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OS4 > Psoas Syndrome - Lecture > Flashcards

Psoas Syndrome - Lecture Flashcards

1
Q

Origin and insertion of psoas

A

O = T12-L5 bodies/TPs

I = Lesser trochanter

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2
Q

Functions of psoas

A
  • Walk
  • Flex femur/pelvis/lumbar spine
  • Maintain pelvis when standing
  • Return hip to neutral when rotated (either direction)
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3
Q

What visceral structure is directly adjacent to the psoas muscle?

So?

A

Ureter

Kidney stone may cause psoas irritation

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4
Q

Viscerosomatic reflexes that can affect the psoas muscle

A
  • Diverticulosis
  • Ureter stone
  • Prostatitis
  • Descending colon cancer
  • Salpingitis
  • Psoas abscess
  • Appendicitis
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5
Q

How can psoas syndrome and lumbar lordosis be related? Causes of each?

A

Increased lordosis = psoas pulling vertebrae/sacrum forwards

Decreased lordosis = tight hamstring/gluteus maximus/abdominals = pulling inominate posteriorly and psoas superiorly

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6
Q

Special test for psoas syndrome

A

Thomas test

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7
Q

Osteopathic testing for psoas syndrome

A

Hip ROM

Tender points – iliacus, low ilium, AL 1-5

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8
Q

Tight psoas b/l…expected SDs?

Treatments?

A

Type 2 dysfunctions

Passive (rolled towel)
Muscle relaxants

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9
Q

***Tight R psoas u/l…expected SDs?

Treatments?

A

***L1 F RR SR
L2-5 N RL SR

Fix SDs (L1, then others)
Psoas stretch
Muscle relaxants/NSAIDs

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10
Q

Stage 3 of psoas syndrome?

***Finding (R psoas)

Treatment?

A

Sacral torsion

***L on R sacral torsion
L pelvic side shift

Treat the torsion

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11
Q

Stage 4 of psoas syndrome? Why?

Treatment?

A

CONTRALATERAL piriformis spasm - due to L pelvic side shift

Treat piriformis

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12
Q

Stage 5 of psoas syndrome? Why?

Positive test?

Treatment?

A

CONTRALATERAL sciatica (due to piriformis)

SLR (above 30º

Low dose steroid

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13
Q

Psoas syndrome…first treatment target?

ME technique? How to do it?

A

L1 flexion

FDDR (Long Lever) – LR, PTP down, shoulder to table, flex H/Ks then straighten lower leg, ABD upper leg, Pt ADDs down toward table against resistance

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14
Q

Psoas syndrome…CS points? Describe each

A

Iliacus - 1-2in medial to ASIS, deep in fossa – frog leg w/ ankles on doc’s knee

Piriformis - 1/2 to 2/3 from ILA to GT – prone, flex leg over table, ABD and ER hip

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15
Q

Psoas syndrome…psoas ME/stretch

A

Extend leg over table, stabilize opposite ASIS, patient flexes against doc

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16
Q

Good NSAIDs for psoas syndrome

Good muscle relaxants for psoas syndrome

A

Naproxen, Ibuprofen, Meloxicam, Celecoxib

Metaxalone, Cyclobenzaprine, Baclofen, Carisoprodol

17
Q

Psoas syndrome stretches (home)

A

Psoas – Kneel on 1 knee, IR back hip (moving ankle out to side), posteriorly rotate pelvis

Piriformis – supine, F/ER, pull knee/ankle towards head

Lumbar – child’s pose, happy baby pose

OS4 (3 decks)

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