Sacral SD Treatments

Question 1

Explain the muscle nrg treatment for Bilateral Flexion; what about HVLA

What tests do you run after to reassess?

Answer 1

Patient is prone with doctor at side of table; place heel of caudad hand at ILA and place other hand on top; apply an anterior and superior force during inhalation and resist during exhalation until no new barriers are found; for HVLA apply a thrust on last inhale

Perform lumbar spring test and resp exam to reassess

Question 2

Explain muscle nrg treatment for bilateral extension; what about HVLA

What tests do you perform to reassess

Answer 2

Patient prone in sphinx position with doc at side of table; caudad hands index and middle fingers go to both sulci and cephalad hand lays ontop; apply anterior and inferior force during exhale and resist during inhale until no new barriers found; apply thrust on last exhale for HVLA

Perform spring test and resp test to reassess

Question 3

Describe treatment for unilateral flexion

Answer 3

Patient prone with doctor at effected side; monitor lumbosacral junction with cephalad hand and abduct and internally rotate effected leg with caudad hand; place caudad hand on effected sides ILA with other hand on top and apply an anterior and superior force during inhale and resist during exhale until no new barriers

Question 4

Describe treatment for unilateral extension

Answer 4

Patient prone in sphinx position with doctor on side of SD; contact sacral base and abduct and internally rotate effected sides leg; place heel of hand at sacral sulcus with fingers pointed toward apex with other hand on top; apply an anterior and inferior force during exhale and resist during inhale until no new barriers

Question 5

What tests do you perform to reassess unilateral SD?

Answer 5

Side bend passive

Seated flexion

Question 6

Explain treatment for forward torsion

Answer 6

Put patient in modified sims; patient prone and pull hip and knee to 90 degrees so that effected axis is down (second letter is down); stand facing patient and monitor lumbosacral junction while you pull flexes legs off of the table so that knees hang off table; while monitoring lumbosacral junction apply a downward force on knees and then have patient push against your force for 3 to 5 seconds then repeat until no new barriers

Question 7

Explain treatment for backward torsion

Answer 7

Have patient lie lat recumbent with effected axis down (second letter); pull bottom arm so that patients is laying face down and his arms are off of table; contact lumbosacral junction and pull top leg off of table until motion is felt; push on top of knee down towards floor and have patient resist for 3 to 5 seconds then repeat until no new barriers are found

Question 8

What two tests do you perform to reassess torsion SD?

Answer 8

4 digit contact

4 point passive

Question 9

Explain HVLA for backward torsion

Answer 9

Patient supine with you on side of effected axis; push patients torso and legs so that the patient forms a C shape; have patient interlock fingers behind their neck; contact contralateral ASIS to stabalize and then with other hand reach over and under opposite arm and pull them towards you so you hand is on their sternum; then apply a thrust while they exhale