Sacrum and Pelvis Review

Question 1

inguinal ligament TP location

Answer 1

superior surface of pubic tubercle

Question 2

inguinal ligament TP technique

Answer 2

• patient is supine- flex both legs 90 degrees and place on doc’s thigh. move leg on tender side under the opposite leg. adduct the femur. internally rotate the femur by moving the ipsilateral leg towards yourself until TP resolves

Question 3

iliacus (psoas) TP location

Answer 3

2 in inferior and 2 in medial from ASIS

Question 4

iliacus TP technique

Answer 4

• patient: supine- stand on tender side. flex patient’s legs, externally rotate the legs and place them on your thigh. flex, sidebend toward the TP until it resolves

Question 5

low ilium (SI) TP location

Answer 5

lateral ramus of the pubic bone anterior surface

Question 6

low ilium (SI) TP technique

Answer 6

• patient: supine- flex the tender side only (90 degrees); add abduction if needed for resolution of pain

Question 7

lateral trochanter TP location

Answer 7

lateral surface of the femur 0-15cm distal from great trochanter in the IT band

Question 8

lateral trochanter TP technique

Answer 8

• patient: prone- doctor is seated supporting the pt’s leg on his thigh. slightly flex the hip, add abduction and internal rotation

Question 9

posterior lateral trochanter TP location

Answer 9

superior lateral surface of the posterior greater trochanter

Question 10

posterior lateral trochanter TP technique

Answer 10

• patient: prone- doctor is standing with knee on table under the pt’s thigh; add in a moderate amount of extension, some abduction and a whole lot of external rotation until the TP resolves

Question 11

posterior medial trochanter TP location

Answer 11

3-5mm inferior to the greater trochanter between the posterior medial surface of the shaft of the femur and the posterior lateral surface of the ischial tuberosity

Question 12

posterior medial trochanter TP technique

Answer 12

• patient: prone- grasp leg on tender side and place your knee under the thigh; slightly extend the leg, moderately externally rotate it and bring the leg across the midline with adduction until TP resolves

Question 13

anterior lateral trochanter TP location

Answer 13

5-7cm lateral and inferior to the ASIS but anterior and superior to the greater trochanter

Question 14

anterior lateral trochanter TP technique

Answer 14

• patient: supine- flex hip 70-90 degrees; add abduction and external rotation until TP resolves

Question 15

high ilium sacroiliac (HISI) TP location

Answer 15

4-5cm lateral to PSIS

Question 16

HISI TP technique

Answer 16

• pt: prone or supine- doctor is standing on affected side; extend leg and slight abduction until TP resolves

Question 17

mid pole sacroiliac (ilium in flare superior) (MPSI) TP location

Answer 17

3-4cm inferior to PSIS in the divot in the mm just lateral to the sacrum. approach the TP from the lateral side

Question 18

MPSI TP technique

Answer 18

• patient: prone- doctor is standing on the affected side; slightly flex the hip and knee; add abduction and some external rotation of the hip until TP resolves

Question 19

piriformis TP location

Answer 19

belly of the piriformis 8-9cm medial and slightly superior to greater trochanter

Question 20

piriformis TP technique

Answer 20

• pt: prone- doctor is seated on side of TP. suspend pt’s leg off table and rest the leg on your thigh. flex the hip to about 135 degrees, abducts slightly via the knee and internally or externally rotate the knee until TP resolves

Question 21

high ilium out flare (HIFO) TP location

Answer 21

sacrococcygeal joint or on the coccyx

Question 22

HIFO TP seen in?

Answer 22

coccydynia

Question 23

HIFO TP technique

Answer 23

• pt: prone- doctor is standing on affected side; raise (extend) the affected side just enough to be able to adduct the leg over the other leg and then adduct the leg

Question 24

sacral TP location

Answer 24

found along the media crest of the sacrum on the spinous and transverse processes

Question 25

sacral TP technique

Answer 25

• pt: prone- doctor is standing and will apply gentle pressure to the opposite part of the sacrum of where the TP is located

Question 26

L5/sacral rules

Answer 26

1. L5 sidebent, a sacral oblique axis is engaged on the same side as the sidebending
2. when L5 is rotated, sacrum rotates the opposite way on an oblique axis
3. oblique axis is on the opposite side of the pos seated flexion test

Question 27

L5 FRRSR; sacral SD?

Answer 27

L on R

Question 28

4 types of sacral motion

Answer 28

1. respiratory motion: superior transverse axis of the sacrum at superior-posterior aspect of the body of S2
2. craniosacral motion: same as resp motion
3. sacroiliac axis (postural motion): middle transverse axis at inferior-posterior aspect of S2
4. iliosacral axis: inferior transverse axis at body of S3