Sacral Dx And Tx With HVLA and BLT

Question 1

Bilateral Sacral Flexion SD HVLA

Answer 1

Monitor SI, ABduct leg until motion is palpate, IR legs

Place heel of hand and apply anterior/ superior force to apex of sacrum to engage RB

Encourage inhalation and resist exhalation with ME
On last ME cycle, apply quick anterior and superior HVLA thrust to sacral apex

Recheck

Question 2

Bilaterally extended sacrum SD HVLA setup

Answer 2

Patient prone
Monitor SI and Abduct leg until motion is felt and ER leg to gap anterior SI joint

With heel of hand, apply anterior/inferior force at sacral base

Resist inhalation and encourage exhalation with ME

On last cycle apply quick anterior and inferior HVLA thrust to sacral base

Question 3

R/L torsion or L/R torsion

Answer 3

Patient supine with physician on side of involved axis
Sidebend patient away from deep sulcus
Patient grabs hands behind head
Grasp opposite ASIS and induce rotation towards side of axis into RB while preventing motion at opposite ASIS

Pt takes a deep breath and during exhalation physician applies a rotational thrust

Question 4

Bilaterally Exteded sacrum BLT, supine setup

Answer 4

Lift sacral apex anterior to point of ligamentous balance
BLT principles
Repeated 3x

Question 5

Bilaterally Flexed Sacrum BLT

Answer 5

Lift sacral base anterior to point of BLT
Apply principles of BLT
Repeat 3x

Question 6

L/L or R/R BLT supine

Answer 6

Apply anterior pressure to base opposite the axis

Bridge ASIS to gap SI joint

apply BLT techniques

3x

Reassess

Question 7

R/L or L/R BLT supine

Answer 7

Sit on ipsilateral side of rotation and apply anterior force to ILA of axis

Bridge ASIS to gap SI joint

Apply BLT principles

3x

Reassess

Question 8

R/L or L/R BLT, seated

Answer 8

Monitor sacral suicide
Induce flexion above patient until anterior sacral base is palpated moving posterior
Rotate patient in direction of rotation
Sidebend to contralateral side

Hold inhalation
Recheck and repeat as needed until TART is reduced

Question 9

R/R or L/L BLT, seated

Answer 9

Monitor sacral soul I
Induce extension from above until postierior sacral are is palpated as moving anterior to balance with other side

rotate patient in direction of sacral rotation

Sidebend to contralateral side ass rotation

Hold exhalation

Recheck and repeat as needed until tart improves