Sacrum and Pelvis Review Lab

Question 1

Treating inguinal ligament

TP on pubic tubercle

Answer 1

Patient 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 the TP resolves

Question 2

Treating psoas

TP is 2 in inferior and 2 in medial from ASIS

Answer 2

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 3

Treating SI

TP on lateral ramus of pubic bone

Answer 3

Patient supine

Flex the tender side only (90 degrees); add abduction if needed for resolution of pain

Question 4

Treating lateral trochanter

TP is on the lateral surface of the femur 0-15 cm distal from great trochanter in the ITBand

Answer 4

Patient prone
Doctor is seated supporting the pt’s leg on his thigh. Slightly flex the hip, add abduction (generally more than flexion) and internal rotation (sometimes)

Question 5

Treating posterior lateral trochanter

TP is on the superior lateral surface of the posterior greater trochanter

Answer 5

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 6

Treating posterior medial trochanter
(TP is 3-5 mm 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)

Answer 6

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 the TP resolves

Question 7

Treating anterior lateral trochanter

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

Answer 7

Patient supine

Flex hip 70-90 degrees; add abduction and external rotation until the TP resolves

Question 8

Treating High Ilium Sacroiliac

TP is 4-5 cm lateral to PSIS

Answer 8

Doctor is standing on affected side; extend leg and slight abduction until TP resolves

Question 9

Treating Mid pole Sacroiliac
(TP is 3-4 cm inferior to PSIS in the divot in the muscle just lateral to the sacrum. Approach the TP from the lateral side)

Answer 9

Patient prone
Doctor is standing on affected side; slightly flex the hip and knee; add in abduction (major component of this treatment) and some external rotation of the hip until the TP resolves

Question 10

Treating piriformis
(TP is in the belly of the piriformis 8-9 cm medial and slightly superior to greater trochanter)

Answer 10

Patient 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, abduct slightly via the knee and internally or externally rotate the knee until the TP resolves

Question 11

Treating high ilium outflare

TP is at sacrococcygeal joint or on the coccyx

Answer 11

Patient 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 12

Sacral tenderpoints

Answer 12

On sacrum

Apply gentle pressure to ILA side opposite TP