Treatments Flashcards
Inhalation Dysfunction MET/ART - Rib 1
- pt supine; physician at head of table
- MCP of index finger contacts superior surface of rib
- pt’s head gently flexed, ST and RA
- pt inhales -> prevent motion
- pt exhales -> exaggerate motion down into rib
Inhalation Dysfunction MET/ART - Rib 2-6
- pt supine, physician’s knee on table underneath pt’s upper thoracic area (on dysfunctional side); only need to flex head for 2-3
- pt’s body sidebend towards rib until tension take off of it
- thumb and index finger placed on intercostal space above rib (try to grab as much of rib as possible)
- pt inhales -> prevent motion
- pt exhales -> exaggerate motion down into rib
Inhalation Dysfunction MET/ART - Rib 7-10
- pt supine, physician at side of dysfunctional rib
- abduct pt’s shoulder and place thumb on superior surface of dysfunctional rib
- pt inhales -> prevent motion
- pt exhales -> exaggerate motion down into rib and sidebend pt towards rib w/ each breath
Inhalation Dysfunction MET/ART - Rib 11-12
- pt prone and physician on opposite side
- sidebend pt’s legs towards rib (C-shape)
- place thenar eminence under affected rib
- pull pt’s hip up to relax quadratus lumbrorum
- pt inhales -> prevent motion
- pt exhales -> exaggerate motion superior and laterally
Exhalation Dysfunction MET/ART - Rib 1-2
- pt supine and physician on opposite side
- pt rotates head 30 degrees away from rib and places hand on forehead
- physician reaches around to grab rib
- pt inhales -> holds breath -> pushes head into hand while you resist
- pt exhales and relaxes -> you pull inferiorly on rib
Exhalation Dysfunction MET/ART - Rib 3-5
- pt supine w/ physician on opposite side
- reach behind and find rib and put pt’s hand above their head
- put hand on pt’s elbow
- pt inhales -> holds breath -> pushes elbow into your hand while you resist
- pt exhales and relaxes -> you pull inferiorly on rib
Exhalation Dysfunction MET/ART - Rib 6-8
- pt supine w/ physician on same side
- place hand under pt on superior surface of rib
- place pt’s arm on top of them w/ elbow flexed and pointed upwards
- pt inhales -> holds breath -> pushes elbow into your hand (up to ceiling) while you resist
- pt exhales and relaxes -> you pull inferiorly on rib
Exhalation Dysfunction MET/ART - Rib 9-10
- pt supine w/ physician on same side
- place hand under pt on superior surface of rib
- abduct pt’s arm and place hand on pt’s elbow
- pt inhales -> holds breath -> pushes elbow into your hand (adducting arm) while you resist
- pt exhales and relaxes -> you pull inferiorly on rib
Exhalation Dysfunction MET/ART - Rib 11-12
- pt prone and physician standing on opposite side
- sidebend pt’s legs away from rib (C-shape towards you)
- stabilize the rib above the one you’re treating w/ thenar eminence
- pull pt’s hip down towards feet
- pt inhales -> holds breath and pulls hip up to head
- pt relaxes and exhales -> pull hand caudally
Anterior Innominate MET/ART - supine
- flex pt’s hip and knee to barrier (induces posterior rotation)
- pt extends hip while you resist
Anterior Innominate MET/ART - prone
- flex pt’s leg off table and place foot on your thigh
- pt extends hip while you resist
Posterior Innominate MET/ART - supine
- stabilize pt’s opposite ASIS
- extend pt’s leg off side of table to barrier (lock around pt’s leg to prevent it from dangling)
- pt flexes hip and you resist
Posterior Innominate MET/ART - prone
- stabilize pt’s opposite PSIS
- extend pt’s leg up
- pt flexes leg back to table and you resist
Superior Innominate Shear MET/ART
- grasp tib/fib just above the ankle
- internally rotate and abduct leg
- lean back and tell pt to pull hip towards shoulder while you resist
Inferior Innominate Shear MET/ART
- rest pt’s foot on thigh
- internally rotate and abduct leg
- lean forward and tell pt to push leg towards your thigh while you resist
Outflare Innominate MET/ART
- pt supine with you on opposite side
- flex dysfunctional leg over opposite leg
- put one hand on outside of flexed knee and other on same PSIS of knee
- adduct hip to restrictive barrier
- tell pt to push knee out towards your hand while you resist
Inflare Innominate MET/ART
- pt supine with you on opposite side
- flex dysfunctional leg over opposite leg
- put one hand on inside of flexed knee and other on contralateral ASIS of knee
- abduct hip to restrictive barrier
- tell pt to push knee towards hand while you resist
Unilaterally Extended Sacrum MET/ART
- monitor SI joint and abduct leg until motion is felt at joint
- externally rotate leg
- place heel of hand on sacral base on dysfunctional side (fingers facing down)
- pt inhales -> resist motion
- pt exhales -> exaggerate motion anterior/inferior
Unilaterally Flexed Sacrum MET/ART
- monitor SI joint and abduct leg until motion is felt at joint
- internally rotate leg
- place heel of hand on affected ILA (fingers up)
- pt inhales -> allow motion
- pt exhales -> resist posterior/inferior motion w/ pressure on ILA
Bilaterally Extended Sacrum MET/ART
- abduct and externally rotate both legs
- place heel of hand in middle of sacral base (fingers facing down)
- pt inhales -> resist motion
- pt exhales -> exaggerate motion anterior/inferior
Bilaterally Flexed Sacrum MET/ART
- abduct and internally rotate both legs
- place heel of hand in middle of sacral apex (fingers facing up)
- pt inhales -> allow motion
- pt exhales -> resist posterior/inferior motion w/ pressure on ILA
Forward Sacral Torsion MET/ART
- pt in modified sims position (chest on table) with axis side down
- monitor L5-S1 joint
- flex pt’s hips and knees to 90 degrees and drop them off the table (support pt’s knees on your thighs while sitting)
- pt pushes legs up towards the ceiling while you resist
Backward Sacral Torsion MET/ART
- pt is lateral recumbent w/ axis side down
- lay pt’s shoulder posterior so their back is toward the table
- monitor L5-S1 joint
- flex the top hip and knee 90 degrees off the table
- pt pushes knee towards the ceiling while you resist
Posterior Innominate Rotation - BLT
- pt seated w/ physician seated in front
- grab distal tibia bilaterally
- have pt turn body towards dysfunctional hip
- push pt’s dysfunctional leg posterior and opposite leg anterior (induce posterior rotation)
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
Anterior Innominate Rotation - BLT
- pt seated w/ physician seated in front
- grab distal tibia bilaterally
- have pt turn body away from dysfunctional hip
- pull pt’s dysfunctional leg anterior and opposite leg posterior (induces anterior rotation)
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
Pubic Dysfunctions MET aka “Shotgun Approach”
- pt supine w/ hips flexed to 45 and knees flexed to 90 (feet flat on table)
- fixed compression: place hands on inside of knees and have pt adduct
- fixed gapping: place hands on outside of knees and have pt abduct
Bilaterally Extended Sacrum - BLT, supine
- place hand under sacrum w/ thenar eminence on sacral apex
- push sacral apex up (more posterior w/ thenar eminence)
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
Bilaterally Flexed Sacrum - BLT, supine
- place hand under sacrum w/ thenar eminence on sacral apex
- push sacral base up (more posterior w/ fingers)
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
Forward Sacral Torsion - BLT, supine
- sit on same side as direction of rotation (top letter)
- place hand under sacrum and apply anterior pressure to the opposite side of the sacrum (L/L ST = push on right sacrum)
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
Backward Sacral Torsion - BLT, supine
- sit on same side as direction of rotation (top letter)
- place hand under sacrum and apply anterior pressure to the opposite side of the sacrum (R/L ST = push on left sacrum; further induces rotation)
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
Backward Sacral Torsion - BLT, seated
- pt seated w/ physician behind monitoring sacral sulci
- flex pt until motion in sacral base is felt (extends sacrum further)
- rotate pt towards sacral rotation
- side bending may be induced to opposite side of rotation if it helps motion
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
Forward Sacral Torsion - BLT, seated
- pt seated w/ physician behind monitoring sacral sulci
- extend pt until motion in sacral base is felt (flexes sacrum further)
- rotate pt towards sacral rotation
- side bending may be induced to opposite side of rotation if it helps motion
- have pt inhale/exhale and tell pt to hold breath til air hunger during breath that had less tension
PC1 - Inion
Flex occiput, RaSt
PC1 & PC2 Occiput
Extend occiput, Ra Sa
PC2, PC4-PC8
Extend occiput/neck, RaSa
PC3
Flex occiput/neck, RaSa
PT 1-12 SP
treat inferior aspect of spinous process and extend pt
PT 1-3 TP
Extend pt’s head/neck, RaSa
PT 4-9 TP
- ERTSa
- pt lays prone w/ arms at sides
- grab pt’s shoulder on side of tenderpoint sidebend body away and rotate towards (lift shoulder up towards tenderpoint - also includes extension)
- OR have pt bring arm up over yours and lift it up to rotate/sidebend/extend
PT 10-12 TP
- ERaSa
- pt prone w/ you on opposite side
- sidebend legs away from tenderpoint
- pull back on opposite ASIS for rotation/extension
PL 1-5 SP
- Extend, adduction, Rt
- pt prone w/ you on opposite side of tendernpoint
- extend pt’s leg on affected side and rotate pelvis (using leg) towards you
PL 1-3 TP
- ERTSa
- pt prone w/ you standing on opposite side of tenderpoint
- sidebend pt’s legs away from tenderpoint
- extend pt’s hip on side of tenderpoint to rotate towards
UPL5 (Upper Pole L5)
- Extend, Adduct, IR/ER
- pt prone w/ you standing on opposite side
- grab pt’s leg opposite you (extends)
- add IR/ER to point of most relief
LPL5 (Lower Pole L5)
- Flex, Adduct, IR
- pt prone w/ you on same side
- while monitoring tednerpoint, drop pt’s flexed leg off the table and support their leg w/ your thigh
- internally rotate leg (using your stool)
HISI (High Ilium Sacroiliac)
Extend, Abduct, ER
- pt prone w/ you standing on same side
- extend pt’s leg, Abduct, and externally rotate
- can use your leg to support
PL3 and PL4 - Gluteus
- Extend, Abduct, ER
- pt prone w/ you standing on same side
- extend pt’s leg, Abduct, and externally rotate
- can use your leg to support