bone displacement correction. Adjust the Ischium to a precise vector according to challenge and restore the muscle dysfunctions of the Coccygeus, both the Sacral and Coccyx divisions. Quad and Hamstring balancing may occasionally be necessary.

Question 5

Category V

Answer 5

Category V:

In essence, the Category V is a “pelvic flare” of the innominate. After Spine / Pelvis / Local / Priority / Bone Displacement, of the pelvis challenge for the Category V. The anterior challenge is to touch the finger tips into the upper half of the Iliac fossa, and the posterior challenge is to locate the specific contact of Innominate Ala or Ischium. Then check the CNDX for the gravitational posture of Prone or Side posture of LSD or RSD. Firm steady compression will modify the SI position and reactivate the pelvic muscles of the perineum.

Question 6

Category VI

Answer 6

Right Category Six (VI) Supine:

The patient is always supine for this procedure. The superior wedge is applied first to the side of lesion pointing cranially. The inferior wedge is always parallel to the superior wedge angle.

1. If a two disc pattern is present at C7 and L5, and the Priority / End Point is Supine / Pelvis / Bone Displacement….Test PSIS for side of lesion.
2. If supine correction:
   a. Place superior wedge under iliac crest on side of lesion pointing cranially.
   b. Place inferior wedge under trochanter facing caudally and parallel to the superior wedge.
3. If prone correction, hip capsule ligament will be positive with a possible necessary specific hip position of the acetabulum using Local / POP
4. If side posture correction, correct with a specific vector and position of the acetabulum using Local / POP
5. Test Level Sacrum-Lumbar Paraspinals, Ischiums, and Trochanters