Week 2

Question 1

Condition that causes low back pain that can be referred to the hip or groin. Can cause diaphragm restriction and 12th rib exhalation dysfunction.

Answer 1

Quadratus Lumborum Spasm

Question 2

Major disease to rule out in patients that present with symptoms indicating quadratus lumborum spasm.

Answer 2

Renal Disease

Question 3

What KEY somatic dysfunction often presents with psoas syndrome?

Answer 3

Non-neutral dysfunction with L1 or L2

either flexed or extended

Question 4

Main etiology for psoas syndrome.

Answer 4

Bending over at the waist for extended periods of time and the returning to a neutral position rapidly.
(muscle spindles get used to the overly-relaxed psoas muscle in this position and then when the patients stand up the spindles sense a “stretch” which causes the psoas muscles to tighten)

Question 5

What are the lumbar, inominate, and sacral findings for a non-neutral LEFT psoas syndrome?

Answer 5

1. Lumbar - L1 and/or L2 sidebend left (same side as the tight psoas)
2. Inominate - pelvis shifts to the right (opposite of tight psoas)
3. Sacrum - left oblique axis engaged and sacrum rotates right. (right on left)

Question 6

What type of sacral dysfunctions arise from a neutral vs. non-neutral psoas syndrome?

Answer 6

1. Neutral - sacral flexion (left on left or right on right)

2. Non-neutral - sacral extension (left on right, or right on left)

Question 7

What is the first step to treating an acute muscle spasm?

Answer 7

Ice

cool down an acute muscle spasm before you stretch it

Question 8

Define Piriformis Syndrome.

Answer 8

Peripheral neuritis of the sciatic nerve caused by an abnormal condition of the piriformis muscle.

Question 9

Percent of the population with anatomical variation of the sciatic nerve.

Answer 9

10%

Question 10

How do you differentiate a disc herniation from psoas syndrome?

Answer 10

Patients don’t want to bend over with disc herniation but they WANT to bend over with psoas syndrome to releive pain.

Question 11

How do you differentiate a disc herniation from piriformis syndrome?

Answer 11

Both have pain in the gluteal region that radiates down the posterior thigh, however, disc herniation causes neruological deficits in reflex testing whereas piriformis syndrome does not.

Question 12

Difference between muscle energy and counterstrain techniques.

Answer 12

ME - DIRECT

CS - INDIRECT