Sacrum Treatments Flashcards
1
Q
Left Unilateral Sacral Flexion LVM
A
“Butt CPR”
- Stand on the side of the disfunction
- pt on stomach
- gap SI joint by abd/add ext/in rotate bent knee (stand between leg and table)
- place hand on left ILA
- Ask pt to breathe and hold while you spring ILA
2
Q
Left Unilateral Sacral Flexion HVLA
A
HVLA Tug
- Stand at the end of table
- pt supine
- place towel under left ILA
- abduct and internally rotate the left leg
- grasp at ankel and lean back to barrier
- HVLA tug on pts exhale
3
Q
Left Unilateral Sacral Extension LVMA
A
“Butt sandwich”
- Stand on left side
- pt prone
- point pt toes inward
- place hyothenar eminsense on the base and the other at the iscial tuberocity
- squeeze hands together to perform sacral screening
4
Q
Left Sacral Margin Posterior
Seated Muscle Energy
A
- Pt seated straddling table
- dr seated behind pt
- place left hand on left SI joint
- ask pt to place left hand on the back of their neck and grab their elbow with their other hand
- rotate the pt to the right
- ask pt to rotate to the left while you resist (3-5 sec 3x)
5
Q
Left Posterior Sacral Margin Posterior
Supine HVLA
A
- Pt supine
- Stand on OPPOSITE side of the table
- Make a V with pt body by pushing shoulders and feet away from you
- Ask the pt to cross arms (like kriksville crunch)
- loop your arm through and stand up to pull pt towards you
- other hand is on the left ASIS
- Breathe in and out
- HVLA thrust on exhale
6
Q
Bilateral Sacral Flexion
Supine ME
A
- Pt supine
- stand so that you can get over top the pt
- flex pt knees and place them on your chest
- place hands so that your fingers are monitoring L5 and the sacrum on both sides
- Ask pt to push against your chest while you resist
7
Q
Bilateral Sacral Extension
Prone Direct pt cooperation with respiratory force
A
- pt prone
- place heel of hand on sacral base
- ask pt to come up on elbows
- ask pt to take a deep breath
- when they exhale push more anteriorly and ask them to bend back more
8
Q
Left Rotation on a Left Oblique axis
LVMA
A
- Stand on opposite side of dysfunction
- start with the pt chest on the table
- bend both knees up and swing them to the right side of the table (knees and hips at 90 degrees and place them on your knee (makes sure your calf is above their knee) while pulling up on L5
- Monitor L5 sacral junction
- spring on the ankles (repeat 3x)
9
Q
Left Rotation on a Left Oblique axis
ME and physiological response
A
- Stand on opposite side of dysfunction
- start with the pt chest on the table
- bend both knees up and swing them to the right side of the table (knees and hips at 90 degrees and place them on your knee (makes sure your calf is above their knee) while pulling up on L5
- Monitor L5 sacral junction
- ask pt to try and bring their legs to the ceiling while you resist (3-5 seconds 3x)
10
Q
Left Rotation on a Left Oblique axis
Physiologic response and Respiratory Force
A
- Stand on opposite side of dysfunction
- Scoot pt to the edge of the table (right edge)
- start with the pt chest on the table
- bend both knees up and swing them to the right side of the table (knees and hips at 90 degrees and place them on your knee (makes sure your calf is above their knee) while pulling up on L5
- hang feet and arm over the table
- stabilize by putting a hand on their shoulder
- instruct pt to take a deep breath and reach toward the floor with their arm and toes on exhale
11
Q
Left Rotation on Left Oblique Axis
Physiological response and combined activating forces
A
- ) start with reaching technique (LOL set up at edge of table and instructed to reach toward floor on exhale)
- ) Add LOL Muscle energy technique
- ) Complete with LOL ME
12
Q
Left Rotation on a Left Oblique Axis
Seated Direct ME and Physiologic response
A
- pt straddles the table
- seated behind pt
- place right hand on pt right shoulder and left thumb on pt left ILA
- ) FLEX
- ) Rotate left
- ) Side bend left
- ask to to try to bend to the right while you resist
13
Q
Right Rotation on a left oblique axis
Lateral recumbent - direct respiratory force and LVMA
A
- Pt laying axis side down
- pull elbow out as you would for lumbar roll
- flex knees and hips so they just barely are off the table
- have pt make “ I dream of jeanie arms” come through so that you can monitor sacral base
- use your shoulder to keep the pts right shoulder back
- place hands on pt legs
- deep breath and out
- on exhale push shoulder back and spring feet toward floor (3-5x)
14
Q
Right Rotation on a left oblique axis
Seated- direct method ME
A
- Seated straddling the table
- monitor right sacral base with right thumb
- place left hand on pt right shoulder
- ) Sidebend left
- ) Extend
- ) turn to right
- Ask pt to bend to the right while you resist
15
Q
Right Rotation on a left oblique axis
Supine- indirect method; respiratory force
A
- Seated opposite the anterior ILA
- position hand under the sacrum so that your fingers are at the base and the apex is in your palm
- Pronate your palm to point of balance
- find balance with breath and hold until air exhaustion (repeat 3x)
